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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Jerrympls on October 7, 2002, at 20:10:20
Hi all
I was on Vicodin daily for a 2-3weeks following a procedure that - of course - left me in a lot of pain until just recently. During my "vicodin days, " my depression lifted significantly - my socialabiliy was almost back at 100%, my sense of humor, wit, ability to laugh re-blossomed. My confidence level increased a bit. At work I received a raise and praise regarding my office morale, motivation and willingness to help others. I felt more able to take on a couple extra projects. Overall my general sense of well-being was knocked up a 2 or 3 notches.
Then, I no longer had need for the Vicodin - for my physical pain because things had healed. Now -a couple weeks post-Vicodin, I feel terrible most of the time. I have no interest in anything. I only look forward to food. I don't laugh as much and it's too much work to use wit. I can barely make myself go to work none the less wake up for it. I've been having terrible bouts of anxeity and insomnia. My work performance has decreased significantly to the point of being called in for a private meeting with my two supervisors regarding my numerous sick days taken. They know I am dealing with an illness, but that's not gonna get me out of anything. I have no motivation for anything - don't listen to music -struggle to spend time with friends......The list goes on and on. And one would think being on:
20mg Lexepro
60mg Dexedrine
1mg Ativan 3x daily
10mg Ambienand a borg implant device - I'd be living life to its fullest.
All I do now is think about how suicide would help me in a pinch if I needed to escape all this. Not that I am planning suicide. I just fantasise about it. I feel flat, grey, plain, bored, unimportant, and hungry.
At work, most are sympathetic - but I haven't fully disclosed my condition to anyone except our Chief of Staff. She's been great throughout my downs. However, she's worried others in the office will be suspicious and/or upset about the amount of time I have taken for being sick, etc. My other supervisor - who I am not sure knows of my depression - has been trying her best to be sympathetic -but she's more of a "pull yourself up by your boot straps" kinda person. I'm afraid I'll be yelled at for the projects I have lost to procrastination.
I've been researching my rights under the Disability Acts - however, I don't want to go into these meetings and all the sudden spout off about how I have depression and it's the cause of everything so they can't blame me - you know? But - at the same time - it is what is holding my head underwater.
I wish I could tell my doc about the Vicodin. He wants to add lamactil to my cocktail. My research thus far points to a severe problem with cortisol-type depression. I am supposed to see an endocrineologist. But all of this will take time - and I am afraid that by the time all the tests have been done and another medication trial of something that is hitting the wrong part of my depression symptoms - I'll have gone crazy or just given up requiring hospoitalization. I fear I'll lose my job and friends.....I see no light at the end of this tunnel.
Why can p-docs see that opioids help TD depression tremendously? If nothing else helps me and I've been on ALL SSRIs, Effexor, Trazodone, Remeron, Serzone,Wellbutrin, Ascendin, Imipramine, Desipramine, Nortryptaline, Cytomel, Ritlain, Adderall, Dexedrine, Seroquel, Lithium, Depakote, Neurontin, Tegretol, Naltrexone (for SSRI aug.), Parnate, Lexepro, ECT and bionic implants - why not let me be on Vicodin ( i guess it's hycrodone? without the tylenol part)? I didn't take any more than prescribed when on it and have never abused any drug including alcohol or stimulants?
How do I defend myself at work?
How do I get better? If I take unpaid leave at work - what money do I live on? I live paycheck-to-paycheck.
Dear God help me.........
thanks in advance to anyone who responds.
email: slateman@mn.rr.com
Posted by BrittPark on October 7, 2002, at 21:48:32
In reply to The Vicodin semi-cure...and workplace depression, posted by Jerrympls on October 7, 2002, at 20:10:20
You've just touched one of my hot buttons. There is good evidence (lots of it pre-MAOI) but some more recent that opioids can be effective ADs. Buprenorphine is a partial opiate agonist and is being used with significant success for TRD at McLean Hospital near Boston. Do some googling and searching of Psycho-Babble to learn about opiods and depression.
I take vicodin 5mg a day (with my psychiatrist's knowledge) and its been very helpful. The only problem is that I have to take vacations from it because I become tolerant after a few months.
One of the travesties of research in Depression therapeutics is the almost complete lack of interest in studying the opiate system as it relates to depression. They have explored serotonin, norepinephrine, and less well, dopamine systems but have done nothing with the opiate system. I'll venture a cultural opinion here. Most Americans think that anything that makes you feel better than normal is somehow wrong. Thus the war on drugs, and thus the lack of basic research into the opiate system.
Gather your evidence and convince your doctor. The biggest help is if you can get hold of a psychiatrist who has used opiates for TRD for your doctor to talk to. There aren't many but there are some.
Feel better,
Britt
P.S. Lookup a company called Pain Therapeutics. They are developing Morphine and Oxycodone combinations with small amounts of naltrexone and have been finding that the combinations are more potent analgesics, and in animal models seem not to cause tolerance.
Posted by Hattree on October 7, 2002, at 21:52:17
In reply to The Vicodin semi-cure...and workplace depression, posted by Jerrympls on October 7, 2002, at 20:10:20
Sorry to hear you're in such a rough spot. I think you should go ahead and tell your doc about your experience with Vicodin...you were using it legitimately after all. If you look at back posts here, there are apparently some docs out there who are willing to prescribe opiates in some cases.
That said, you never know, the Lamictal might just help. It seems to have a pretty good track record around here, which is more than I can say for most.
Posted by katiemom on October 8, 2002, at 14:58:49
In reply to Re: The Vicodin semi-cure...and workplace depression, posted by Hattree on October 7, 2002, at 21:52:17
I had the same experiance with Vicodin when I had surgery. I felt upbeat, sociable and just plain happy. I told my pdoc, but he said that I needed to prove to him through research to prescribe it. I got lazy and didn't do any thing. Can someone direct me to a web site that might have some informaiton. Then he may prescribe it for me.
Posted by oracle on October 8, 2002, at 15:58:31
In reply to Re: The Vicodin semi-cure...and workplace depression, posted by katiemom on October 8, 2002, at 14:58:49
Can someone direct me to a web site that might have some informaiton.
http://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=opioids+depression
Posted by BrittPark on October 8, 2002, at 19:54:15
In reply to Re: The Vicodin semi-cure...and workplace depression, posted by katiemom on October 8, 2002, at 14:58:49
Here's some more on line references. A medline search would probably turn up more not on the web.
http://opioids.com/antidepressant/history.html
This one comes from McClean Hospital (attached to Harvard Medical School). The group there has, I believe, continued to work with opioids with patients. I imagine they haven't had much luck getting research funding. Opioid research has been made politically incorrect thanks to the "war on drugs".
http://opioids.com/buprenorphine/buprefdep.html
Here's the full article:
http://balder.prohosting.com/~adhpage/bupe.html
There is also a lot of anecdotal evidence on PB. Just do a search on opiods and depression, buprenorphine and depression, etc.
Hope this gets you started,
Britt
Posted by Gracie2 on October 9, 2002, at 2:19:27
In reply to Re: The Vicodin semi-cure...and workplace depressi » katiemom, posted by BrittPark on October 8, 2002, at 19:54:15
You know that most doctors are afraid to prescribe Vicodin on a regular basis because of it's abuse potential and because the body quickly develops a tolerance to it, requiring increasing dosages to achieve the desired effect. This would no doubt be as true for treating depression as treating physical pain.
Prehaps eventually you will find a doctor who is willing to consider a small, regulated dose of hydrocodone to treat your depression. In the meantime, your doctor may be more willing to prescribe Ultram (tramadol) for you. It's a non-narcotic that has an opiate effect, and it may help ease your depression.
-Gracie
Posted by BrittPark on October 9, 2002, at 10:55:30
In reply to Re: The Vicodin semi-cure...and workplace depressi, posted by Gracie2 on October 9, 2002, at 2:19:27
Tramadol and its active metabolite, O-desmethyl tramadol, are in fact opioids, though their binding to the mu-opiate receptor is relatively week, and their anelgisic effect is only partially blocked by opiate antagonists. It is believed that tramadol is less tolerance producing than other opioids. Studies in animals show tolerance development. It has also been reported on this board that tramadol is less mood lifting than other opioids, but YMMV. If your doctor won't prescribe a regular opiod, then tramadol might be worth trying.
Posted by katiemom on October 9, 2002, at 14:10:51
In reply to Re: The Vicodin semi-cure...and workplace depressi » katiemom, posted by BrittPark on October 8, 2002, at 19:54:15
Thanks for the information. I've read some of the links you provided and it is interesting. I'm going to e-mail my pdoc the information.
Posted by Jerrympls on October 9, 2002, at 20:18:24
In reply to Re: The Vicodin semi-cure...and workplace depressi » Jerrympls, posted by BrittPark on October 7, 2002, at 21:48:32
Britt / anyone -
I forgot to mention one of my reactions to a certain opiate: Morphine. About a year ago I had surgery and afterwards they gave me a couple shots of morphine to ease the pain. Well, it was the worst I had ever felt in my life - menatlly and physically. I felt so dysphoric I was almost amazed. It wasn't even helping the pain. The doctor then ordered Tylenol #3 - no pain relief at all. Finally the doctor ordered something else and I think it was Vicodin. Well, as soon as they shot it through my IV I was fine- no pain and felt pretty good (although I just had surgery). Also, about a 2 years prior to that I was given a small dose of morphine at the ER and it was as if I had taken a sugar pill.
I've always had such good antidepressant responses to synthetic opiates - like hydrocodone, etc. I guess I respond better to those? Or perhaps the morphine dysphoria was due to the combination of anesthetic/waking up, etc?
Wierd.
Posted by Jerrympls on October 9, 2002, at 20:21:51
In reply to Re: The Vicodin semi-cure...and workplace depressi » BrittPark, posted by katiemom on October 9, 2002, at 14:10:51
Hi Katie -
Please keep us informed on your pdoc's reaction, etc. I'm wondering if showing him the research will invoke interest, doubt, laughter or ? Hope it goes well for you!!
Jerry
> Thanks for the information. I've read some of the links you provided and it is interesting. I'm going to e-mail my pdoc the information.
Posted by katiemom on October 10, 2002, at 16:23:35
In reply to Re: The Vicodin semi-cure...and workplace depressi, posted by Jerrympls on October 9, 2002, at 20:21:51
I saw my pdoc last night and he said he received my e-mail and that he is going to take the time to look at them and also do some research. He also said that he has come across some recent talk about opiods being used for depression. He took me seriously which made me feel great. One thing I give my pdoc credit for is that he knows I do research on meds and that we discuss my med regime and we both make the decision on what I should take. He takes my concerns seriously.
I'll keep you posted in what he has found and his opinion on the subject. I see him in a week and a half
Colleen (katie comes from my daughter)
Posted by David T. on November 20, 2002, at 19:28:35
In reply to Re: The Vicodin semi-cure...and workplace depressi » BrittPark, posted by Jerrympls on October 9, 2002, at 20:18:24
> Britt / anyone -
>
> I forgot to mention one of my reactions to a certain opiate: Morphine. About a year ago I had surgery and afterwards they gave me a couple shots of morphine to ease the pain. Well, it was the worst I had ever felt in my life - menatlly and physically. I felt so dysphoric I was almost amazed. It wasn't even helping the pain. The doctor then ordered Tylenol #3 - no pain relief at all. Finally the doctor ordered something else and I think it was Vicodin. Well, as soon as they shot it through my IV I was fine- no pain and felt pretty good (although I just had surgery). Also, about a 2 years prior to that I was given a small dose of morphine at the ER and it was as if I had taken a sugar pill.
>
> I've always had such good antidepressant responses to synthetic opiates - like hydrocodone, etc. I guess I respond better to those? Or perhaps the morphine dysphoria was due to the combination of anesthetic/waking up, etc?
>
> Wierd.
>
>Awaking from anesthetisia does produce ill effects for some. Everyone is different. As far as myself goes, I am hyper-sensitive to most opiate pain meds, synthetic or not. A Percodan gets me sick for a full day. Hydrocodone is not as bad but did not take the pain away after I had surgery on my foot. They finally tried Dilaudid which did not get me to sick. So I react differently to every medication. After 4 surgeries it was quite a relief to find something that didn't get me sick.
So, post-operative side effects notwithstanding, your reaction to Morphine may be different to Vicodin.
I guess you can say that everyone reacts to certian medications differently. But give me a Vicodin and point me to the toilet!
Best regards, David T.
This is the end of the thread.
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