![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 16 to 40 of 40. Go back in thread:
Posted by paulbwell on July 29, 2004, at 21:30:29
In reply to Re: Opiates for depression, posted by J. Backer on July 29, 2004, at 15:39:14
> i think opiates/opoids would fall under the catagory of "euphoriant" rather then "anti-deppresant"
> honestly i am an opiate addict, im now in NA and iv been heroin/opiate free for about 11 months. (besides one incident with 24 viconden).
> i kinda have mixed feelings about the idea, i mean scince the early 19th century when bayer patented heroin everybody knew it was the ultimate in mood-elevation. opiates dont do as neer as much liver damage as drinking or benzos and the only real threats are addiction,tolerance,withdrawl and overdose. If your not using street smack and you know your opiates are controlled by the FDA through a pharmacy, the chance of accendental overdose is almost unheard of. most people can handle using opiates without fiending out and becomeing a serious junky. some people (like myself) became addicted as soon they tried them once. either way having a drug addiction is very REAL, its more depressing than anything iv faced sober.
>
> now if you really think that opiates are the answer, you need to be prepared to have them at every moment. because once you need them and you don't have them....your a million times worse then if you never did them.
> as for a real idea, get a non-synthetic opiate in your system (codine/morphine/heroin) and go to a methadone clinic. iv been on it and i can say its the best opiate/opoid that could double as an anti-D. it lasts all day. but be warned you will be very addicted within a week, there is no way to avoid it once you start. but methadone is always available to addicts and you wont overdose when its given to you specifcly every morning.
> peace, JIm the guy who posted the first thread. Codeine first got me on the anti- depressant- anxiety path(thanks nurofen plus)200-3--mgs a dose the first results were serenety. no stimulation like prozac and the like. Im now on ritalin and its a short acting fast acting anti-depressant. but I hate the stimulation it sometimes gives. Im 31 and have been suffering from bipolar/depression from 17 like dansopinion. Job stabilisation is all but impossible for me. I live day to day, and with my parents. I often wish to go to sleep and not come to again, iv tried Tegretol and it caused worst depression. so its Clonazepam Ritalin and ocassional Diazepam when my Doc thinks its appropriate! like when my anxiety reaches agitation. I know Opiates can cause more probs than they are worth to some, but they have given me some very needed psychic peace at times.
is seroqual the answer? side effects?
opiates? advice please,Thanks
Posted by J. Backer on July 30, 2004, at 14:33:43
In reply to Re: Opiates for depression » J. Backer, posted by paulbwell on July 29, 2004, at 21:30:29
man paulbwell, seems like your in a heavy situation. i,ve never been bi-polar but i am diagnosed with Chronic Major Deppresion, SAD, GAD, PPD and ADD-I. So i couldnt truly understand how uppers and downers effect someone with it. although, i was on ritalin and adderal for years and they did help me alot but they made my mood considerably less stable. even though im....well, much cleaner then i used to be. I always avoid strait downers (klonopin/xanax/ativan/valume..alcohol) because they also screwed my stability up, even more so then stimulants. and i know im a fairly stable person, mood wise, off drugs. so i can only guess how much they could mess someones mood that is bi-polar. if i were in your situation, i would really try my hardest to do whatever i could before opting to become an opiates addict especially becuse i know first hand how horrible it becomes.
have you given mood-stabalizers a shot? how about wellbutrin?
mabey a combo..moodstabalizer+Anti-deppresant
and i know we have all heard this before, or at least i have and at the time it pissed me off. but drugs arnt really going to make you completely happy. (exception: opiates, although its VERY temparary) you got to be cool inside and its a complete bitch to make that happen when your deppresed. thats why after you get the med situation checked out.....u know whats up
then you could clean-up your diet?
skateboard.....(or any excersize, but i skateboard)
and meditate (i meditate in a taoist method, you have to do it right or your better off watching tv...heh heh)anyway good luck bro, and dont do heroin to fix your problems i did that for years and in the end, it only made me more incomplete and unhappy.
peace, J
Posted by BarbaraCat on July 30, 2004, at 15:18:08
In reply to Re: Opiates for depression, posted by J. Backer on July 29, 2004, at 15:39:14
Hi,
Your message really made me think about addiction. I have ready access to oxycodone because of fibromyalgia pain. 2.5mg consistently affects me and 5mg is about all I need for a day. Sometimes I feel serene, othertimes activated, othertimes just dopey. Too much and I feel jaggy and wired and weird, which is opposite of what the going rap is on 'euphoric opiods'. They make me speedy and I can clean house like a demon! I don't understand this paradoxical effect thing.If someone said I could never have another pill I'd have a moment of 'acckk!' but not for long. Days go by and I don't think about taking one. Now, this is a bit different from my few experiences with smoking opium. THAT was a euphoric high and one that I just might be a tad too drawn to if were readily available.
I wonder about why someone, such as yourself, gets hooked immediately. Why do you think that happens to you? I had a jones with meth about 30 years ago. Now that was a substance that had a hold on me because I felt so awful when it wore off. Something about my chemistry craved whatever meth gave me, which makes me consider where I might be shortchanged biochemically, as in dopamine. What do you think it is with you? Something that one person can take or leave, although it's definitely an enjoyment, is something that grabs ahold of you? If you don't mind answering, what does an opiod addiction feel like? Thanks. Barbara
> i think opiates/opoids would fall under the catagory of "euphoriant" rather then "anti-deppresant"
> honestly i am an opiate addict, im now in NA and iv been heroin/opiate free for about 11 months. (besides one incident with 24 viconden).
> i kinda have mixed feelings about the idea, i mean scince the early 19th century when bayer patented heroin everybody knew it was the ultimate in mood-elevation. opiates dont do as neer as much liver damage as drinking or benzos and the only real threats are addiction,tolerance,withdrawl and overdose. If your not using street smack and you know your opiates are controlled by the FDA through a pharmacy, the chance of accendental overdose is almost unheard of. most people can handle using opiates without fiending out and becomeing a serious junky. some people (like myself) became addicted as soon they tried them once. either way having a drug addiction is very REAL, its more depressing than anything iv faced sober.
>
> now if you really think that opiates are the answer, you need to be prepared to have them at every moment. because once you need them and you don't have them....your a million times worse then if you never did them.
> as for a real idea, get a non-synthetic opiate in your system (codine/morphine/heroin) and go to a methadone clinic. iv been on it and i can say its the best opiate/opoid that could double as an anti-D. it lasts all day. but be warned you will be very addicted within a week, there is no way to avoid it once you start. but methadone is always available to addicts and you wont overdose when its given to you specifcly every morning.
> peace, J
Posted by carriejane on August 1, 2004, at 6:17:57
In reply to Re: MORPHINE- and derivitives for depression, posted by thinkfast on July 9, 2004, at 5:24:26
i used heroin to cure my depression only to end up homeless and going to rehab. I admit the feeling it gave me was the best in my life but i grew a tolerance to it and needed more and more. You know what that means! Loads of crime lol.
Posted by chess on August 1, 2004, at 10:15:30
In reply to Re: Opiates for depression, posted by chess on July 31, 2004, at 23:46:24
Somebody correct me if i'm wrong, but doesn't alcohol effect gaba and mu-opoid receptors in the brain, and the gaba part makes you feel relaxed, while the mu-opoid part makes you feel good because mu-opoid receptors cause the release of dopamine. So then would Wellbutrin (which is a dopamine re-uptake inhibitor) give the same kind of "well-being" effect like Vicodin would because they both cause the availability of more dopamine in the brain?
Posted by pablo1 on August 1, 2004, at 15:55:34
In reply to MORPHINE- and derivitives for depression, posted by paulbwell on July 8, 2004, at 5:27:08
A few thoughts on the topic...
Couldn't an opiate like that have the proper antidepressant effect in low doses if prescribed or does it just not work unless you get to the massive euphoria of shooting up? I can't imagine taking such strong drugs like that anyways... I had some pill in the hospital once after appendicitis surgery and was so dizzy and felt I was going to float out of my body and was pretty scared.
Something similar I was reading about is Xyrem (GHB) which if you don't binge is supposed to have a therapeutic effect in doses that *do* get you high but only for a few hours and not the sort of heavenly euphoria of heroine (some people don't even like it). Unfortunately it's nearly impossible to get now and the addiction is quite awful. But it sounds wonderful used in moderation long term with no ill effects. It could concievably be prescribed off label but not damn likely. It is a GABA enhancer that also effects dopamine.
Another thought is those Holosync meditation tapes which sound awfully gimmicky but I know people who swear by them. Supposed to use special frequencies to stimulate the brain (kinda like some other electric stimulation devices) to control brain waves like if you practiced brain wave biofeedback. Supposed to decrease cortisol & increase endorphins (they say it actually does in studies) which gives that shield of protection against pain like childhood as described. Endorphins are what give you runner's high (if you had the energy to exercise). Certainly there's the effect of forced meditation & relaxation also. And it's bundled with a CB Therapy approach as well.
Well anyways the common thread there is none of these makes you feel like crap as the SSRI's & others can do.
Of the above options, heroine perhaps has the least lasting effect. The appeal of the Xyrem is it's supposed to make depression evaporate and have some impact later as well.. and useful for releasing emotions in therapy like the tapes. SSRI's also I think can work this way and have a lasting impact allowing you to feel strong enough to move forward in life. I get the impression heroine is really not useful that way unless it was only once to remind you that it is possible to feel good when you had forgot.
Posted by carriejane on August 2, 2004, at 9:10:34
In reply to MORPHINE- and derivitives for depression » paulbwell, posted by pablo1 on August 1, 2004, at 15:55:34
I think the only good thing about heroin at the time was, that it made me apathetic, and numb. But the drug is a lie, it gives you a false reality. We have to feel some pain after all, we are human.
Posted by pablo1 on August 2, 2004, at 12:22:13
In reply to MORPHINE- and derivitives for depression » paulbwell, posted by pablo1 on August 1, 2004, at 15:55:34
Here's a page about the xyrem used in conjunction with therapy http://www.a1b2c3.com/drugs/ghb_02.htm
as a more detailed explanation of what I'm talking about there.
Posted by jerrympls on August 2, 2004, at 19:44:50
In reply to Re: Opiates for depression » J. Backer, posted by paulbwell on July 29, 2004, at 21:30:29
> Im the guy who posted the first thread. Codeine first got me on the anti- depressant- anxiety path(thanks nurofen plus)200-3--mgs a dose the first results were serenety. no stimulation like prozac and the like. Im now on ritalin and its a short acting fast acting anti-depressant. but I hate the stimulation it sometimes gives. Im 31 and have been suffering from bipolar/depression from 17 like dansopinion. Job stabilisation is all but impossible for me. I live day to day, and with my parents. I often wish to go to sleep and not come to again, iv tried Tegretol and it caused worst depression. so its Clonazepam Ritalin and ocassional Diazepam when my Doc thinks its appropriate! like when my anxiety reaches agitation. I know Opiates can cause more probs than they are worth to some, but they have given me some very needed psychic peace at times.
> is seroqual the answer? side effects?
> opiates? advice please,
>
> ThanksMy psychiatrists have ultimately prescribed me hydrocodone (the opiate in Vicodin) and even a trial on Fentenyl for depression when all else has failed. Takes a gutsy psychdoc to do this however and it was at a teaching clinic at a Big Ten university.
Seroquel effects many dopamine receptors and sub receptors - but I think it has more of a blunting effect on emotions - somewhat numbing - and it's VERY sedating.
Opiates don't get me high or euphoric, they just get me back to "normal."
Some pdocs will tell you benzos and stimulants are the anit-christ - while others will use them for what they were made to do.
I have researched meds and my own depression for 12 years (I'm 32 now) and have figured out that my dopamine system (very general term I know) is out of whack. Hydrocodone and other opiates are very well tied into the dopaminergic system.
Hope this helps
Jerry
Posted by chess on August 2, 2004, at 22:28:22
In reply to Re: Opiates for depression » paulbwell, posted by jerrympls on August 2, 2004, at 19:44:50
jerrympls,
I'm interested if you have ever tried Wellbutrin?
It is a reuptake inhibitor of dopamine and thus allows for more dopamine to be present in the brain.I'm thinking of trying it myself but I would like to know how it worked for somebody else who like me is helped by hydrocodone for depression.
Posted by jerrympls on August 2, 2004, at 23:25:44
In reply to jerrympls: Re: Opiates for depression » jerrympls, posted by chess on August 2, 2004, at 22:28:22
> jerrympls,
>
> I'm interested if you have ever tried Wellbutrin?
> It is a reuptake inhibitor of dopamine and thus allows for more dopamine to be present in the brain.
>
> I'm thinking of trying it myself but I would like to know how it worked for somebody else who like me is helped by hydrocodone for depression.
>
>Wellbutrin I have tried many times - too much akathasia, anxiety and severe insomnia.
Posted by chess on August 3, 2004, at 5:52:15
In reply to Re: jerrympls: Re: Opiates for depression » chess, posted by jerrympls on August 2, 2004, at 23:25:44
Did you get any benefit from the extra dopamine in regards to your mood in spite of the akathasia and anxiety and insomnia?
I'm currently taking Klonopin which might help with the akathasia-anxiety-insomnia.
Posted by BarbaraCat on August 3, 2004, at 12:02:19
In reply to Re: Opiates for depression » paulbwell, posted by jerrympls on August 2, 2004, at 19:44:50
> I have researched meds and my own depression for 12 years (I'm 32 now) and have figured out that my dopamine system (very general term I know) is out of whack. Hydrocodone and other opiates are very well tied into the dopaminergic system.
>
**Hi Jerry, if you have anything pertinent to opiods and dopamine, let me know. Otherwise, I'll just do a google search. I've often felt there was a dopamine tie-in because of the activation I experience from Vicodin especially (not so much oxycodone). I too felt akathasia, anxiety with Wellbutrin so perhaps another dopamine pathway is getting hit. Also, the euphoric effects of opiods may smooth out the jittery primarily dopamine meds. - Barbara
Posted by BarbaraCat on August 3, 2004, at 12:27:37
In reply to MORPHINE- and derivitives for depression » paulbwell, posted by pablo1 on August 1, 2004, at 15:55:34
I have used both GHB and the Holosync tapes and would like to share my experiences.
GHB primarily made me sleepy. It did not have the touted euphoric effects whatsoever. It was, however, a very good sleeper. I can't imagine doing anything BUT sleeping on it. It's supposed to increase human growth hormone as well, which is a good thing. I got it from a few different sources, so the lack of the touted effects were not due to a bum batch. I found no problem whatsoever getting off it when my supply ran out, right about the time it became a federal crime to own it.
The exhorbitant price the pharm companies are getting from the GHB analog is preposterous. Before it was placed in class 1 or 2 drug status, it was ridiculously easy to get the chemical compounds to make it yourself (I never did, but know of folks who did). But this is not the case any longer. I did not notice any antidepressant effect at all. This might just be my chemistry, but I was fairly underwhelmed after all the hype I'd read.
Holosync: I did not like it at all. The theory is based on Nobel prize winner Ilya Prirogine's chaos structure theory in that systems will undergo a disorganizing chaotic dissonance before settling into a coherent pattern. This is fine in theory, but I found that the unsettling disorganizing principle in these tapes/CDs never resolved into anything but anxiety. I liked the very first in the series, but afterwards, despite the babbling brook and windchimes, there's something going on in the background that felt like nails on a blackboard.
A few friends went through the whole program and found it beneficial, however. The cost is exhorbitant. I get much more benefit from my good old mantra meditation which leaves me feeling centered and peaceful. I also practice a Buddhist mindfullness meditation at times when I need extra focus. My life works so much better when I keep a regular meditation practice. I don't think there are any shortcuts to this state, no high-tech methods are going to get you there any quicker, no matter what they say. But you don't really need a shortcut. The benefits become apparent pretty quickly without any special gear. That's the beauty of it. Whatever practice you decide upon (preferably low-tech), the secret is to just sit yourself down every day and do it. - Barbara
Posted by J. Backer on August 3, 2004, at 13:15:19
In reply to Re: Opiates for depression » paulbwell, posted by jerrympls on August 2, 2004, at 19:44:50
> My psychiatrists have ultimately prescribed me hydrocodone (the opiate in Vicodin) and even a trial on Fentenyl for depression when all else has failed. Takes a gutsy psychdoc to do this however and it was at a teaching clinic at a Big Ten university.
>
> Seroquel effects many dopamine receptors and sub receptors - but I think it has more of a blunting effect on emotions - somewhat numbing - and it's VERY sedating.
>
> Opiates don't get me high or euphoric, they just get me back to "normal."
>
> Some pdocs will tell you benzos and stimulants are the anit-christ - while others will use them for what they were made to do.
>
> I have researched meds and my own depression for 12 years (I'm 32 now) and have figured out that my dopamine system (very general term I know) is out of whack. Hydrocodone and other opiates are very well tied into the dopaminergic system.
>
> Hope this helps
> Jerry
>
...benzos and stimulants are fine, i think there is alot of people who might benifit from using them but are turned away by misinformed psychiatrists. most people on these forums are on the same page about the issue. As am I also.the way opiates effect your dopamine system are drasticly diffrent than other medications. where as amphetimines release your dopamine reserves and dump them into the synaps (please excuse speling) opiates fit into the dopamine receptors better then the dopamine inself. there for your brain stops making ints own dopamine, not to metion the effect opiates have on endorphine system.
the point im trying to make is that if i have a 50% effective dopamine system and i need X amount of opiates to make it 100% eventually my own system will become far worse than it started and i will need more than X to reach this 100%.the addiction is completely diffrent than in benzodiazaphines, where one could just take the same amount consistantly and not always feel the need to up the anti. esspecially if they are taking them for anxiety. The nature of Deppresion it self is treated diffrently than anxiety so it could be possible that someones conseption of this sort of "treatment" has a paralell to somebody taking benzodiazaphines regularly, which is certantly not the case.
a "whacked-out" dopamine system isnt something that comes in waves and niether is a misconcived notion that one needs opiates to become normal.
that is a sign of being medically dependant and if you are a sufferer of chronic physical pain especially with a terminal illness it is quite understandable. You shouldnt be prescribed to opiates bro, there is no nice way of putting it, and i CANT/WONT side step that fact. i know you must already be fumming (unless you had just recently taken your "medicine") and i want you to know i am not trying to make you angry, i am honestly concerned. I TOO am an opiates addict, and i have thought the same thought and ALLOWED myself to use HYDROCODONE for my deppresion because i TOO have a "whacked-out" dopamine system. im going to stop messing around, you are rationalizing your use of hydrocodone. YOU ARE NOT IN PAIN, you just belive you are. That feeling of "normalness" is a very standard reaction. That almost childlike contentment that is described as "normal" is the high and if you take more of a stronger opiate you will feel even higher, thats just how opaites work. i TOO took them to be "normal" but the true state of normalness is the state a person is in before he/she ever tries opiates and to get back there once they are dependant is very difficult.
weather or not you are a drug addict i cannot answer, but i do know the signs of being medically dependant, opiate use/abuse and denialgood luck
peace J
Posted by BarbaraCat on August 3, 2004, at 13:29:03
In reply to Re: Opiates for depression, posted by J. Backer on August 3, 2004, at 13:15:19
I've noticed an interesting phenomenon. I occassionally take oxycodone and sometimes hydrocodone for fibromyalgia pain. Sometimes the drugs will lift a depression, sometimes not. Sometimes the drugs will help the fibro pain but not always. What I do notice is that after a few days of taking the opiate after a flare-up, my fibro pain will be worse, even though the other symtpoms (fatigue, headache, anxiety) are lessened. I've wondered about opiates interferring with the body's own natural production and stores of morphine like compounds, making pain perception more sensitive after stopping.
I also wonder what happens to the addictive tendency when opiods are taken for pain vs. pleasure. I have never had a problem taking them/not taking them and have never suffered any withdrawals, no cravings at all. But I can't take high doses, just don't want to, so maybe this has something to do with it. I cannot say the same for Chardonnay, whereby just a teensy bit sets me up for a major jones. Anyhow, the nature of addiction is curious.
Posted by paulbwell on August 3, 2004, at 18:52:03
In reply to Re: Opiates for depression » J. Backer, posted by BarbaraCat on August 3, 2004, at 13:29:03
> I've noticed an interesting phenomenon. I occassionally take oxycodone and sometimes hydrocodone for fibromyalgia pain. Sometimes the drugs will lift a depression, sometimes not. Sometimes the drugs will help the fibro pain but not always. What I do notice is that after a few days of taking the opiate after a flare-up, my fibro pain will be worse, even though the other symtpoms (fatigue, headache, anxiety) are lessened. I've wondered about opiates interferring with the body's own natural production and stores of morphine like compounds, making pain perception more sensitive after stopping.
>
> I also wonder what happens to the addictive tendency when opiods are taken for pain vs. pleasure. I have never had a problem taking them/not taking them and have never suffered any withdrawals, no cravings at all. But I can't take high doses, just don't want to, so maybe this has something to do with it. I cannot say the same for Chardonnay, whereby just a teensy bit sets me up for a major jones. Anyhow, the nature of addiction is curious.Curious indeed!,
I cant stand booze, however a belly of Codeine and some valium does it for me. It takes away the constant cold i feel, gives comfort, like im ok right now like feeling. I have ready access to Codeine, but not to stronger ones like Hydro or Oxy which (seem to be videly used in the US,) in my country.
Posted by jerrympls on August 3, 2004, at 22:14:29
In reply to Re: jerrympls: Re: Opiates for depression » jerrympls, posted by chess on August 3, 2004, at 5:52:15
> Did you get any benefit from the extra dopamine in regards to your mood in spite of the akathasia and anxiety and insomnia?
>
> I'm currently taking Klonopin which might help with the akathasia-anxiety-insomnia.
>
>
>...you mean while taking Wellbutrin? I remember taking Darvocet/Darvon (propoxyphene - sp?) while on Wellbutrin and it helped VERY MUCH to calm me and help me sleep.
Posted by jerrympls on August 3, 2004, at 22:24:05
In reply to Re: Opiates for depression » jerrympls, posted by BarbaraCat on August 3, 2004, at 12:02:19
> > I have researched meds and my own depression for 12 years (I'm 32 now) and have figured out that my dopamine system (very general term I know) is out of whack. Hydrocodone and other opiates are very well tied into the dopaminergic system.
> >
> **Hi Jerry, if you have anything pertinent to opiods and dopamine, let me know. Otherwise, I'll just do a google search. I've often felt there was a dopamine tie-in because of the activation I experience from Vicodin especially (not so much oxycodone). I too felt akathasia, anxiety with Wellbutrin so perhaps another dopamine pathway is getting hit. Also, the euphoric effects of opiods may smooth out the jittery primarily dopamine meds. - BarbaraHere you go Barbara:
USE OF OPIATES FOR TREATMENT RESISTANT DEPRESSION
1: J Clin Psychiatry. 2001 Mar;62(3):205-6.
Treatment of refractory major depression with tramadol monotherapy.
Shapira NA, Verduin ML, DeGraw JD.
Publication Types:
Case Reports
LetterPMID: 11305709 [PubMed - indexed for MEDLINE]
----------------------------
2: Aust N Z J Psychiatry. 2000 Dec;34(6):1032-3.
The efficacy of intramuscular tramadol as a rapid-onset antidepressant.
Spencer C.
Publication Types:
Case Reports
LetterPMID: 11127616 [PubMed - indexed for MEDLINE]
-----------------------
3: Am J Psychiatry. 1999 Dec;156(12):2017.
Treatment augmentation with opiates in severe and refractory major
depression.Stoll AL, Rueter S.
Publication Types:
Case Reports
LetterPMID: 10588427 [PubMed - indexed for MEDLINE]
----------------------
4: J Clin Psychopharmacol. 1999 Aug;19(4):373-6.
Long-term codeine use is associated with depressive symptoms.
Romach MK, Sproule BA, Sellers EM, Somer G, Busto UE.
Department of Pharmacology, Faculty of Pharmacy, University of Toronto,
Centre
for Addictions and Mental Health, Ontario, Canada.
myroslava.romach@utoronto.caA community survey was conducted among long-term (>6 months) users
of codeine-containing products to characterize chronic use of these
extensively consumed medications. Respondents recruited through newspaper
advertisements completed a mailed questionnaire. Three hundred thirty-nine completed questionnaires were obtained, yielding a response rate of 70%. Codeine dependence/abuse as defined by DSM-IV criteria was present in 41% of
the respondents. Two thirds of the subjects had sought help for mental
health problems, most often depression (70%). Scores on the Symptom
Checklist-90 subscales were modestly elevated, particularly on the Depression subscale (1.2 +/- 0.9). Long-term codeine use is strongly associated with dependence. Depression and depressive symptoms are common. These data suggest that dysphoric mood states may be significant in maintaining long-term codeine use.PMID: 10440467 [PubMed - indexed for MEDLINE]
------------------------
5: Biol Psychiatry. 1996 Jun 15;39(12):989-90.Buprenorphine for depression: the un-adoptable orphan.
Callaway E.
Publication Types:
EditorialPMID: 8780832 [PubMed - indexed for MEDLINE]
---------------------
6: Am J Psychiatry. 1996 Jun;153(6):843-4.
Mood alterations and tramadol.
Pinkofsky HB, Woodward RA, Reeves RR.
Publication Types:
Case Reports
LetterPMID: 8633712 [PubMed - indexed for MEDLINE]
---------------------
7: J Am Osteopath Assoc. 1996 Mar;96(3):156.
Long-term narcotic use may complicate treatment for depression.
Tobe EH.
Publication Types:
LetterPMID: 8932590 [PubMed - indexed for MEDLINE]
------------------
8: Biomed Pharmacother. 1996;50(6-7):279-82.
Treatment of depressive syndromes in detoxified drug addicts: use of
methadone.Laqueille X, Bayle FJ, Spadone C, Jalfre V, Loo H.
Service Hospitalo-Universitaire de Sante Mentale et de Therapeutique,
Centre
Hospitalier Specialise Sainte-Anne, Paris, France.Depressive syndromes are very frequent in drug-addicted patients. Their
study is particularly difficult on account of the toxic intake which disturbs
the clinical analysis. Methadone has improved our understanding of these
pathologies. In fact, methadone permits treatment of some depressive
disorders typically linked to addiction, such as a motivational symptoms and
depressive mood following intoxication. It brings to the fore the other mood
disorders which are often associated with drug intake.Publication Types:
Review
Review, TutorialPMID: 8952868 [PubMed - indexed for MEDLINE]
-----------------
9: J Clin Psychopharmacol. 1995 Feb;15(1):49-57.
Buprenorphine treatment of refractory depression.
Bodkin JA, Zornberg GL, Lukas SE, Cole JO.
McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical
School,
Belmont, MA 02178, USA.Opiates were used to treat major depression until the mid-1950s. The
advent of opioids with mixed agonist-antagonist or partial agonist activity, with
reduced dependence and abuse liabilities, has made possible the reevaluation of
opioids for this indication. This is of potential importance for the population
of depressed patients who are unresponsive to or intolerant of
conventional antidepressant agents. Ten subjects with treatment-refractory,
unipolar, nonpsychotic, major depression were treated with the opioid partial
agonist buprenorphine in an open-label study. Three subjects were unable to
tolerate more than two doses because of side effects including malaise, nausea,
and dysphoria. The remaining seven completed 4 to 6 weeks of treatment and as
a group showed clinically striking improvement in both subjective and
objective measures of depression. Much of this improvement was observed by the end of 1 week of treatment and persisted throughout the trial. Four subjects
achieved complete remission of symptoms by the end of the trial (Hamilton Rating
Scale for Depression scores < or = 6), two were moderately improved, and
one deteriorated. These findings suggest a possible role for buprenorphine
in treating refractory depression.Publication Types:
Case Reports
Clinical TrialPMID: 7714228 [PubMed - indexed for MEDLINE]
------------------
10: J Subst Abuse Treat. 1990;7(1):51-4.
Depressive symptoms during buprenorphine treatment of opioid abusers.
Kosten TR, Morgan C, Kosten TA.
Department of Psychiatry, Yale University School of Medicine, New Haven,
CT.Among 40 opioid addicts treated as outpatients with sublingual
buprenorphine (2-8 mg daily) for a month, depressive symptoms significantly decreased in the 19 who were depressed at intake to treatment.PMID: 2313769 [PubMed - indexed for MEDLINE]
------------------
11: Int Clin Psychopharmacol. 1988 Jul;3(3):255-66.
Current and historical concepts of opiate treatment in psychiatric
disorders.Weber MM, Emrich HM.
Max-Planck-Institut fur Psychiatrie, Munchen, Federal Republic of
Germany.In recent years psychiatric research has rediscovered the theoretical
and clinical importance of opiates, especially for the understanding of
depressive disorders. However, opiate treatment is not a new therapeutic concept
in psychiatry. The use of opium for "melancholia" and "mania" may be traced to ancient classical medicine. After Paracelsus and Sydenham, the psychiatry of the German Romantic Era widely discussed therapeutic opium use with the Engelken family going on to develop a structured opium treatment of depression in the first half of the nineteenth century. Although the underlying scientific problems of psychiatric opium therapy were never solved, it gained an outstanding position as a practical treatment for over 100 years.Publication Types:
Historical ArticlePMID: 3153713 [PubMed - indexed for MEDLINE]
Posted by jerrympls on August 3, 2004, at 22:32:31
In reply to Re: Opiates for depression, posted by J. Backer on August 3, 2004, at 13:15:19
>
> > My psychiatrists have ultimately prescribed me hydrocodone (the opiate in Vicodin) and even a trial on Fentenyl for depression when all else has failed. Takes a gutsy psychdoc to do this however and it was at a teaching clinic at a Big Ten university.
> >
> > Seroquel effects many dopamine receptors and sub receptors - but I think it has more of a blunting effect on emotions - somewhat numbing - and it's VERY sedating.
> >
> > Opiates don't get me high or euphoric, they just get me back to "normal."
> >
> > Some pdocs will tell you benzos and stimulants are the anit-christ - while others will use them for what they were made to do.
> >
> > I have researched meds and my own depression for 12 years (I'm 32 now) and have figured out that my dopamine system (very general term I know) is out of whack. Hydrocodone and other opiates are very well tied into the dopaminergic system.
> >
> > Hope this helps
> > Jerry
> >
>
>
> ...benzos and stimulants are fine, i think there is alot of people who might benifit from using them but are turned away by misinformed psychiatrists. most people on these forums are on the same page about the issue. As am I also.
>
> the way opiates effect your dopamine system are drasticly diffrent than other medications. where as amphetimines release your dopamine reserves and dump them into the synaps (please excuse speling) opiates fit into the dopamine receptors better then the dopamine inself. there for your brain stops making ints own dopamine, not to metion the effect opiates have on endorphine system.
> the point im trying to make is that if i have a 50% effective dopamine system and i need X amount of opiates to make it 100% eventually my own system will become far worse than it started and i will need more than X to reach this 100%.
>
> the addiction is completely diffrent than in benzodiazaphines, where one could just take the same amount consistantly and not always feel the need to up the anti. esspecially if they are taking them for anxiety. The nature of Deppresion it self is treated diffrently than anxiety so it could be possible that someones conseption of this sort of "treatment" has a paralell to somebody taking benzodiazaphines regularly, which is certantly not the case.
>
> a "whacked-out" dopamine system isnt something that comes in waves and niether is a misconcived notion that one needs opiates to become normal.
> that is a sign of being medically dependant and if you are a sufferer of chronic physical pain especially with a terminal illness it is quite understandable. You shouldnt be prescribed to opiates bro, there is no nice way of putting it, and i CANT/WONT side step that fact. i know you must already be fumming (unless you had just recently taken your "medicine") and i want you to know i am not trying to make you angry, i am honestly concerned. I TOO am an opiates addict, and i have thought the same thought and ALLOWED myself to use HYDROCODONE for my deppresion because i TOO have a "whacked-out" dopamine system. im going to stop messing around, you are rationalizing your use of hydrocodone. YOU ARE NOT IN PAIN, you just belive you are. That feeling of "normalness" is a very standard reaction. That almost childlike contentment that is described as "normal" is the high and if you take more of a stronger opiate you will feel even higher, thats just how opaites work. i TOO took them to be "normal" but the true state of normalness is the state a person is in before he/she ever tries opiates and to get back there once they are dependant is very difficult.
> weather or not you are a drug addict i cannot answer, but i do know the signs of being medically dependant, opiate use/abuse and denial
>
> good luck
> peace J
>I'm offended - but not "fumming" - and not because I took my "medicine." I know the difference between the two dopaminergic systems. I'm quite offended that you seem to think I'm in la la land and am an addict - when in fact I'm not. In my opinion, I think you are simply generalizing and projecting your experience with opiates onto others *perhaps* with the thought that "if *I* felt like this then *everyone* does.." BUT I could be wrong. Not trying to argue or fight.
And, by the way, the opiates I took for depression were prescribed by two research psychopharmocologists FOR my depression. So, it was legal and it helped tremendously and still does to this day.
Thanks.
Jerry
Posted by BarbaraCat on August 4, 2004, at 12:03:27
In reply to Re: Opiates for depression, posted by paulbwell on August 3, 2004, at 18:52:03
> I cant stand booze, however a belly of Codeine and some valium does it for me. It takes away the constant cold i feel, gives comfort, like im ok right now like feeling.
**Constant cold, huh? Have you had your thyroid checked? A good indication of low thyroid is to take your temperature 3 times a day at the same time (usually before breakfast, before lunch, before dinner) for 3 days. An old fashioned mercury thermometer is best for this. Your average for the 3 days should be 98 to 98.2 (taking into account typical low morning temps). Even if a TSH test comes back normal, having low body temperatures indicates low thyroid. A quickie test is to take your temp while resting after a few minutes during the daytime. It should be 98.6. Hypothyroids will typically have temperatures drop while resting during mid-day hours. Mine hardly gets above 98 during resting, and I'm on thyroid meds.
I may be speaking to the choir here, but hypothyroid condition will make you feel horrible, awful. The thyroid controls all metabolic processes. I sure do understand the warmth feeling from opiods, a warm fuzzyness like a nice blanky. Maybe you've been self-medicating the crummy feeling from a low metabolism all these years. - Barbara
Posted by BarbaraCat on August 4, 2004, at 12:07:06
In reply to Re: Opiates for depression » BarbaraCat, posted by jerrympls on August 3, 2004, at 22:24:05
Thanks, Jerry! That's a load of info and looks real interesting. I appreciate your taking the time to get this together for me. - Barbara
Posted by J. Backer on August 4, 2004, at 14:05:31
In reply to Re: Opiates for depression » J. Backer, posted by jerrympls on August 3, 2004, at 22:32:31
i see your point
peace -j
Posted by Karen Moore on August 8, 2004, at 13:57:38
In reply to Re: Opiates for depression » BarbaraCat, posted by jerrympls on August 3, 2004, at 22:24:05
Jerry,
Thanks so much for posting this excellent concrete list. I'm just starting to do some backup research in this area. I've been on a very low dose (15mg) of oxycodone for the past few months and the results have been startling. Over the past 3 years I've tried over 30 medications to treat a vicious mixed state dysphoria and NOTHING has worked, actually most have made me much sicker. The oxy has been a huge relief, I haven't felt this close to "normal" in ages. And no, it has NEVER made me euphoric, I'm not happy because I'm high. I'm not actually "happy" in fact: I'm STABLE. And not tearing the hair off my head in clumps.I think you mentioned in one of your posts that your psychiatrist is in research. Do you know of any current studies going on in opiates area of research? My psychiatrist is NOT in research so I know her willingness to prescribe opiates is highly precarious. And I live in New Mexico so the likelihood of finding anyone else here to prescribe is extremely low. She is hoping to align herself with some current research. And if I have to move my official residence to San Diego, I will. Because without oxy I am literally disabled.
If anyone out there has any information on recent/ongoing studies re: opiates PLEASE post, and THANKS in advance!
Cheers,
KM
Posted by ramsea on August 9, 2004, at 5:15:33
In reply to Re: Research Opiates--Please Help! » jerrympls, posted by Karen Moore on August 8, 2004, at 13:57:38
I know there's been considerable discussion on this board about this very thing. I'm not exactly sure how you can locate the threads, but worth a try. I mentioned in a post awhile ago how I had acidentally discovered that a small dose of painkiller (like oxyc)for other health conditions did wonders for my untreated bipolar and social phobia. One poster, some name like fem---, wrote that I needn't be ashamed of this and directed me to look at ither discussions. So I am just passing that on. Someone else may be able to offer more substancial advice.
And I am absolutely certain that not everyone who is helped by an opiate medicine is a sick addict. Life just isn't that simple. Same as alcohol, not everyone falls prey to alcoholism. Or other substances that get used by some and abused by others, usually a minority. But yeah--it is a risky subject. I hope you continue to find this medicine a help against your suffering. Take care.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.