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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by willyee on March 21, 2007, at 18:05:41
Ok so after lots of reading,ive since come to the conclusion that i want to try the suboxone/parnate combo.
Reason being not many things are helping in augmentation of parnate,not to many docs are willing to keep trying,and im simply sick of taking these drugs that just set me back.
I do have a handful that work well with parnate however no where near where i need it to.I have searched and dont see a substitute to parnate for my primary drug,the old nardil would have been one,but im simply not prepared to switch to this new one.
Also im hoping suboxone can help with the second part of my illness which i believe i unknowingly created,which is the obession that i need to keep trying drugs,ive seen lots of users in archives speak of the two togther.
Heres my question,i personaly for me know without a doubt that ultram is not safe with parnate,for me its a direct no no,my concern is arent ultram and suboxone very similiar in the opoid family,and if so,would suboxone also like ultram be extremly contradicted,im hoping now as i already started the process.Please help,and please as nice as i can ask in text dont address the question with answers other than the actual question,i already started,so i need to know this,not any other options on different meds etc.
Id be very disappointed if this goes unanswered,i know someone out there has some input please share.
Posted by Jedi on March 22, 2007, at 2:18:28
In reply to Need some feed back guys come on, posted by willyee on March 21, 2007, at 18:05:41
Hi,
Certain drugs in the opiod family will produce serotonin toxicity when mixed with a MAOI. Others do not effect serotonin and thus pose no problem. I have take codeine with Nardil with no reaction at all. Be careful with this though, because even in Canada, where codeine is sold over the counter, other meds are mixed with it which will often times cause serious problems."We can reliably predict that only those opiates that are significant serotonin reuptake inhibitors (or releasers) will precipitate serotonin toxicity with MAOIs.
In summary: Morphine, codeine, oxycodone, buprenorphine do not precipitate serotonin toxicity with monoamine oxidase inhibitors. Pethidine (meperidine), tramadol, methadone and fentanyl, propoxyphene, dextromethorphan, are borderline. They are weakly serotonergic and some may precipitate serotonin toxicity which must be assumed to be dose dependant."
©Dr Ken Gillman MRC Psych - PsychoTropical Research®
http://www.psychotropical.com/8_st_maois_opiate_analgesics.shtmlI saw nothing in the prescribing information that would keep you from using Suboxone with Parnate. (Double and Triple Check!)
US Prescribing Information
www.suboxone.com/patients/pi/Where did you find a doctor who will prescribe buprenorphine for depression?
Good Luck,
Jedi> Ok so after lots of reading,ive since come to the conclusion that i want to try the suboxone/parnate combo.
>
> Reason being not many things are helping in augmentation of parnate,not to many docs are willing to keep trying,and im simply sick of taking these drugs that just set me back.
>
>
> I do have a handful that work well with parnate however no where near where i need it to.
>
> I have searched and dont see a substitute to parnate for my primary drug,the old nardil would have been one,but im simply not prepared to switch to this new one.
>
>
> Also im hoping suboxone can help with the second part of my illness which i believe i unknowingly created,which is the obession that i need to keep trying drugs,ive seen lots of users in archives speak of the two togther.
>
>
> Heres my question,i personaly for me know without a doubt that ultram is not safe with parnate,for me its a direct no no,my concern is arent ultram and suboxone very similiar in the opoid family,and if so,would suboxone also like ultram be extremly contradicted,im hoping now as i already started the process.
>
> Please help,and please as nice as i can ask in text dont address the question with answers other than the actual question,i already started,so i need to know this,not any other options on different meds etc.
>
>
> Id be very disappointed if this goes unanswered,i know someone out there has some input please share.
Posted by willyee on March 22, 2007, at 6:07:59
In reply to Feedback- Suboxone + Parnate, posted by Jedi on March 22, 2007, at 2:18:28
> Hi,
> Certain drugs in the opiod family will produce serotonin toxicity when mixed with a MAOI. Others do not effect serotonin and thus pose no problem. I have take codeine with Nardil with no reaction at all. Be careful with this though, because even in Canada, where codeine is sold over the counter, other meds are mixed with it which will often times cause serious problems.
>
Thank you,thats what i wanted to know,as far as the doc situation,it is a little drawn out,too much maybe for the group,however if one is interested in this med might find it interesting,so email me if u are brklyn234@yahoo.comThanks again for the reassurance info
> "We can reliably predict that only those opiates that are significant serotonin reuptake inhibitors (or releasers) will precipitate serotonin toxicity with MAOIs.
> In summary: Morphine, codeine, oxycodone, buprenorphine do not precipitate serotonin toxicity with monoamine oxidase inhibitors. Pethidine (meperidine), tramadol, methadone and fentanyl, propoxyphene, dextromethorphan, are borderline. They are weakly serotonergic and some may precipitate serotonin toxicity which must be assumed to be dose dependant."
> ©Dr Ken Gillman MRC Psych - PsychoTropical Research®
> http://www.psychotropical.com/8_st_maois_opiate_analgesics.shtml
>
> I saw nothing in the prescribing information that would keep you from using Suboxone with Parnate. (Double and Triple Check!)
>
> US Prescribing Information
> www.suboxone.com/patients/pi/
>
> Where did you find a doctor who will prescribe buprenorphine for depression?
> Good Luck,
> Jedi
>
>
>
> > Ok so after lots of reading,ive since come to the conclusion that i want to try the suboxone/parnate combo.
> >
> > Reason being not many things are helping in augmentation of parnate,not to many docs are willing to keep trying,and im simply sick of taking these drugs that just set me back.
> >
> >
> > I do have a handful that work well with parnate however no where near where i need it to.
> >
> > I have searched and dont see a substitute to parnate for my primary drug,the old nardil would have been one,but im simply not prepared to switch to this new one.
> >
> >
> > Also im hoping suboxone can help with the second part of my illness which i believe i unknowingly created,which is the obession that i need to keep trying drugs,ive seen lots of users in archives speak of the two togther.
> >
> >
> > Heres my question,i personaly for me know without a doubt that ultram is not safe with parnate,for me its a direct no no,my concern is arent ultram and suboxone very similiar in the opoid family,and if so,would suboxone also like ultram be extremly contradicted,im hoping now as i already started the process.
> >
> > Please help,and please as nice as i can ask in text dont address the question with answers other than the actual question,i already started,so i need to know this,not any other options on different meds etc.
> >
> >
> > Id be very disappointed if this goes unanswered,i know someone out there has some input please share.
>
>
Posted by tessellated on March 25, 2007, at 12:27:11
In reply to Re: Feedback- Suboxone + Parnate, posted by willyee on March 22, 2007, at 6:07:59
subutext is much more common and easier to get than suboxone, as it has buprenophine and naloxone mixed in a way that makes it more difficult to "abuse"; as naloxone is an opiod antagonist. both these meds are almost entirely found in withdrawl clinics under guidance of addiction specialists. i doubt many typical pdocs are going to or even able to offer suboxone for "off lable use" much, as they are highly watched scripts. this really is the arena for a psychopharmacologist with addiction medicine specialization.
i tried a tiny amount of subutex the naloxone/buprenorphine mix, and was suprised at its potency. some people even are using naloxone as an AD.
as far as my understanding goes, only through reading, subutext, is handed out quite freely at methadone clinics as a alternative to methadone. but you need to be an addict, they do blood work. pdoc's need to have to an additional layer of "approval training" to script either. bupe is apparently abusable, and the mix in subutex is not, so its likely easier to get.
perhaps until there are more studies done and they are found approvable for depression etc...i think its a hard sale, otherwise its in the realm of a well trained psychopharmacologist discretion.
Posted by Jedi on March 25, 2007, at 13:35:35
In reply to Re: Feedback- Suboxone + Parnate, posted by tessellated on March 25, 2007, at 12:27:11
Hi Tessellated,
Everything you wrote sounded right to me, except you got the med names reversed. Subutex is buprenorphine, Suboxone is buprenorphine + naloxone.
Jedi
Link:
http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm"Subutex (buprenorphine hydrochloride) and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) is approved for the treatment of opiate dependence. Subutex and Suboxone treat opiate addiction by preventing symptoms of withdrawal from heroin and other opiates."
Posted by willyee on March 26, 2007, at 6:56:53
In reply to Re: Feedback-Subutex/Suboxone » tessellated, posted by Jedi on March 25, 2007, at 13:35:35
> Hi Tessellated,
> Everything you wrote sounded right to me, except you got the med names reversed. Subutex is buprenorphine, Suboxone is buprenorphine + naloxone.
> Jedi
>
>
> Link:
> http://www.fda.gov/cder/drug/infopage/subutex_suboxone/default.htm
>
> "Subutex (buprenorphine hydrochloride) and Suboxone tablets (buprenorphine hydrochloride and naloxone hydrochloride) is approved for the treatment of opiate dependence. Subutex and Suboxone treat opiate addiction by preventing symptoms of withdrawal from heroin and other opiates."
>
>
>
>
>Thanks guys,its one of my WING AND PRAYER hopes with parnate now,bless all of us having to deal with this crap with such little overall compassion and or understanding from the general powers that be.
This is the end of the thread.
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