![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 73. Go back in thread:
Posted by Cherry Carver on February 8, 2010, at 6:17:26
In reply to Re: Opioids for Depression, posted by floatingbridge on February 7, 2010, at 22:45:40
Great comment, floatingbridge...I sure responded to them! ;)
Did you create your own mood chart or did someone give you one to fill in? I love the concept!
> > <I keep a mood chart and my doc remarked upon that--that I responded to opiates. Yeah, I said, doesn't everyone?
> > Nope
>
> Really? I'm surprised. Hmmmm.
>
>
Posted by conundrum on February 8, 2010, at 7:00:44
In reply to Re: Opioids for Depression, posted by floatingbridge on February 7, 2010, at 22:45:40
Sad but true. Atleast for me. I truly don't understand it either. I also have some low grade joint pains like many depressives and they don't help much with that either.
Posted by floatingbridge on February 8, 2010, at 9:25:47
In reply to Re: Opioids for Depression » floatingbridge, posted by conundrum on February 8, 2010, at 7:00:44
> Sad but true. Atleast for me. I truly don't understand it either. I also have some low grade joint pains like many depressives and they don't help much with that either.
Conundrum, that is odd, and I'm sorry, too. Have you found things that do work for you?
I'm so curious I'm going to run this by my pdoc. Anything interesting and I'll. post back.
fb
Posted by bulldog2 on February 8, 2010, at 9:51:14
In reply to Re: Opioids for Depression » conundrum, posted by floatingbridge on February 8, 2010, at 9:25:47
> > Sad but true. Atleast for me. I truly don't understand it either. I also have some low grade joint pains like many depressives and they don't help much with that either.
>
> Conundrum, that is odd, and I'm sorry, too. Have you found things that do work for you?
>
> I'm so curious I'm going to run this by my pdoc. Anything interesting and I'll. post back.
>
> fbThere is a hypothesis that some depressions may be caused by a shortage of endogenous opoids. That's why some people say painkillers have no effect on their mood and other people respond well to them.
Posted by floatingbridge on February 8, 2010, at 10:26:57
In reply to Re: Opioids for Depression » floatingbridge, posted by bulldog2 on February 8, 2010, at 9:51:14
> > > Sad but true. Atleast for me. I truly don't understand it either. I also have some low grade joint pains like many depressives and they don't help much with that either.
> >
> > Conundrum, that is odd, and I'm sorry, too. Have you found things that do work for you?
> >
> > I'm so curious I'm going to run this
by my pdoc. Anything interesting and I'll. post back.
> >
> > fb
>
> There is a hypothesis that some depressions may be caused by a shortage of endogenous opoids. That's
why some people say painkillers have no effect on their mood and other people respond well to them.Oh. Endogenous--not related to endorphins? I'll Google.
Thnx Bulldog
Posted by bulldog2 on February 8, 2010, at 18:16:08
In reply to Re: Opioids for Depression » bulldog2, posted by floatingbridge on February 8, 2010, at 10:26:57
> > > > Sad but true. Atleast for me. I truly don't understand it either. I also have some low grade joint pains like many depressives and they don't help much with that either.
> > >
> > > Conundrum, that is odd, and I'm sorry, too. Have you found things that do work for you?
> > >
> > > I'm so curious I'm going to run this
> by my pdoc. Anything interesting and I'll. post back.
> > >
> > > fb
> >
> > There is a hypothesis that some depressions may be caused by a shortage of endogenous opoids. That's
> why some people say painkillers have no effect on their mood and other people respond well to them.
>
> Oh. Endogenous--not related to endorphins? I'll Google.
>
> Thnx Bulldog
>No endogenous means made within your body. There are opiate receptors in your body and the body makes its own opiates (endogenous) for these receptors. perhaps some do not make enough of these feel good neurotransmitters. I guess these opiates are what you referred to as endorphins.
Posted by Cherry Carver on February 8, 2010, at 19:08:38
In reply to Re: Opioids for Depression, posted by bulldog2 on February 8, 2010, at 18:16:08
Fascinating discussion! One would think that if some kinds of depression are relieved by opioids, doctors would prescribe it more often instead of screwing around with SSRIs and NSRIs, etc, which made me really sick.
Do opiates stimulate the endorphins, create more endorphins, or just hit the pleasure center in one's brain? I know next to nothing about the structure or chemistry of the brain, so forgive me if my questions sound really stupid. Couldn't someone invent a drug that stimulates endorphin production without doping people up or making them sick?
> > > There is a hypothesis that some depressions may be caused by a shortage of endogenous opoids. That's
> > why some people say painkillers have no effect on their mood and other people respond well to them.
> >
> > Oh. Endogenous--not related to endorphins? I'll Google.
> >
> > Thnx Bulldog
> >
>
> No endogenous means made within your body. There are opiate receptors in your body and the body makes its own opiates (endogenous) for these receptors. perhaps some do not make enough of these feel good neurotransmitters. I guess these opiates are what you referred to as endorphins.
Posted by Sigismund on February 8, 2010, at 20:28:38
In reply to Re: Opioids for Depression » bulldog2, posted by Cherry Carver on February 8, 2010, at 19:08:38
>One would think that if some kinds of depression are relieved by opioids, doctors would prescribe it more often instead of screwing around with SSRIs and NSRIs, etc, which made me really sick.
One might think that (on one's better days).
My psych summed it up by saying of the opiate receptor: That's the devils receptor (quite unlike those other respectable receptors).
Posted by conundrum on February 8, 2010, at 20:36:50
In reply to Re: Opioids for Depression » conundrum, posted by floatingbridge on February 8, 2010, at 9:25:47
So far I haven't found anything that works, but I haven't tried all that much yet. Fingers crossed.
Posted by Cherry Carver on February 8, 2010, at 23:51:45
In reply to Re: Opioids for Depression, posted by Sigismund on February 8, 2010, at 20:28:38
The devil, you say? ;)
Better the devil you know....
> >One would think that if some kinds of depression are relieved by opioids, doctors would prescribe it more often instead of screwing around with SSRIs and NSRIs, etc, which made me really sick.
>
> One might think that (on one's better days).
>
> My psych summed it up by saying of the opiate receptor: That's the devils receptor (quite unlike those other respectable receptors).
Posted by bulldog2 on February 9, 2010, at 9:00:14
In reply to Re: Opioids for Depression » bulldog2, posted by Cherry Carver on February 8, 2010, at 19:08:38
> Fascinating discussion! One would think that if some kinds of depression are relieved by opioids, doctors would prescribe it more often instead of screwing around with SSRIs and NSRIs, etc, which made me really sick.
>
> Do opiates stimulate the endorphins, create more endorphins, or just hit the pleasure center in one's brain? I know next to nothing about the structure or chemistry of the brain, so forgive me if my questions sound really stupid. Couldn't someone invent a drug that stimulates endorphin production without doping people up or making them sick?
>
>
>
> > > > There is a hypothesis that some depressions may be caused by a shortage of endogenous opoids. That's
> > > why some people say painkillers have no effect on their mood and other people respond well to them.
> > >
> > > Oh. Endogenous--not related to endorphins? I'll Google.
> > >
> > > Thnx Bulldog
> > >
> >
> > No endogenous means made within your body. There are opiate receptors in your body and the body makes its own opiates (endogenous) for these receptors. perhaps some do not make enough of these feel good neurotransmitters. I guess these opiates are what you referred to as endorphins.
>
>opiates just stimulate the opiate receptors. They also cause your body to shut down making its own supply.
Posted by Sigismund on February 9, 2010, at 14:46:05
In reply to Re: Opioids for Depression, posted by bulldog2 on February 9, 2010, at 9:00:14
>They also cause your body to shut down making its own supply.
Unlike those other receptors?
Posted by floatingbridge on February 9, 2010, at 14:58:43
In reply to Re: Opioids for Depression » bulldog2, posted by Sigismund on February 9, 2010, at 14:46:05
Ummm. Okay, I'll say it. LDN for depression, esp w/ pain or autoimmune?
(I know there's a thread going right now about it....)
curious,
fb
Also wiki listed non-opoid pain meds I was unfamiliar with. Under 'endogenous opoids'. Also read that opoids are safe pain relief IF managed well, including dosages not exceeding relief levels, regular rotation of meds, and augmentors. But most of you know that already.
Anyone on this thread try LDN--or is that the wrong tree I'm barking under?
Posted by Sigismund on February 9, 2010, at 15:41:57
In reply to Re: Opioids for Depression, posted by floatingbridge on February 9, 2010, at 14:58:43
I think I might profit from LDN but my reservation is the sleep angle. My sleep is fragile but OK at the moment and I'm fairly sure LDN would worsen things before they got better.
Posted by floatingbridge on February 9, 2010, at 18:05:41
In reply to Re: Opioids for Depression » floatingbridge, posted by Sigismund on February 9, 2010, at 15:41:57
> I think I might profit from LDN but my reservation is the sleep angle. My sleep is fragile but OK at the moment and I'm fairly sure LDN would worsen things before they got better.
Yeah, a concern of mine as well--or if I'd wake terribly anxious. Still....
Posted by Phillipa on February 9, 2010, at 19:59:18
In reply to Re: Opioids for Depression » Sigismund, posted by floatingbridge on February 9, 2010, at 18:05:41
Tea has a lot of info on ldn. Used with a lot of autoimmune diseases from what l.5-4mg? Love Phillipa
Posted by floatingbridge on February 9, 2010, at 20:10:45
In reply to Re: Opioids for Depression » floatingbridge, posted by Phillipa on February 9, 2010, at 19:59:18
Phillipa, you haven't tried it? I'm following Tea's and Cassie's thread. My pdoc hadn't heard of it. Someone I know with PD was looking into it.
fb
Posted by Phillipa on February 9, 2010, at 21:31:06
In reply to Re: Opioids for Depression » Phillipa, posted by floatingbridge on February 9, 2010, at 20:10:45
FB no I haven't. I had saved a great post. Deleted it recently. You can find it as was on babble. Google TeaLady. Love Phillipa
Posted by kirbyw on February 9, 2010, at 23:12:53
In reply to Re: Opioids for Depression » floatingbridge, posted by Phillipa on February 9, 2010, at 21:31:06
I think we are all missing something in this discussion.
1) I would agree that in the worst cases of endogenous depression where the person is acutely suicidal that opioids would probably be of use, but only until an anti-depressive could kick in.
2) The problem with the opioids is that you feel good "for no reason" This was very dangerous in my case, as instead of instigating behaviors that would improve my life, I was content to just sit around and "feel good," and this on a very small dose of Vicodin only about 1 or 2 pills per day.
It took away that horrible depressed feeling and made me feel relaxed and confident. But the next morning I had to do it again, and the next afternoon etc. This was happening from last July until January 6th, the day that I took my last Vicodin.So there is some biochemical property of these artificial opioids that has a temporary effect, but doesn't stimulate any kind of permanent change in neurotransmitters. And it also gives you a false sense of well being. In extremes people on these drugs, feel great as we know, while they lose weight, lose their jobs, steal money from their families, etc.
3) Even worse, your mind/body creates symptoms which cause you to have cravings for the drug.
These can be psychosomatic, in my case a sensation of shortness of breath, or my supposedly incapaciting prostate pain. Well, now that I am 33 days without Vicodin, the shortness of breath has almost completely disappeared. And the severe prostate pain when sitting is managed by 1 extra strength Tylenol.
In fact, sometimes if I forget to take the Tylenol the pain seems minimal anyway. I have not to take more than 3 tylenols in any one day.Before, I always would be conscious of the pain, and would immediately take half a vicodin if i thought I would be sitting on a hard chair, or on a plane, or in a theater etc. for more than a few minutes. I took these pills for seven years. During that time certain aspects of my life went ok, but I was constantly feeling good on a low dose of Vicodin.
When the time came for me to take steps to respond to some crises in my life, my response was to relax and take the Vicodin and more or less ignore the impending disaster. And those disasters led to my first severe depression in over 20 years. So then I was taking the Vicodin
just get out of bed in the morning, to get something done etc. I was on Parnate, but I was feeling "too good". I was self medicating my depression with an opiate, and creating a sense of well being based on nothing.Only since I stopped the Vicodin have I returned to a point where I am trying to really solve my real life problems. I found a therapist, I am going to Narcotics Anonymous groups, and to another mental health support group, etc. I am much more active generally and this contributes to a sense of well being that I hope is far more significant for my life, than the "well being" I felt on the drug.
As the crisis became worse, the use of Vicodin was, I feel, creating or at the very least enhancing the symptoms of depression, so as to
"trick" me into taking some more Vicodin. Its hard to explain, but thats how I see.Now I am taking only Parnate, and I am do so many more things focused on improving my life than I was previously. I still feel bad on some days, I adjust the dosage of Parnate and can improve my mood rather quickly, although the higher the dose the more insomnia that I have. But that's a different issue.
The term "self-medicating for depression" with drugs or alcohol is used all the time. It is actually a meaningless catch all phrase, until it is defined in terms of what is going on very specifically with a given individual.
By the way, I had Vicodin cravings every day for the first week I stopped taking it. The depression was worse, even with Parnate, I had shortness of breath, pain in my chest, pain when sitting. Gradually this has diminished and now I just realize that these are symptoms of Vicodin withdrawl. In any case, if I really think they are "real" I can always go to the Doctor.
Vicodin has a strong mind/body effect. Perhaps there should be an investigation into how to create a codeine based anti-depressant that will not have this effect. But I think that this may be almost impossible.
One final example: When I was hospitalized for a severe endogenous depression in 1982, before I had ever taken parnate, the psychoanalytically oriented Psychiatrist at the hospital decided to give me a "sodium pentathol interview" in order to dig into my childhood or whatever. For one hour, I was only semi-concious. I didn't recover any signficant childhood memories but I remember that I felt, normal for the first time in two years, that is to say the endogenous physical pain of the depression disappeared on the sodium pentathol interview. The Doctor thought that this was some kind of catharsis because I kept saying "I can feel. I feel normal" etc. etc. Well, about an hour after the interview was over, and the drug wore off, I felt exactly the same pain that I had been feeling before this experience. The physiological effects of the Pentathol wore off and that was the end of feeling good. Now if good old Dr. Freud had given me a small dose of Pentathol every hour or so, I probably could have continued to feel better, but I would have to have been hooked up to a sodium pentathol machine for the rest of my life. It was a different drug, parnate, (in a different hospital with a different Doctor) that got me out of the depression.
I regret that I used Vicodin for almost seven years, even though I functioned adequately most of that time. The end result was as I have said a severe crisis and a relapse into endogenous depression.
The Vicodin was orignally prescribed for the prostate pain when sitting. And I got letters from a pain clinic enabling me to continue to get Vicodin prescriptions from other Doctors. For all I know I could have gotten by on Tylenol the whole time.
Rick in Costa rica.
Posted by floatingbridge on February 10, 2010, at 16:09:18
In reply to Re: Opioids for Depression » floatingbridge, posted by Sigismund on February 9, 2010, at 15:41:57
Do dopaminergic gene polymorphisms affect mesolimbic reward activation of music listening response? Therapeutic impact on Reward Deficiency Syndrome (RDS)
http://www.medical-hypotheses.com/article/S0306-9877%2809%2900682-3/abstract
Posted by floatingbridge on February 10, 2010, at 16:40:07
In reply to Re: Opioids for Depression, posted by kirbyw on February 9, 2010, at 23:12:53
Rick,
I support your recovery 100%! Stopping after seven years takes courage and insight--and I am so glad to hear that the parnate is still working for you.
When I have taken vicodin, I have felt motivated and relieved of pain--not at all complacent, but ready to take on the challenge of the day. That could be because I seldom take it, and when I do, am so relived to be out of pain. However, I am convinced that for me, that path would not be a wise one for me. My bottle stays in the back of my cabinet.
I spoke with my pdoc about this very thing today. For a select few, opioid therapy, in his opinion, is indicated and beneficial. He made note of my own positive response because of how I felt--completely normal (in a good way). Well, doesn't everyone, except a few, respond that way? He said no. The average person will usually feel relief of pain but also altered or impaired in some way--dizzy, heady, or high. An unfortunate few will not even receive pain relief. Are you saying you think opiod therapy would be an adjunct for me? I asked. Oh, goodness no, he responded. (Oh goodness no is right!)
However, he sees this as what some patients may need. He feels I have, in addition to back/spine pain, a low threshold for pain. I'm not a wimp--I just feel every darn thing more than the average. He thinks that's due to or certainly exacrebated by long standing ptsd.
I find the whole thing interesting.
I feel so achy from a cold right now--my usual aches really flare. In the back of my cabinet is a pill that will take that away. But I ain't going there today. However, for some, it is a real need. Unfortunately, most docs can't or won't help some of these patients (high cost of monitoring, ignorance, abuse potential).
wishing you continued success in recovery,
fb
Posted by Cherry Carver on February 10, 2010, at 17:17:17
In reply to Re: Opioids for Depression, posted by kirbyw on February 9, 2010, at 23:12:53
Parnate is serious medication. (I just looked it up because I hadn't heard of it before.) Here's the site for anyone else interested in knowing more about it:
<http://www.rxlist.com/parnate-drug.htm>;
The physical description of the pills makes me smile. "Each round, rose-red, film-coated tablet is debossed with the product name PARNATE and SB and contains tranylcypromine sulfate equivalent to 10 mg of tranylcypromine."
It's the "rose-red" part that gets me.
The only experiences I've had with sodium pentathol is watching actors on TV have stunning "truth serum" revelations that solve a crime or a lifelong mystery. I love that you just kept saying you felt normal...the expression on your shrink's face must have been priceless.
A steady diet of opioids couldn't be much worse than what I'm taking now for panic disorder, an illness that ruined my life in many ways before I was diagnosed. I've been to AA and NA and was told I was "self-medicating" and so on. It seemed like a great revelation the first time I heard it--not so great when I heard it over and over. Then I was *officially* medicated by a doctor.
I've been taking Klonopin every day for 14 years. It wears off in 24 hours, my heart starts pounding and the world gets frightening--and then I take another dose and the cycle begins anew. It does not change my neurotransmitters permanently, except in that withdrawal from it could kill me.
So, unless I want to go back to my panic-induced catatonia, I am married to this medication until I die. Wouldn't it be great if I could just take an aspirin and make this thing in my head go away? Wouldn't it be even better if I could take something that makes me feel happy and not merely numb? That's reason enough for me, because some days, I hate my existence so much that ending it would be a relief.
> I think we are all missing something in this discussion.
>
> 1) I would agree that in the worst cases of endogenous depression where the person is acutely suicidal that opioids would probably be of use, but only until an anti-depressive could kick in.
>
> 2) The problem with the opioids is that you feel good "for no reason" This was very dangerous in my case, as instead of instigating behaviors that would improve my life, I was content to just sit around and "feel good," and this on a very small dose of Vicodin only about 1 or 2 pills per day.
> It took away that horrible depressed feeling and made me feel relaxed and confident. But the next morning I had to do it again, and the next afternoon etc. This was happening from last July until January 6th, the day that I took my last Vicodin.
>
> So there is some biochemical property of these artificial opioids that has a temporary effect, but doesn't stimulate any kind of permanent change in neurotransmitters. And it also gives you a false sense of well being. In extremes people on these drugs, feel great as we know, while they lose weight, lose their jobs, steal money from their families, etc.
>
> 3) Even worse, your mind/body creates symptoms which cause you to have cravings for the drug.
> These can be psychosomatic, in my case a sensation of shortness of breath, or my supposedly incapaciting prostate pain. Well, now that I am 33 days without Vicodin, the shortness of breath has almost completely disappeared. And the severe prostate pain when sitting is managed by 1 extra strength Tylenol.
> In fact, sometimes if I forget to take the Tylenol the pain seems minimal anyway. I have not to take more than 3 tylenols in any one day.
>
> Before, I always would be conscious of the pain, and would immediately take half a vicodin if i thought I would be sitting on a hard chair, or on a plane, or in a theater etc. for more than a few minutes. I took these pills for seven years. During that time certain aspects of my life went ok, but I was constantly feeling good on a low dose of Vicodin.
>
> When the time came for me to take steps to respond to some crises in my life, my response was to relax and take the Vicodin and more or less ignore the impending disaster. And those disasters led to my first severe depression in over 20 years. So then I was taking the Vicodin
> just get out of bed in the morning, to get something done etc. I was on Parnate, but I was feeling "too good". I was self medicating my depression with an opiate, and creating a sense of well being based on nothing.
>
> Only since I stopped the Vicodin have I returned to a point where I am trying to really solve my real life problems. I found a therapist, I am going to Narcotics Anonymous groups, and to another mental health support group, etc. I am much more active generally and this contributes to a sense of well being that I hope is far more significant for my life, than the "well being" I felt on the drug.
>
> As the crisis became worse, the use of Vicodin was, I feel, creating or at the very least enhancing the symptoms of depression, so as to
> "trick" me into taking some more Vicodin. Its hard to explain, but thats how I see.
>
> Now I am taking only Parnate, and I am do so many more things focused on improving my life than I was previously. I still feel bad on some days, I adjust the dosage of Parnate and can improve my mood rather quickly, although the higher the dose the more insomnia that I have. But that's a different issue.
>
> The term "self-medicating for depression" with drugs or alcohol is used all the time. It is actually a meaningless catch all phrase, until it is defined in terms of what is going on very specifically with a given individual.
>
> By the way, I had Vicodin cravings every day for the first week I stopped taking it. The depression was worse, even with Parnate, I had shortness of breath, pain in my chest, pain when sitting. Gradually this has diminished and now I just realize that these are symptoms of Vicodin withdrawl. In any case, if I really think they are "real" I can always go to the Doctor.
>
> Vicodin has a strong mind/body effect. Perhaps there should be an investigation into how to create a codeine based anti-depressant that will not have this effect. But I think that this may be almost impossible.
>
> One final example: When I was hospitalized for a severe endogenous depression in 1982, before I had ever taken parnate, the psychoanalytically oriented Psychiatrist at the hospital decided to give me a "sodium pentathol interview" in order to dig into my childhood or whatever. For one hour, I was only semi-concious. I didn't recover any signficant childhood memories but I remember that I felt, normal for the first time in two years, that is to say the endogenous physical pain of the depression disappeared on the sodium pentathol interview. The Doctor thought that this was some kind of catharsis because I kept saying "I can feel. I feel normal" etc. etc. Well, about an hour after the interview was over, and the drug wore off, I felt exactly the same pain that I had been feeling before this experience. The physiological effects of the Pentathol wore off and that was the end of feeling good. Now if good old Dr. Freud had given me a small dose of Pentathol every hour or so, I probably could have continued to feel better, but I would have to have been hooked up to a sodium pentathol machine for the rest of my life. It was a different drug, parnate, (in a different hospital with a different Doctor) that got me out of the depression.
>
> I regret that I used Vicodin for almost seven years, even though I functioned adequately most of that time. The end result was as I have said a severe crisis and a relapse into endogenous depression.
>
> The Vicodin was orignally prescribed for the prostate pain when sitting. And I got letters from a pain clinic enabling me to continue to get Vicodin prescriptions from other Doctors. For all I know I could have gotten by on Tylenol the whole time.
>
> Rick in Costa rica.
Posted by bulldog2 on February 10, 2010, at 17:23:24
In reply to Re: Opioids for Depression, posted by kirbyw on February 9, 2010, at 23:12:53
> I think we are all missing something in this discussion.
>
> 1) I would agree that in the worst cases of endogenous depression where the person is acutely suicidal that opioids would probably be of use, but only until an anti-depressive could kick in.
>
> 2) The problem with the opioids is that you feel good "for no reason" This was very dangerous in my case, as instead of instigating behaviors that would improve my life, I was content to just sit around and "feel good," and this on a very small dose of Vicodin only about 1 or 2 pills per day.
> It took away that horrible depressed feeling and made me feel relaxed and confident. But the next morning I had to do it again, and the next afternoon etc. This was happening from last July until January 6th, the day that I took my last Vicodin.
>
> So there is some biochemical property of these artificial opioids that has a temporary effect, but doesn't stimulate any kind of permanent change in neurotransmitters. And it also gives you a false sense of well being. In extremes people on these drugs, feel great as we know, while they lose weight, lose their jobs, steal money from their families, etc.
>
> 3) Even worse, your mind/body creates symptoms which cause you to have cravings for the drug.
> These can be psychosomatic, in my case a sensation of shortness of breath, or my supposedly incapaciting prostate pain. Well, now that I am 33 days without Vicodin, the shortness of breath has almost completely disappeared. And the severe prostate pain when sitting is managed by 1 extra strength Tylenol.
> In fact, sometimes if I forget to take the Tylenol the pain seems minimal anyway. I have not to take more than 3 tylenols in any one day.
>
> Before, I always would be conscious of the pain, and would immediately take half a vicodin if i thought I would be sitting on a hard chair, or on a plane, or in a theater etc. for more than a few minutes. I took these pills for seven years. During that time certain aspects of my life went ok, but I was constantly feeling good on a low dose of Vicodin.
>
> When the time came for me to take steps to respond to some crises in my life, my response was to relax and take the Vicodin and more or less ignore the impending disaster. And those disasters led to my first severe depression in over 20 years. So then I was taking the Vicodin
> just get out of bed in the morning, to get something done etc. I was on Parnate, but I was feeling "too good". I was self medicating my depression with an opiate, and creating a sense of well being based on nothing.
>
> Only since I stopped the Vicodin have I returned to a point where I am trying to really solve my real life problems. I found a therapist, I am going to Narcotics Anonymous groups, and to another mental health support group, etc. I am much more active generally and this contributes to a sense of well being that I hope is far more significant for my life, than the "well being" I felt on the drug.
>
> As the crisis became worse, the use of Vicodin was, I feel, creating or at the very least enhancing the symptoms of depression, so as to
> "trick" me into taking some more Vicodin. Its hard to explain, but thats how I see.
>
> Now I am taking only Parnate, and I am do so many more things focused on improving my life than I was previously. I still feel bad on some days, I adjust the dosage of Parnate and can improve my mood rather quickly, although the higher the dose the more insomnia that I have. But that's a different issue.
>
> The term "self-medicating for depression" with drugs or alcohol is used all the time. It is actually a meaningless catch all phrase, until it is defined in terms of what is going on very specifically with a given individual.
>
> By the way, I had Vicodin cravings every day for the first week I stopped taking it. The depression was worse, even with Parnate, I had shortness of breath, pain in my chest, pain when sitting. Gradually this has diminished and now I just realize that these are symptoms of Vicodin withdrawl. In any case, if I really think they are "real" I can always go to the Doctor.
>
> Vicodin has a strong mind/body effect. Perhaps there should be an investigation into how to create a codeine based anti-depressant that will not have this effect. But I think that this may be almost impossible.
>
> One final example: When I was hospitalized for a severe endogenous depression in 1982, before I had ever taken parnate, the psychoanalytically oriented Psychiatrist at the hospital decided to give me a "sodium pentathol interview" in order to dig into my childhood or whatever. For one hour, I was only semi-concious. I didn't recover any signficant childhood memories but I remember that I felt, normal for the first time in two years, that is to say the endogenous physical pain of the depression disappeared on the sodium pentathol interview. The Doctor thought that this was some kind of catharsis because I kept saying "I can feel. I feel normal" etc. etc. Well, about an hour after the interview was over, and the drug wore off, I felt exactly the same pain that I had been feeling before this experience. The physiological effects of the Pentathol wore off and that was the end of feeling good. Now if good old Dr. Freud had given me a small dose of Pentathol every hour or so, I probably could have continued to feel better, but I would have to have been hooked up to a sodium pentathol machine for the rest of my life. It was a different drug, parnate, (in a different hospital with a different Doctor) that got me out of the depression.
>
> I regret that I used Vicodin for almost seven years, even though I functioned adequately most of that time. The end result was as I have said a severe crisis and a relapse into endogenous depression.
>
> The Vicodin was orignally prescribed for the prostate pain when sitting. And I got letters from a pain clinic enabling me to continue to get Vicodin prescriptions from other Doctors. For all I know I could have gotten by on Tylenol the whole time.
>
> Rick in Costa rica.There may be a subset of depressives who have a shortage of endogenous opiates. They may not respond to standard ads and their opiate systems may never kick in and produce enough internal endorphins. That is why they need their opiate meds every day.
Posted by bulldog2 on February 10, 2010, at 17:27:36
In reply to Opioids for Depression: link for Sigi + all, posted by floatingbridge on February 10, 2010, at 16:09:18
They key is to give enough of the synthetic opiate to stimulate activity rather than a euphoric high where you bask in a good feeling. I was on percocet for four months for pain and when I took my perocet it also worked on my depression. I found myself doing more things and becoming more active. So how much you stimulate the receptor is key.
Posted by Cherry Carver on February 10, 2010, at 17:35:47
In reply to Opioids for Depression: link for Sigi + all, posted by floatingbridge on February 10, 2010, at 16:09:18
Great link!!!
This study reminds me of another study I read about in school (over 30 years ago now) in which the subjects' brains were exposed and probes were inserted that vividly brought back memories of happier times and beautiful music, among other things. The author said that this could be useful therapy for Altzheimer's patients or a way simply to alleviate depression in aging people. It always sounded like a great trip to me. Never heard about any follow-up to it, though--the risk of infection might have been too great, and the expense was probably tremendous.
> Do dopaminergic gene polymorphisms affect mesolimbic reward activation of music listening response? Therapeutic impact on Reward Deficiency Syndrome (RDS)
>
>
> http://www.medical-hypotheses.com/article/S0306-9877%2809%2900682-3/abstract
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