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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by AlexCanada on June 19, 2014, at 2:10:21
I have melancholic depression along with hypothyroid. Basically very low emotional capacity, lot of apathy, very poor interest and level of enjoyment, low energy, constant tiredness etc. Extreme amounts of brain fog and slow mindedness. Often rely on stimulants to bring some life into me. I been on over 20+ meds including Parnate, Paxil, Modafinil, Ritalin, SSRIs, SNRIS, TCAs, etc. Paxil was one of the best along with Parnate until they pooped out. Other srris I felt very dumb. Ritalin/Dexedrine were amazing during the first weeks but later on tolerance and down regulation.
I am currently on Cymbalta 30mg and it makes me feel duller if anything, I have less Fibromyalgia pains from it though. Some minor mood benefit but no benefit to cognition.
I have tried Tylenol 1 with codeine before as my doctor recommended. Some partial results were obvious but it's pretty mild. More pleasurable existence it would create. Tramadol I have been prescribed as well and it has some remarkable effects after 3 hours or so at certain times especially for bringing more creativity to mind and nostalgic feelings, some reemergence of interest in old hobbies but it's Very sedating for me and it does make me feel a bit weird.
What are less sedating painkiller options or options in general?
Gabapentin helps for pleasure but creates much tolerance.
If anyone has any ideas that do not relate to pain killers please let me know. I am investigating all options!!! I want to feel more emotion especially more empathy. But interest in general, sense of reward etc I am hoping to discover.
Posted by Phillipa on June 19, 2014, at 9:59:33
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
Tramadol has been compared to motrin. As used for up to moderate pain. Phillipa
Posted by rjlockhart37 on June 19, 2014, at 13:46:36
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
best awnser i can give is suboxone, which is usally treated for addiction with people who addicted to higher potency opiate medications, or herione.....
you can't get like high off it, it just gives the person a small wellbeing feeling, it's not like taking 2 hydrocodones.....but similar, but it can't be abused because it has naloxone in it
ask your doctor maybe about it, but seriously you would have to really work with your doctor to do that because it's main idications are for pain or addiction treatment
and of course you just take hydrocodone.....both give a feeling of well being but suboxone is less able to get high off of
Posted by Beckett on June 19, 2014, at 15:10:51
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
I like tramadol (Ultram). I find it energizing. Interesting how people get different effects. I have similar lethargy. I was going to suggest effexor, but it might be sedating given your response to Cymbalta. Most pain meds are sedating :-( Suboxone?
Posted by Phillipa on June 19, 2014, at 18:36:42
In reply to Re: Best Painkillers for Resistent Depression? » AlexCanada, posted by Beckett on June 19, 2014, at 15:10:51
When had surgery made me high as a kite. So went off them quickly. Phillipa
Posted by Bob on June 21, 2014, at 10:06:20
In reply to Re: Best Painkillers for Resistent Depression? » AlexCanada, posted by Beckett on June 19, 2014, at 15:10:51
> I like tramadol (Ultram). I find it energizing. Interesting how people get different effects. I have similar lethargy. I was going to suggest effexor, but it might be sedating given your response to Cymbalta. Most pain meds are sedating :-( Suboxone?
Isn't tramadol a no-no with serotonin drugs?Bob
Posted by Phillipa on June 21, 2014, at 19:09:16
In reply to Re: Best Painkillers for Resistent Depression? » Beckett, posted by Bob on June 21, 2014, at 10:06:20
Yes it is but I know some take a very low dose with a low dose of an SSRI? Phillipa
Posted by Beckett on June 21, 2014, at 19:36:29
In reply to Re: Best Painkillers for Resistent Depression? » Beckett, posted by Bob on June 21, 2014, at 10:06:20
>Isn't tramadol a no-no with serotonin drugs?
I do't want to speak for anyone else concerning Cymbalta. I just started effexor today, and I take 200 mg of tramadol ER daily. I have also taken tramadol with Pristiq and Cymbalta. My doctors have always monitored me. I have no history of seizures which would rule out using both meds together. I also take an anti-seizure med, and maybe that makes it a safer bet for my physicians. Not sure.
Posted by tom2228 on June 22, 2014, at 11:19:10
In reply to Re: Best Painkillers for Resistent Depression?, posted by Beckett on June 21, 2014, at 19:36:29
> >Isn't tramadol a no-no with serotonin drugs?
>Eh it's pretty much fine, unless perhaps you're using ultra-high doses and definitely not with MAOIs
Posted by phidippus on June 22, 2014, at 15:02:37
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
I find oxycodone is a versatile mood enhancer and does not cause too much sedation.
Eric
Posted by LostBoyinNC45 on July 11, 2014, at 23:50:55
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
Here in the USA, narcotic painkillers are NOT FDA approved for any psychiatric use. Seeking narcotics to treat psychiatric problems will quickly get you diagnosed as a drug addict here in the USA and a "drug seeker." Narcotics are highly addictive, you build tolerance quickly and none exist where you are not going to be "stoned" and dopey acting...such as having slurred speech, impaired motor skills. You cannot drive a car here in the USA if you are taking prescription narcotics...doing so can easily get you charged with the serious crime of DUI.
Try a drug that is formally approved for major depression in your country. Other things to try is to go to a sleep medicine specialist as poor sleep can cause depression.
The legal problems that longterm addiction to "narcotics for depression" will only cause you severe financial and psycho social problems that will severely worsen your "depression." For example, to stay out of prison, you will have to come up with large sums of money to pay a criminal defense attorney and for court appearances and for rehab. This sort of thing can only cause your mood to worsen severely.
While narcotics may for some "depressed" people seem an effective way to "anesthesia" themselves out of their "depression," its a total dead end medium and long term.
Eric
Posted by babbler20 on July 14, 2014, at 0:10:04
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
The best option for depression has to be Oxycontin. I took it a couple times in college and I was reallly freakin happy. Interestingly, it made me really happy the next day as well. As far as the empathy is concerned, you could either be a psychopath or just depressed. I've been super depressed my whole life and I'm not a psychopath, but I don't get emotionally attached to things. I think depression blunts your ability to feel all emotions and that includes empathy. I don't think there is a way to increase empathy.
Posted by brynb on July 16, 2014, at 20:06:42
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
Tramadol (ultram) is excellent. I take it w/ Lexapro (w/o a problem).
Though an analgesic, it is also an snri, and works on glutamate receptors. It works within hours of taking it, and most (I certainly don't) get high or loopy from it. Also, you have a better chance of getting it prescribed for TRD than heavier painkillers--not to mention, the heavy duty pills such as Oxys, etc., undoubtedly cause dependence and frequent dosage increases. That's not the case with Tramadol.
Good luck,
B
Posted by Phillipa on July 16, 2014, at 22:20:01
In reply to Re: Best Painkillers for Resistent Depression? » AlexCanada, posted by brynb on July 16, 2014, at 20:06:42
Bryn how did you know that I was thinking of you today and the tramadol as it's getting to where I will need something for pain and with the SSRI's of course you were the first person I thought of. Now what is the dose again of tramadol as my back neuro surgeon had said he would prescribe me. It also is now a schedule IV drug. But that is no different from benzos. Phillipa
Posted by brynb on July 17, 2014, at 5:33:19
In reply to Re: Best Painkillers for Resistent Depression? » brynb, posted by Phillipa on July 16, 2014, at 22:20:01
> Bryn how did you know that I was thinking of you today and the tramadol as it's getting to where I will need something for pain and with the SSRI's of course you were the first person I thought of. Now what is the dose again of tramadol as my back neuro surgeon had said he would prescribe me. It also is now a schedule IV drug. But that is no different from benzos. Phillipa
Ha ha, ESP, Phillipa! Yes, it is scheduled (I don't think it's scheduled as high as benzos, but it might be state-mandated). I get terrible neuropathic/arthritic/unidentifiable pain in my legs (it runs in my family) and Tramadol really helps it (usually within an hour). Then there's the added plus that it works great as an antidepressant--and fast!
I take 20mg Lexapro, 150mg (3, 50 mg) Tramadol, 6mg Ativan (a lot, yes, but it helps me sleep), and 30mg Vyvance. I'd like to cut out the Vyvance soon. I feel like I'm on too many meds!
Many doctors and pharms will warn you of the dangers mixing sris and nris w/ Tramadol, but it's been my experience MANY people take this combo without any problems, and as long as you stay in a reasonable range (say, under 200mg of Tramadol) you won't risk the hyped up "seizure." You also are guarded by the benzos you take, so again, that helps prevent seizures.
Moreover, I've read many articles of late that actually negate the idea that Tramadol doesn't go well w/ sris. It's just a precaution, but the combo does me wonders.
How's your Summer going? Hope you feel well!
xxx-e
Posted by Octothorpe on August 1, 2014, at 11:07:11
In reply to Best Painkillers for Resistent Depression?, posted by AlexCanada on June 19, 2014, at 2:10:21
I've had experience with hydrocodone 10/325 Apap for about 3 years. I started with 1 - 3x/day. The first six months were pretty good, it really helped with anxiety and so with reduction in anxiety came a better mood. At 6 months, I developed tolerance and decided to quit. I tapered off fine, but then decided I needed the hydrocodone. As I had a bunch of pills left, I quickly upped my dose to 8 pills/day. My psychiatrist, to my surprise, increased my dosage to that amount. Keep in mind I have had TRD and anxiety all of my adult life-it's not like this was my first option. I have finally tapered off again and will not re-start. They are physically and psychologically addictive. Was the 6 months of relief worth it? In my opinion yes. Be aware though that it is only a temporary crutch and you will face physical dependence, making it hard to quit unless you taper very carefully. I think the reason I could quit this time is I have hope/availability of other treatments-intranasal ketamine, oxytocin, dextromethorphan and low-dose naltrexone. Without hope opioids are going to be very hard to quit, and if you are prone to addiction they could very well ruin your life. Not a drug to be taken lightly.
Sorry for the long post. My best to you.
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