Posted by JMC on July 25, 2005, at 17:52:37
In reply to Re: Opioids as a treatment of last resort - Metyrapone » JahL, posted by ed_uk on July 13, 2005, at 15:00:48
Hello All.
Thank you Jamie for your post on Electro Convulsive Therapy (ECT). I find it very hard to explain Major Clinical Depression. I have it and like yours it is treatment resistant. Your story shows how much pain we endure moment by moment and what we are willing to subject our selves to for relief.
I was on the road to voluntary ECT but with a little luck or divine intervention (depending on your direction of prayer Vegas or the Heavens) a path opened to me that has worked. 20 years ago I was in an accident that broke a few bones; the important one for this story is my right humorous. The break was from elbow to shoulder and over the years bone growth has impinged upon my right radial nerve. This caused a horrible burning sensation and a concomitant loss in range of motion in my right hand. I was referred to a Neurologist who did an EMG ordered an MRI, scheduled surgery and kindly handed me a prescription for a fairly strong opiate pain reliever. The surgery went well I have full range of motion and am pain free. I am however still on opiates.
While waiting for the surgery date, on my daily dose of pain medication, I noticed that I was not depressed. I could not even see the storm of hopelessness on the horizon, no feelings of impending doom and energy to burn. After surgery I was tapered off of the pain medication and all symptoms of my depression returned. I started doing research on opiate therapy for depression. I found that in the 1950’s this form of therapy for Major Clinical Depression was common, and worked. The draw backs were tolerance; a slow or fast rise in amounts used to get the same effect depending on use patterns, and abuse, taking more than prescribed to chase the euphoria. Bottom line is that it worked. I took my findings including the 1995 Harvard study Buprenorphine Treatment of Refractory Depression (1) to my General Practitioner who referred me to a Pain Specialist who referred me to another Addiction/Pain Medicine M.D.
The doctor was open to the idea, he said to me “pain is pain, if depression is painful and an opiate efficacious then that’s what we are going to do”, and he had read the same psychopharmacology article that I had. as well as a lot of others. He induced me to a small amount of Buprenorphine (Suboxone TM). The drug has an antagonist in it that limits the amount of opiate that is received in the brain. I get a steady, consistent dose that I can not change no matter how many pills I take. I have been on opiate therapy for Major Clinical Depression with Social anxiety aspects for six months, my dose has been adjusted once and that was down. I no longer take Xanax TM or any other psychotropic drug.
For me this has been a wonderful find. I have had no depressive episodes for over half a year now. I have a hard time even trying to put my self in that mind set. I do not even dwell on time and opportunities lost to this disease, I cope. Today, I enjoy the present; I get out of bed looking forward to another day. I now actively chase my dreams (hell I actually have dreams). I suffered through 25 years of depression with several long term inpatient stays. The disease for me was progressive with the last five being the worst. In finding opiate therapy I feel like the man pardoned from a “life without parole jail term” for a crime he did not commit. Today I understand the words Carpe Diem!!
Cheers,
JMC
1.J. Alexander Bodkin, MD, Gwen L. Zornberg, MD, Scott E. Lukas, PhD,
and Jonathan O. Cole, MD.
Journal of Clinical Psychopharmacology, 1995, 15, pp. 49-57
poster:JMC
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URL: http://www.dr-bob.org/babble/wdrawl/20050712/msgs/533372.html