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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by bobby on April 4, 2003, at 7:28:38
If so, I may be on the verge of a breakthough. I would appreciate any input concerning this matter. I always feel normal on them---or maybe it's just the buzz.....
Posted by Caleb462 on April 6, 2003, at 3:11:01
In reply to has anyone here been precribed opiates for BP?, posted by bobby on April 4, 2003, at 7:28:38
> If so, I may be on the verge of a breakthough. I would appreciate any input concerning this matter. I always feel normal on them---or maybe it's just the buzz.....
I think a few lucky folks on this board have had some doctor-prescribed opiate/opiod treatment.
Opiods are the only things that make me feel "normal" too. I'd sacrifice a testicle right now for a few dozen milligrams of anything that ends in -codone.
Posted by paxvox on April 6, 2003, at 17:57:11
In reply to Re: has anyone here been precribed opiates for BP?, posted by Caleb462 on April 6, 2003, at 3:11:01
OK, I'll toss in a bone here. Yes, opiates/opioids CAN help certain types of depression, but are obviously not for everyone. It MAY be a paradoxical effect (e.g. amphetamines for ADD/HD), but I think it is more a binding of parent and matabolites to opioid receptors in the brain that block reuptake of norepinephrine and to some degree serotonin. OK, I'll pause here for all the pharmacologists to stop laughing.......OK, now where were we, oh yea.
Anyway, for ME personally, hydrocodone, oxycodone and even codeine ALL cause mood elevation WITHOUT sedation. So, is this true AD activity? I don't know, but since most AD's state the "the exact mechanism of activity is unknown but is suspected to be..." Do a couple of beers lift depression? Not for me, I got a buzz, but that was just a temporay thing. Both opiates/oids and alcohol produce some of their "feel good effects" by interaction with dopamine. Thus ADs like Wellbutrin produce their AD effect by dopamine interaction. There was one poster here a year or so ago who was REALLY into the study of this theory, I don't know if she still posts. But she was specifically looking at Buprenorphine hydrochloride (Buprenex)which is actually a mixed opioid agonist and antagonist. She was not interested in my input. She may have been from the UK where Buprenex *may* have been tried as an AD. Anyway, I think that there is a whole lot of science that is unexplored in the territory of this class of drug being used as antidepressants due to the high incidence of abuse and addiction. Same goes with the benzos. Just because a few people DO abuse them, we use "shotgun managed medicine" to prevent ANYONE from getting to much of it. Seems to me a mixed agonist/antagonist like Buprenex would preclude overdosing by its own mechanism of action. Now, as to your question: I SERIOUSLY doubt any Pdoc would prescribe opiates/oids as an off-lable use AD, though some GPs might do so. All I know is that according to government statistics, a whole hell of a lot of hyrdocodone gets prescribed by U.S pharmacies (always seems to be in the top 10 list). You figure it out. Anyone else want to jump in here with personal experience?
PAX
Posted by utopizen on April 6, 2003, at 18:38:52
In reply to Re: has anyone here been precribed opiates for BP?, posted by paxvox on April 6, 2003, at 17:57:11
I was prescribed opiates for a condition my doc calls "Drug-Seeking Behavior". I don't know what it is, but he keeps giving me all these controlled substances for it and tells me to take them to make my condition better!
=0)
Posted by JahL on April 6, 2003, at 22:16:28
In reply to has anyone here been precribed opiates for BP?, posted by bobby on April 4, 2003, at 7:28:38
> If so, I may be on the verge of a breakthough. I would appreciate any input concerning this matter. I always feel normal on them---or maybe it's just the buzz.....
+++++++++++++++++++++++++++++++++
Standard word of caution - but congrats!!!
I have Bipolar NOS and have been taking Methadone 5mg (self-prescribed) for about 18 months now. In that period my dose has not increased one iota. Above that dose I experience vastly diminishing returns. Meth improves my cognition a little and blesses me with a small increase in energy. I can just about work out on the bag now, which is good for all sorts of reasons.
I have a strong feeling that 'real' opiates (i.e: full agonists & not Heroin substitutes) may also be (part of) the answer for myself, at least in the shortish term, taking into a/c the obvious problem of tolerance.
Here in the UK it is impossible to get opiates prescribed; your leg could be falling off and you'd still get given Paracetamol! Therefore it's impossible to validate this hunch over here. If the course of ECT I'm about to embark upon doesn't help then I think a trip to America beckons (as once before)...
Since this is an area of medicine that greatly interests me I am keen to hear of your further exploits. Keep us posted! Ramble over.
Ta,
Jah.
Posted by judy1 on April 7, 2003, at 12:05:13
In reply to has anyone here been precribed opiates for BP?, posted by bobby on April 4, 2003, at 7:28:38
actually my pdoc does prescribe them for panic disorder (in low doses) and is aware i take them for depressive episodes (and stop when well or manic). i get the heavy stuff (morphine) from my internist for pain but was well aware of the AD effect almost immediately. i really don't know if my pdoc would prescribe it for an AD, probably, but more on the level of hydrocodone. Elizabeth was extremely knowledgeable about opiates- you might want to do a search. best of luck-judy
Posted by fairnymph on April 7, 2003, at 12:40:41
In reply to has anyone here been precribed opiates for BP?, posted by bobby on April 4, 2003, at 7:28:38
I would think opiates would be AWFUL for someone with bipolar...bipolar people are extremely susceptible to addiction with central nervous system depressants (opiates, alcohol, weed, etc)...I would avoid opiates if I had bipolar...I saw how much my ex liked it and it was scary!
be careful!
fn
Posted by bobby on April 7, 2003, at 14:07:30
In reply to Re: has anyone here been precribed opiates for BP?, posted by Caleb462 on April 6, 2003, at 3:11:01
I feel like I have a little devil on one shoulder and a little angel on the other---and they're fighting like Arabs and Jews. I know that opiates will most definately make me feel good, but then Just like fairnymph thinks---I would probably take them like candy because it feels so good to be "whole". My doc says that I must take pills for the rest of my life--so why should'nt they be opiates? I would prefer weed but it's illegal and I don't want my children to think it's o.k. I probably won't even approach my Doc because I already feel "guilty". Still, it would be nice......I sound like Gollum fighting with myself. Thanks for all the advice people--really
Posted by paxvox on April 7, 2003, at 14:54:54
In reply to Re: has anyone here been precribed opiates for BP?, posted by utopizen on April 6, 2003, at 18:38:52
Oh, that's really humorous!
Posted by BrittPark on April 7, 2003, at 21:34:58
In reply to has anyone here been precribed opiates for BP?, posted by bobby on April 4, 2003, at 7:28:38
I don't know about opioids for BP specifically. They have been and still are used in the treatment of depression. 1 5/500 vicodin a day is part of my cocktail and is helpful. 4 or 5 times that would probably be very helpful but I'm disinclined to bet that I'm one of the non-tolerance-builders. Lots of other people on PB have had good responses to opioids. Others are not helped at all.
There has been a small amount of clinical research supporting the use of Buprenorphine and Tramadol as ADs. Do a search on PB and you'll find references to the papers.
The number of psychiatrists who would suggest opioids is probably vanishingly small. The number who would, given a reasoned request from a patient is much higher. But, the majority would be constitutionally opposed to opioid treatment even given research results. They are too concerned about insurance issues, or fretted by fears of their state licencing board, or generally swallow the propaganda that the DEA pushes in the name of the puritanical American people. The general logic that seems to cover the treatment of affective disorders is that any drug that makes non-ill people feel good is inappropriate for the treatment of people who are ill.
Apologies for my bitterness, but as you can tell I'm not particularly happy about some of the ways my tax money is spent, and more than a little peeved by the sluggish pace at which improved treatments for affective disorders are found.
To address your original post: ask yourself what difference it makes if the reason you feel better on opioids is because of some obscure neurological pathway, or because of the already understood euphoriant effects of opioids. To paraphrase Alexander Pope "Whatever works is right."
Posted by paxvox on April 8, 2003, at 19:56:07
In reply to Re: has anyone here been precribed opiates for BP? » bobby, posted by BrittPark on April 7, 2003, at 21:34:58
YES!
PAX
Posted by bobby on April 9, 2003, at 7:14:06
In reply to Re: has anyone here been precribed opiates for BP?, posted by paxvox on April 8, 2003, at 19:56:07
Thanks for your input PAX. Believe it or not, I sometimes think of you when I look at my Bolivia key chain. Anyway, Thanks mam.
Posted by fairnymph on April 9, 2003, at 15:01:40
In reply to Yes, I mean No, I mean yes, No ,well maybe......., posted by bobby on April 7, 2003, at 14:07:30
bobby, what meds have you tried so far? Are you bipolar type I or type II?
Posted by bobby on April 10, 2003, at 7:43:05
In reply to Re: Yes, I mean No, I mean yes, No ,well maybe.... » bobby, posted by fairnymph on April 9, 2003, at 15:01:40
HI Fairnymph, Well lets see, I've tried lithium, Depekote, Tegretol(sp?), Klonapin, And now I take Lamactil,Zyprexa, And oxazipam(sp?). As for what type bipolar I am--I don't know if my Docs have ever specified. I'll try to ask next visit. I would prefer no meds at all and I hope to try soon to go med free. I would love to feel something--good or bad.I guess that's why I asked about opiates--they give me "feeling." By the way, I used to date a fairnymph but I had to give her up---She would'nt even let me sleep. Now she's married.Poor husband--I'll bet he's exhausted 24/7.
Posted by bee happy on April 10, 2003, at 13:29:51
In reply to has anyone here been precribed opiates for BP?, posted by bobby on April 4, 2003, at 7:28:38
I am not bipolar..but have been taking buprenorphine for ad resistant depression for the past 7 months. 2mgs 4X's daily with life saving results.The place to start is with the Harvard/McClean hospital/Dr Bodkin Study.You might also check out the info on subutex the newly approved form for treatment of opiate addiction.
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