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Dr. Bob is Robert Hsiung, MD,
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Posted by Sigismund on February 12, 2010, at 2:26:06
In reply to Re: Opioids for Depression » emmanuel98, posted by floatingbridge on February 11, 2010, at 21:27:51
>I was ready to throw in the towel.
I'm not surprised people do.
There's a lot of med trials with no real guide, or at any rate no certainty.
Posted by europerep on February 12, 2010, at 12:45:10
In reply to Re: Opioids for Depression » emmanuel98, posted by floatingbridge on February 11, 2010, at 21:27:51
> europerep--good luck in your decision-making process!
>thanks.. in fact your post a lil' earlier left me a little bit worried.. where you said that you responded well to opioid therapy, but your doc (and you yourself) said it was not the right thing for you.. I thought that, if I am going to try it, I'd "only" have to see whether it helps me without making me high/intoxicated/etc., and if it does, then I'd know I should pursue this option.. could you explain to me what were the reasons for the decision in your case?
thx!
Posted by floatingbridge on February 12, 2010, at 16:23:19
In reply to Re: Opioids for Depression » floatingbridge, posted by europerep on February 12, 2010, at 12:45:10
europerep,
I'm sorry my post provoked any worry. Opoid therapy was never suggested for me. I have other options to try, like maoi's, TMs, augmentations. My physical pain levels do not require it either. When I'm older, well, maybe, who knows, depending on what ailment develops as I age. However, my beloved pdoc, who I am blessed with, is older than myself, and odds are that he may not be in practice.
You may have more options left than you realize. I hope so. If you care to post,
I'm curious what symptoms you are addressing.Take care and hugs (if I may),
fb
med trials, chronic illnesses, like depression stink. Don't throw in the towel. Courage.
Posted by emmanuel98 on February 12, 2010, at 18:12:02
In reply to Re: Opioids for Depression » emmanuel98, posted by floatingbridge on February 11, 2010, at 21:27:51
I started on 6mg, then went up to 12mg. It had no effect on me at all. Parnate has been great. Complete remission of depression and minimal side effects.
> Emsam failed? How long and at what dosages, may I ask?
>
> So you are pleased with parnate? I'm glad to hear.
>
Posted by floatingbridge on February 12, 2010, at 18:17:49
In reply to Re: Opioids for Depression, posted by emmanuel98 on February 12, 2010, at 18:12:02
Thanks, emme98, and I am very happy for you!
:)
fb
Posted by Metafunj on February 12, 2010, at 19:07:49
In reply to Re: Opioids for Depression, posted by emmanuel98 on February 12, 2010, at 18:12:02
It's nice to hear a success story. There is hope! Good job!
Posted by europerep on February 14, 2010, at 14:36:41
In reply to Re: Opioids for Depression » europerep, posted by floatingbridge on February 12, 2010, at 16:23:19
> europerep,
>
> I'm sorry my post provoked any worry. Opoid therapy was never suggested for me. I have other options to try, like maoi's, TMs, augmentations. My physical pain levels do not require it either. When I'm older, well, maybe, who knows, depending on what ailment develops as I age. However, my beloved pdoc, who I am blessed with, is older than myself, and odds are that he may not be in practice.
>
> You may have more options left than you realize. I hope so. If you care to post,
> I'm curious what symptoms you are addressing.
>
> Take care and hugs (if I may),
>
> fb
>
> med trials, chronic illnesses, like depression stink. Don't throw in the towel. Courage.of course you may :)..
well, I do not have any physical pain (luckily), so from that point of view I don't need opioids, but maybe they could do something against my depression..the symptoms I have include difficulties to get up in the morning (or, with doses of venlafaxine lower than 600mg/d, the inability to do so before 1 or even 2p.m.); the incapability to get pleasure out of anything in life; a lack of motivation for everything that makes out my life, a disinterest in any kind of social activity (even if I am a rather calm person, I used to enjoy talking and "interacting" with others around me); a lack of, or an absence rather, of self-confidence, hope for the future, etc..(plus physical symptoms)...
I do know that I have only had a fraction of the medication available against depression, but the point is that, since the end of childhood (around 10yrs) I have either been anxious or, for the last eight years, depressed, and so much so that it has basically precluded any actual social life, let alone for once finding a girlfriend, etc.. and this is not because I'm somehow not capable of it, but because my depression is just f##king up my life.. and I have done psychotherapy etc., and it was good, but, there are limits to it, you know? I do not have time for trying another tricyclic, or another SSRI, etc.. I know that, trying opioids now, is kind of like, instead of following the regular road, I'll take a shortcut through a mine field, but I WILL be cautious.. and if the road is leading to that very minefield anyway, then I might as well skip the rest of the road.. hmm, I like metaphores ;)..
yeah, that's my situation right now.. and, to make things "worse" (or better, depends on the POV), I do have a small quantity of buprenorphine at hand (10 x 0.4mg), so that way I could check whether it does me good, or not.. and I guess I'll do so soon, but I'm scared of both if it doesn't help me, and if it does but I won't find a MD who accepts this treatment.. hmmm...
well, thanks for reading anyway :)..
you take care too.. cu
Posted by jedi on February 15, 2010, at 2:22:49
In reply to Re: Opioids for Depression » floatingbridge, posted by europerep on February 14, 2010, at 14:36:41
europerep,
Opioids do make my depression feel better in the short term. I have seen no long term success from anybody in this thread. If your depression is atypical with social anxiety disorder may I suggest Nardil with a long acting benzo. I use clonazepam. This is the only thing that has worked for me out of 45+ different combinations of antidepressants.Atypical Depression is defined as:
A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events)
B. At least two of the following:
1. Significant weight gain or increase in appetite ("comfort eating")
2. Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)
3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)
4. Long-standing pattern of sensitivity to interpersonal rejection (not limited to episodes of mood disturbance; fits of rage, hysteria, aggression and irrational reactions) that results in significant social or occupational impairment.
Atypical depression is actually the most common type of depression. When Nardil works, it can be like flipping a switch. It is an amazing and powerful medication. The food restrictions are way overblown.
Good Luck,
Jedi
> I do know that I have only had a fraction of the medication available against depression, but the point is that, since the end of childhood (around 10yrs) I have either been anxious or, for the last eight years, depressed, and so much so that it has basically precluded any actual social life, let alone for once finding a girlfriend, etc.. and this is not because I'm somehow not capable of it, but because my depression is just f##king up my life.. and I have done psychotherapy etc., and it was good, but, there are limits to it, you know? I do not have time for trying another tricyclic, or another SSRI, etc.. I know that, trying opioids now, is kind of like, instead of following the regular road, I'll take a shortcut through a mine field, but I WILL be cautious.. and if the road is leading to that very minefield anyway, then I might as well skip the rest of the road.. hmm, I like metaphores ;)..
>
> yeah, that's my situation right now.. and, to make things "worse" (or better, depends on the POV), I do have a small quantity of buprenorphine at hand (10 x 0.4mg), so that way I could check whether it does me good, or not.. and I guess I'll do so soon, but I'm scared of both if it doesn't help me, and if it does but I won't find a MD who accepts this treatment.. hmmm...
>
> well, thanks for reading anyway :)..
> you take care too.. cu
Posted by Cherry Carver on February 15, 2010, at 20:29:19
In reply to Re: Opioids for Depression » europerep, posted by jedi on February 15, 2010, at 2:22:49
Has anyone here actually been given opioids specifically for depression in the long term? Like you, I take Klonopin (clonazepam), and it was the only thing that worked for me as well, except for prior, brief experiences with some opiates.
I'm just asking out of curiosity, because I wonder if opioids would work on depression and anxiety long-term. I understand why doctors don't prescribe it (due to the incidence of abuse), but couldn't it be applied therapeutically if it were monitored carefully? After all, there are people who get high on benzos like Klonopin and Ativan (I don't get high on Klonopin--it just makes me feel normal). It makes me think about the relative cost of all these drugs and what the pharmaceutical companies' real motivation is.
The fact that Klonopin is now a street drug disturbs me tremendously, because it works so well for my panic. Now I have to worry that the DEA will ban it and I'll be forced to take something less effective and more harmful.
> europerep,
> Opioids do make my depression feel better in the short term. I have seen no long term success from anybody in this thread. If your depression is atypical with social anxiety disorder may I suggest Nardil with a long acting benzo. I use clonazepam. This is the only thing that has worked for me out of 45+ different combinations of antidepressants.
>
> Atypical Depression is defined as:
> A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events)
> B. At least two of the following:
> 1. Significant weight gain or increase in appetite ("comfort eating")
> 2. Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)
> 3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)
> 4. Long-standing pattern of sensitivity to interpersonal rejection (not limited to episodes of mood disturbance; fits of rage, hysteria, aggression and irrational reactions) that results in significant social or occupational impairment.
> Atypical depression is actually the most common type of depression. When Nardil works, it can be like flipping a switch. It is an amazing and powerful medication. The food restrictions are way overblown.
> Good Luck,
> Jedi
>
>
Posted by Phillipa on February 15, 2010, at 21:25:00
In reply to Re: Opioids for Depression » jedi, posted by Cherry Carver on February 15, 2010, at 20:29:19
Cherry seriously I know no one that abuses benzos for pleasure just feeling normal. Love Phillipa
Posted by Cherry Carver on February 16, 2010, at 9:48:56
In reply to Re: Opioids for Depression » Cherry Carver, posted by Phillipa on February 15, 2010, at 21:25:00
Phillipa, please check out these sites, from the USA and UK respectively:
http://www.deadiversion.usdoj.gov/drugs_concern/benzo_1.htm
http://www.ixion.demon.co.uk/benzodiazepines.htm
> Cherry seriously I know no one that abuses benzos for pleasure just feeling normal. Love Phillipa
Posted by Phillipa on February 16, 2010, at 20:52:27
In reply to Re: Opioids for Depression » Phillipa, posted by Cherry Carver on February 16, 2010, at 9:48:56
Some might but not those using for simple relief of anxiety. 40 years later on the lowest doses ever. And not raising them. The pooped out. Phillipa
Posted by Cherry Carver on February 17, 2010, at 6:35:03
In reply to Re: Opioids for Depression » Cherry Carver, posted by Phillipa on February 16, 2010, at 20:52:27
*LOL* Tell me about it...I'm on 2 mgs of K and tomorrow I have to see a shrink so he can keep my sanity going. I'm praying he won't try to change what works for me. Love, Cherry
> Some might but not those using for simple relief of anxiety. 40 years later on the lowest doses ever. And not raising them. The pooped out. Phillipa
Posted by slw2 on February 17, 2010, at 10:59:55
In reply to Re: Opioids for Depression » Phillipa, posted by Cherry Carver on February 17, 2010, at 6:35:03
i'm new -- i posted over in alternative's because i thought opiates for mental issues would be alternative.
should i post here too? it was long, i hate eat space like that.
opiates are the only thing that worked for my son -- he's like a completely normal person on them. without them, he can't function because of the depression & anxiety -- none of the meds he's taken have really helped get to the core problem.
he developed an addiction and is now on suboxone -- it's great for the cravings & withdrawels. some days it even helps the depression/anxiety, but some days it doesn't.
his psychiatrist won't even discuss opiates as an option with him.
does anyone actually treat with opiates?
i'm still reading through the above posts -- so forgive me if the info is there.addiction scares me -- but i also don't want to automatically eliminate what might be his best hope of a normal life because of moral issues and other peoples opinions.
Posted by emmanuel98 on February 17, 2010, at 19:02:18
In reply to Re: Opioids for Depression, posted by slw2 on February 17, 2010, at 10:59:55
I never heard of anyone actually treating with opiates. The FDA monitors docs, the drugs are addictive and you build tolerance fast. They work for depression though.
>
> does anyone actually treat with opiates?
> i'm still reading through the above posts -- so forgive me if the info is there.
>
> addiction scares me -- but i also don't want to automatically eliminate what might be his best hope of a normal life because of moral issues and other peoples opinions.
Posted by Cherry Carver on February 17, 2010, at 19:22:19
In reply to Re: Opioids for Depression, posted by slw2 on February 17, 2010, at 10:59:55
What I'm going to say may sound controversial, but I think the concept of "addiction" is becoming really overblown. It is, after all, a multi-million dollar industry.
Everybody here who takes ADs is addicted to their medication. We have no other choice, and if we stop taking these meds, most of us will suffer lengthy, nightmarish withdrawal and then return to the miserable way we were before we were medicated.
My heart goes out to you and your son. Opiates obviously do help alleviate depression. The fact that no doctor will prescribe them (in the USA at least; I am not familiar with international law) is because of unbelievably stringent DEA regulations. This is a country where some doctors deny morphine to terminal cancer patients because they fear the patients will become addicted!!!
Needless to say, I think the law ought to be changed where psychiatric disorders are concerned. Opiates work as well as any of the garbage I've been on for severe panic. However, the US government seems more and more prone to offer medication with side effects as extreme as "death events."
So, I'm in full agreement with you. Opiates used to be prescribed for depression and anxiety, and I think they should be considered for that purpose again. I don't think their side effect of "addiction" should worry people any more than it does with medications like the one I'm taking.
> i'm new -- i posted over in alternative's because i thought opiates for mental issues would be alternative.
>
> should i post here too? it was long, i hate eat space like that.
>
> opiates are the only thing that worked for my son -- he's like a completely normal person on them. without them, he can't function because of the depression & anxiety -- none of the meds he's taken have really helped get to the core problem.
>
> he developed an addiction and is now on suboxone -- it's great for the cravings & withdrawels. some days it even helps the depression/anxiety, but some days it doesn't.
>
> his psychiatrist won't even discuss opiates as an option with him.
>
> does anyone actually treat with opiates?
> i'm still reading through the above posts -- so forgive me if the info is there.
>
> addiction scares me -- but i also don't want to automatically eliminate what might be his best hope of a normal life because of moral issues and other peoples opinions.
Posted by floatingbridge on February 17, 2010, at 20:03:59
In reply to Re: Opioids for Depression, posted by slw2 on February 17, 2010, at 10:59:55
Sales,
Welcome here, regardless of the awful situation that brings you here.
Low dose morphine treatment is approved for OCD. Your son's history of addiction may complicate this, I don't know.
What do the rehab psychiatrists have to say about his depression? Contrary to popular belief, and as you undoubtedly know, most addictions occur because
someone has been self-treating a real illness, albeit an often undiagnosised. I'm wondering if his pdoc is onboard with treatment resistant depression in recovering addicts--they must have urgent special needs as a population.If you think you can get a better pdoc for
your son, maybe that might help.In your list of meds, has your son tried MAOI inhibitors. Nardil helps many with the symptoms you describe. There are other. MAOI'S as well. Therapy may not be effective until his symptoms are under control and he's feeling more comfortable.
Google morphine +OCD.
Disclaimer: I'm only a person with depression, with no authority to offer anything but personal advice and support.
Good luck to you! Be strong!
fb
Posted by Phillipa on February 17, 2010, at 20:16:39
In reply to Re: Opioids for Depression » slw2, posted by floatingbridge on February 17, 2010, at 20:03:59
FB no your're not the only one!!!! Serious about morphine? Never heard that before. But opiods also work for me. Love Phillipa
Posted by slw2 on February 18, 2010, at 7:17:29
In reply to Re: Opioids for Depression » floatingbridge, posted by Phillipa on February 17, 2010, at 20:16:39
thanks for the replies -- maybe i said something wrong, i don't think he has OCD.
his problems started with social anxiety -- and always seem to go back to that at the core.
he also has general anxiety, depression, sleep issues, and while not bipolar or schizophrenic, he has had 3 psychotic breaks that involve paranoia & delusions -- which are always about people, so it's still like social anxiety taken to the extreme.
he saw his regular psychiatrist yesterday, when we tried to talk about the opiate use last month, he kind of brushed it off & said don't do that. but our son had already gotten to the point that he was dependent on them -- cravings, mild withdrawels, that kind of thing. when my son told him yesterday what was going on, he got a real funny look on his face as he was writing things down -- and i spoke up and told him that while he still has bad days, at least he comes out of his room & talks now instead of isolating completely. he seemed a little better then, but you can never tell what these guys are really thinking.
the addiction psychiatrist (he also treats anxiety, depression, ADHD, etc) he will see again on friday. he's open to treating him for depression with the suboxone if it works out well. i don't sit in on these appts, and the guy talked to him for an hour and a half the first visit -- his regular pdoc has never spent more than 15 minutes at a time with him. my son said that the new dr said he understood why people wouldn't want to give opiates up if they are the only thing that ever made them feel normal. i'm not saying the original doc isn't a good dr, he's great about fitting us in or calling back in an emergency -- and listening to what we'd like to try -- good about everything until we got to this point. i'm not even saying he doesn't have a point.
my son has been on various AD's, benzo's, anti-psychotics, adderall, over the past several years -- they were miracles when he had a psychotic break although they did turn him pretty much into a zombie. but nothing else really did much at all for him -- maybe take the edge off a little, but no real relief.
it's only been a month on the suboxone, so who knows if this one will be the answer, but i'm hoping.
Posted by Phillipa on February 18, 2010, at 19:55:53
In reply to Re: Opioids for Depression, posted by slw2 on February 18, 2010, at 7:17:29
No you didn't say anything wrong at all. OCD is an anxiety based disorder also. But I know someone who is on the subtonex and it really works takes time and may have to increase doseage in the beginning according to the person. Phillipa
Posted by europerep on February 20, 2010, at 15:40:59
In reply to Re: Opioids for Depression » europerep, posted by jedi on February 15, 2010, at 2:22:49
hey jedi,
sorry for replying late, but thanks for the info..
I did look into atypical depression before, and I do not think that it is what I have.. my mood reactivity only works in the negative direction, i.e. if something bad happens, i feel worse, but it is not the other way around.. plus, of the additional symptoms, I only have an increased desire for sleep, but this is a very common depressive symptom in general, I think.. and while I do have an sensitivity to interpersonal rejection, I do not have any of the things included in the brackets, fits of rage etc..I might have to try phenelzine nonetheless though, since it is one of the two irreversible MAOIs available here..
But as for the opioids, I do know that there are people who have profited from them in the long term, not only through the scientific publications, but I did send a few emails to psychiatrists at different universities, and they did (cautiously) confirm it to me - unfortunately none of them is, geographically speaking, accessible to me.. but I think I will give buprenorphine a try (with the small amount I have), and after that, I will see.. it might be wiser to employ a big gun (MAOIs) before the biggest gun, but I am really desperate, i.e. I think my depression-over-time-curve has never been lower, and I can't go on like this, let alone drop medication, spend two weeks completely without 'em, to then maybe achieve an improvement.. you know?
and as for the food restrictions.. well, it is not like I do not know what to choose, life without depression or life without cheese, but I fear that it is going to even further curtail the way I am living - I do already now have to do all kinds of adaptations to my life that do irritate me - drinking no alcohol, i.e. avoiding 99% of "social gatherings" at night, going to bed early because I need so much sleep, doing this, not doing that, and I don't want even more of it.. it's stupid, I know, but...anyway, it's nice to know that MAOIs do help people tho, doctors here are very hesitating when it comes to prescribing them..
> europerep,
> Opioids do make my depression feel better in the short term. I have seen no long term success from anybody in this thread. If your depression is atypical with social anxiety disorder may I suggest Nardil with a long acting benzo. I use clonazepam. This is the only thing that has worked for me out of 45+ different combinations of antidepressants.
>
> Atypical Depression is defined as:
> A. Mood reactivity (i.e., mood brightens in response to actual or potential positive events)
> B. At least two of the following:
> 1. Significant weight gain or increase in appetite ("comfort eating")
> 2. Hypersomnia (sleeping too much, as opposed to the insomnia present in melancholic depression)
> 3. Leaden paralysis (i.e., heavy, leaden feelings in arms or legs)
> 4. Long-standing pattern of sensitivity to interpersonal rejection (not limited to episodes of mood disturbance; fits of rage, hysteria, aggression and irrational reactions) that results in significant social or occupational impairment.
> Atypical depression is actually the most common type of depression. When Nardil works, it can be like flipping a switch. It is an amazing and powerful medication. The food restrictions are way overblown.
> Good Luck,
> Jedi
>
>
>
>
>
> > I do know that I have only had a fraction of the medication available against depression, but the point is that, since the end of childhood (around 10yrs) I have either been anxious or, for the last eight years, depressed, and so much so that it has basically precluded any actual social life, let alone for once finding a girlfriend, etc.. and this is not because I'm somehow not capable of it, but because my depression is just f##king up my life.. and I have done psychotherapy etc., and it was good, but, there are limits to it, you know? I do not have time for trying another tricyclic, or another SSRI, etc.. I know that, trying opioids now, is kind of like, instead of following the regular road, I'll take a shortcut through a mine field, but I WILL be cautious.. and if the road is leading to that very minefield anyway, then I might as well skip the rest of the road.. hmm, I like metaphores ;)..
> >
> > yeah, that's my situation right now.. and, to make things "worse" (or better, depends on the POV), I do have a small quantity of buprenorphine at hand (10 x 0.4mg), so that way I could check whether it does me good, or not.. and I guess I'll do so soon, but I'm scared of both if it doesn't help me, and if it does but I won't find a MD who accepts this treatment.. hmmm...
> >
> > well, thanks for reading anyway :)..
> > you take care too.. cu
>
>
Posted by Phillipa on February 26, 2010, at 19:57:29
In reply to Re: Opioids for Depression » jedi, posted by europerep on February 20, 2010, at 15:40:59
I don't understand why this was redirected to alternative as just this week my pdoc throught tramadol would be great for both back pain and anxiety? Phillipa
Posted by jedi on February 26, 2010, at 20:03:43
In reply to Re: Opioids for Depression, posted by Phillipa on February 26, 2010, at 19:57:29
> I don't understand why this was redirected to alternative as just this week my pdoc throught tramadol would be great for both back pain and anxiety? Phillipa
Hi Phillipa, I'm still reading the thread in medication. Where did you see a redirection?
Jedi
Posted by Phillipa on February 26, 2010, at 21:42:45
In reply to Re: Opioids for Depression » Phillipa, posted by jedi on February 26, 2010, at 20:03:43
Jedi I got a redirect to alternative could have been a clitch as it's not alternative? Hope it's still on meds. Love Phillipa
Posted by CrAzYmEd on March 3, 2010, at 9:41:18
In reply to Re: Opioids for Depression » jedi, posted by Phillipa on February 26, 2010, at 21:42:45
NMDA antagonists have been shown in many studies to inhibit tolerance to opiates.
In combination with memantine opiates may be a long term and effective solution.
This is the end of the thread.
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