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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Zonked on August 13, 2011, at 10:23:55
I know this has been brought up before, but let me share a little story. Whenever I've had pain bad enough to warrant an opiod prescription, my depression has instantly and completely disappeared. I also find them activating as opposed to sedating. I am afraid to bring this up with doc, but may have to. He seems open minded. Has anyone had long term success with this? I wish when I had money I could have doctor shopped to fine someone willing to try this, but when I was making money my meds were working. Do you guys think the really well off allow themselves to suffer? This is a shadow of a life. When I was in a mental health residence, there were a lot of addicts. The methadone or bupe they got indefinitely, for free, seemed to kill off any depression. It doesn't seem fair. Sometimes I wonder if former heroin addicts have it better. Anyway... I dream of a day with better agents. I am sticking with Nardil for awhile before I just say I am SICK of daily life being a challenge, give me something that works.
Posted by Christ_empowered on August 13, 2011, at 11:14:42
In reply to Buprenorphine: long term success?, posted by Zonked on August 13, 2011, at 10:23:55
I've always thought its ridiculous that former drug users sometimes get the best Rx drugs. Former meth addict--dexedrine. Coke head--Ritalin. Opiates--methadone or Temgesic.
Anyway, opiates are usually well-tolerated and they're (get this) pleasant, so it makes sense that you'd ask about them. From what I've read, the doses used in psychiatric conditions are lower than those used for pain management or drug dependence. Ask and see what your doctor says; all he can say is "(hell) No."
Good lcuk
Posted by floatingbridge on August 13, 2011, at 12:09:51
In reply to ask and see, posted by Christ_empowered on August 13, 2011, at 11:14:42
I would love to hear more on this.
I have had a similar response to opoids, but there is the escalation problem and cognitive effects that go with the opoid pain meds.
I think in my state, but am not sure, the script can only be written by an MD trained and then certified to dipense? (I could be very mistaken on this.)
Posted by SLS on August 13, 2011, at 12:20:00
In reply to Buprenorphine, posted by floatingbridge on August 13, 2011, at 12:09:51
> I would love to hear more on this.
>
> I have had a similar response to opoids, but there is the escalation problem and cognitive effects that go with the opoid pain meds.
>
> I think in my state, but am not sure, the script can only be written by an MD trained and then certified to dipense? (I could be very mistaken on this.)
>Any MD can prescribe it. However, they must be trained if they are to use it to treat opiate addiction. Strange.
- Scott
Posted by floatingbridge on August 13, 2011, at 13:07:13
In reply to Re: Buprenorphine » floatingbridge, posted by SLS on August 13, 2011, at 12:20:00
> > I would love to hear more on this.
> >
> > I have had a similar response to opoids, but there is the escalation problem and cognitive effects that go with the opoid pain meds.
> >
> > I think in my state, but am not sure, the script can only be written by an MD trained and then certified to dipense? (I could be very mistaken on this.)
> >
>
> Any MD can prescribe it. However, they must be trained if they are to use it to treat opiate addiction. Strange.
>
>
> - Scott
Scott, have you heard of any long term efficacy with it? Or use as an add-on? I am back on Xanax, but honestly, it doesn't do what it did. And I'm not increasing my overall benzo use. I am not comfortable with escalation scenarios. I used to think an mao inhibitor would decrese my benzo need, but think that was founded on wishful thinking.
Posted by floatingbridge on August 13, 2011, at 13:16:09
In reply to Buprenorphine: long term success?, posted by Zonked on August 13, 2011, at 10:23:55
http://www.psychiatrictimes.com/mdd/content/article/10168/1733207
Kappa?
(Is this the same doctor from Harvard that researched Emsam?)
Posted by Phillipa on August 13, 2011, at 13:33:02
In reply to Re: Buprenorphine: long term success?, posted by floatingbridge on August 13, 2011, at 13:16:09
Yes special training now required to dispense. Phillipa
Posted by SLS on August 13, 2011, at 13:37:25
In reply to Re: Buprenorphine, posted by floatingbridge on August 13, 2011, at 13:07:13
> > > I would love to hear more on this.
> > >
> > > I have had a similar response to opoids, but there is the escalation problem and cognitive effects that go with the opoid pain meds.
> > >
> > > I think in my state, but am not sure, the script can only be written by an MD trained and then certified to dipense? (I could be very mistaken on this.)
> > >
> >
> > Any MD can prescribe it. However, they must be trained if they are to use it to treat opiate addiction. Strange.
> >
> >
> > - Scott
>
>
> Scott, have you heard of any long term efficacy with it?
I don't recall anyone on Psycho-Babble attaining a stable remission of depression with buprenorphine. Some people do feel better while taking it, but I don't see these same people staying on it for very long. What can it hurt, though?Ever thought of mixing Nardil with Abilify?
- Scott
Posted by floatingbridge on August 13, 2011, at 13:49:26
In reply to Re: Buprenorphine » floatingbridge, posted by SLS on August 13, 2011, at 13:37:25
> > > > I would love to hear more on this.
> > > >
> > > > I have had a similar response to opoids, but there is the escalation problem and cognitive effects that go with the opoid pain meds.
> > > >
> > > > I think in my state, but am not sure, the script can only be written by an MD trained and then certified to dipense? (I could be very mistaken on this.)
> > > >
> > >
> > > Any MD can prescribe it. However, they must be trained if they are to use it to treat opiate addiction. Strange.
> > >
> > >
> > > - Scott
> >
> >
> > Scott, have you heard of any long term efficacy with it?
>
>
> I don't recall anyone on Psycho-Babble attaining a stable remission of depression with buprenorphine. Some people do feel better while taking it, but I don't see these same people
staying on it for very long. What can it hurt, though?
>
> Ever thought of mixing Nardil with Abilify?
>
>
> - ScottI have thought of Nardil quite a bit. I wish I had just gone ahead and started it with new doctor, but I can understand both of our hesitancies. Abilify I wasn't able to tolerate. Right now I am committed to Emsam and risperdone for the next three weeks at least.
Since undergoing that withdrawal episode, both Emsam and Xanax at slightly higher doses have not been working as well as before.....
Right now I am reading about sulpride (sp?).
I haven't really heard of anyone sticking with bupe here either....
Posted by zonked on August 13, 2011, at 13:58:52
In reply to ask and see, posted by Christ_empowered on August 13, 2011, at 11:14:42
> Anyway, opiates are usually well-tolerated and they're (get this) pleasant, so it makes sense that you'd ask about them. From what I've read, the doses used in psychiatric conditions are lower than those used for pain management or drug dependence. Ask and see what your doctor says; all he can say is "(hell) No."
>
> Good lcukCE,
Thanks. You've reminded me of a technique I use sometimes to get past terribly anxiety-provoking situations like this: "What's the worst that could happen?"
Like most things that appear in self help books or out of therapists' mouths, it never helps completely. But it does help.
Posted by zonked on August 13, 2011, at 14:34:59
In reply to Re: Buprenorphine » floatingbridge, posted by SLS on August 13, 2011, at 13:37:25
> Ever thought of mixing Nardil with Abilify?
>
>
> - ScottI have. You were on Abilify awhile, right? Ever get anything resembling TD, akathisia or the other antipsychotic uh-ohs with it?
That's the only reason I haven't tried it - that it belongs to that class and some horror stories I've heard from people I've met, and read on the net. I have never seen you complain about Abilify.
Do let me know. I desperately need a boost.
Waiting for the blip return, ( :-) )
-z
Posted by floatingbridge on August 13, 2011, at 14:56:52
In reply to Re: Buprenorphine » SLS, posted by zonked on August 13, 2011, at 14:34:59
Zonked, I was on it, and did get the akathisia, but it was brightening and activating at low does, so maybe you will not have that same adverse reaction. It seems well tolerated, generally, weight gain only reallynat upper dose.
I know you were talking to Scott. :J
Above symptom remitted for me immediately upon reduction and then full taper.
>
> > Ever thought of mixing Nardil with Abilify?
> >
> >
> > - Scott
>
> I have. You were on Abilify awhile, right? Ever get anything resembling TD, akathisia or the other antipsychotic uh-ohs with it?
>
> That's the only reason I haven't tried it - that it belongs to that class and some horror stories I've heard from people I've met, and read on the net. I have never seen you complain about Abilify.
>
> Do let me know. I desperately need a boost.
>
> Waiting for the blip return, ( :-) )
>
> -z
>
Posted by emmanuel98 on August 13, 2011, at 20:09:45
In reply to Buprenorphine, posted by floatingbridge on August 13, 2011, at 12:09:51
Docs need a special license to prescribe suboxone. Few have it. The FDA has a list of providers easily found by googling. Most suboxone providers will not take insurance and charge ridiculous fees -- $400 to $500 per visit. Demand far outstrips supply and it has made the suboxone industry into a money-grubbing mess. Also, suboxone (or buprenorphine, the opiate component of the drug) is an opiate and you build tolerance and need more and more to acheive the same sense of well-being. I considered this, as a former opiate addict with severe depression once I stopped. You are not likely to get a scrip unless you are in a hospital with providers or can find a provider privately whom you can afford to see. Most private providers will not prescribe unless you are currently addicted to opiates.
Posted by emmanuel98 on August 13, 2011, at 20:14:48
In reply to Re: Buprenorphine » floatingbridge, posted by SLS on August 13, 2011, at 12:20:00
> Any MD can prescribe it. However, they must be trained if they are to use it to treat opiate addiction. Strange.
>
>
Is this true? It wasn't when I took it 4-1/2 years ago to taper from opiates. At that time you needed a special FDA number to prescribe. Also, at that time, prescribers could have only 30 patients at a time. I know that rule has been relaxed.
Posted by Christ_empowered on August 13, 2011, at 20:34:08
In reply to Re: Buprenorphine, posted by emmanuel98 on August 13, 2011, at 20:14:48
yeah, sorry to give "feel the fear and do it anyway" type advice, but its all I've got for you. I guess you could be labeled a drug-seeker, but then again, voluntarily going to a shrink is in and of itself drug seeking behavior.
I hope you get the Rx. I imagine opiates would be safer than MAOIs and decidedly more pleasant.
Posted by Phillipa on August 13, 2011, at 21:12:49
In reply to Re: Buprenorphine, posted by Christ_empowered on August 13, 2011, at 20:34:08
A poster that regularily posted for years on babble first broke her back hypotension on nardil got addicted to opiods and last we talked was now seeing addiction specialist who gave her bupe and she was now addicted to that and providgil. Phillipa ps was also back on an SSRI I think zoloft
Posted by SLS on August 13, 2011, at 22:37:28
In reply to Re: Buprenorphine, posted by emmanuel98 on August 13, 2011, at 20:14:48
Hi.
See what you can glean from this webpage:
http://www.buppractice.com/howto/comply/prescription
- Scott
Posted by bleauberry on August 14, 2011, at 9:13:53
In reply to Buprenorphine: long term success?, posted by Zonked on August 13, 2011, at 10:23:55
I agree with SLS in that I do not recall anyone having a stable longterm improvement with any of the opioid choices. Short term for sure, great stuff for some people including me. I tell you what, last year I came home from outpatient surgery with a bottle of vicadin, didn't even take as much as the minimum amounts suggested, and yet depression was gone, life was back, and I felt 20 years younger. It was not euphoria. It was not a "fake" feeling. It was a bona fide very real feeling of normalcy, remission. And it happened in less than a day! No 6 week wait.
Woud that continue if I kept taking it? I seriously doubt it. I use it as an emergency med for really unusually bad days.
Here's another weird thing about it with me. Vicadin has a very short half life. Sometimes a dose I take is so small I can't even hardly feel it. And even if I did, it is wearing off in 3 hours. But, the next day is a good day. Very strange. It somehow does something today, in a short time, that makes me feel better tomorrow after it is gone. So weird.
Anyway, there is a bright side to your experience. That is, your dealings when pain have produced a happy accident....you now know what circuits are involved in your mood problems....the opioid circuits, which indirectly ties into dopamine and the others, with the opioids leading the way. That's a great clue....it pretty much rules out almost anything a pdoc would commonly prescribe and saves a lifetime of wasted med trials.
So how can we target the opioid system without taking opioid meds?
Rhodiola rosea. D-Phenylalanine. N-acetyl-cysteine. LDN (low dose naltrexone). Maybe DL-Phenylalanine if you don't mind the extra noradrenaline component in it. Maybe just a dash of 5htp along with the other stuff (by a dash I'm talking 5mg-25mg). Regular heavy exercise or dance. Acupuncture. All of the above are going to work directly on the opioid circuits, with some side benefits to the other circuits. NAC is not directly a neurotransmitter substance, but what it does is mop up crap that might be competing with your own neurotransmitters for receptor sites. Crap equals metals, plastics, toxins from microbes, herbicides, pesticides, toxins from inappropriate metabolism of foods....it cleans stuff out. Actually it does a ton of stuff, enough to write a book. it can directly help mood, sleep, energy, brain fog.
So anyway there ya go. Some opioid stuff to work on and experiment with before embarking on a slippery slope of opioid meds. Hopefully you won't need those. The supps I mentioned are more potent at what they do than people realize. They just don't get the advertising or marketing the meds get, so we don't hear about them as much. A pharmaceutical rep won't be pushing them on you, by I will, because I happen to feel they are at least as good and not uncommonly better than whatever the pharm rep has to offer.
Back to vicadin. Here's my theory on why it works for me. Toxins of many kinds, including those of lyme organisms, have a high affinity for opioid receptors. Therefore my own natural opioids have competition and are being partly or mostly blocked out of the receptors where they are intended to dock. I have also had lab tests showing high mercury, lead, and cadmium, which also do the same blockage. Well, I think vicadin has a stronger affinity for the receptors than do all those toxins....so it competitively displaces them and let's the receptors work the way they are supposed to....and thus feeling better even then next day....the toxins haven't had enough time yet to sneak back in after being locked out.
Posted by sigismund on August 15, 2011, at 4:35:10
In reply to Re: Buprenorphine: long term success?, posted by bleauberry on August 14, 2011, at 9:13:53
>Rhodiola rosea.
I really like rhodiola.
But for me it is too long lasting to not mess up my already fragile sleep.
This is the end of the thread.
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