Posted by Elizabeth on April 5, 2001, at 20:55:50
In reply to Re: ML Opiates and Treatment resistant Psychiatrists » Elizabeth, posted by ShelliR on April 5, 2001, at 12:34:52
> Thanks Elizabeth for the information. I just went to a new pdoc yesterday and he approved my small amount to hydrocodeine (about 3.75mg per day). He says, however, he cannot prescribe it for me because you can not prescribe it for depression. Right now I am getting it from my gyn for premenstral pain.
Hi. I think you probably mean either hydrocodone or dihydrocodeine, right? If your doctor is licensed in the U.S., I'm a little confused by his claim that he can't prescribe it for depression. He might not want to because it's an unusual use, but I don't know of any legal reason why he couldn't if he wanted to.
> When I read what you wrote I wondered if I should be talking about buprenorphine or some other form of opiate with my doctor. However, I don't believe he is much of a specialist in this and I am so grateful to find a pdoc who can accept that I take this, that I don't know if I want to push it any further.
I know, I sort of feel the same way, like I don't have a right to ask my doctor about alternatives to buprenorphine because he is already doing me a favour by prescribing that. This isn't true, of course -- we should feel like we can speak to our doctors freely, right? -- but it still feels awkward. (Personally I think the government shouldn't interfere so much with doctors' ability to make medical decisions.)
> Perhaps along the line it ought to be a neurologist I consult with? It seems the main reason you suggest not using codeine because of the higher risk of addiction which I have not experienced yet, after three years, but of course I cannot rule it out in the future. shelli
A neurologist won't treat depression (except maybe if it's related to a problem, such as epilepsy or stroke, that the neurologist is already treating), and almost certainly won't be willing to use unconventional treatments. The ideal person to see would be a pdoc who has experience with opiates (using them to treat patients, that is!). The only other thing I can think of would be maybe a pain specialist, since they tend to have more experience prescribing opiates than psychiatrists do.
I really don't think using opiates is the best way to treat depression at all, if you can find anything else that works, but I've tried all the standard things and then some and there just doesn't seem to be any alternative (except ECT, but I very much prefer to avoid that).
poster:Elizabeth
thread:57821
URL: http://www.dr-bob.org/babble/20010403/msgs/58855.html