Posted by Elizabeth on May 12, 2001, at 20:36:43
In reply to Re: Whats... and Drug Seeking Behavior, posted by kazoo on May 12, 2001, at 0:13:38
> An "opiate" is any set of various SEDATIVE narcotics which dulls the senses and induces relaxation or torpor; inducing sleep or sedation; soporific; causing dullness or apathy; deadening.
You seem to be using a very outdated definition, perhaps one that was used before the opioid receptor was discovered. The effects you describe are more characteristic of barbiturates than of opiates.
"Opiate" is a term that refers to drugs that act as agonists at a particular receptor. Often it is used to include synthetic drugs, although technically I believe that only the active components of opium (morphine and codeine) are "opiates" ("opioids" is the more inclusive term).
Opioids are not simply "sedatives" or CNS depressants and have different effects on different people (just like any drug). They have both excitatory (increasing the rate of neuronal firing; CNS stimulant) and inhibitory (decreasing the rate of firing; CNS depressant) properties. Once again, they are defined by their chemical and pharmacological activity, not by their observed effects -- which, again, vary.
I have taken several drugs of the opioid agonist type, all of which were primarily activating rather than sedating. Sedation is not necessarily a bad characteristic for an antidepressant, in any case: most people find tricyclics such as amitriptyline, imipramine, and clomipramine sedating, but they have been recognised as effective antidepressants for more than 40 years (and yes, they do have CNS depressant activity). (Opioids, incidentally, were known to be effective ADs long before the tricyclics, amphetamines, or even barbiturates were discovered.)
"Narcotic" is mainly a legal term today and has (appropriately) been all but dropped from medicine.
> If you thought unconventionally, you may fool yourself into believeing that the soporific effect may "lessen" the doldrums of depression, but that's not a judicious or wise approach given the addictive nature of the opiate family.
It takes an addictive personality and addictive behaviour to produce addiction -- an addictive drug won't make an addict by itself.
> Over dinner the other night, I asked a psychiatrist from the Yale Psychiatric Clinic (YPI) whether he would prescribe an "opiate" to relieve depression. Without looking up, he said "No, that's ludicrous."
He should consult the literature, then, rather than speak without thinking.
> I've yet to encounter a doctor who does this, so you must be one of the lucky ones who has a doctor who does this sort of off-beat thing. How lucky can you get?
Lucky enough to live near a major medical centre where research into novel treatments is common?
> Opitates are not used for depression. To even think such a thing is an insult to the medical profession.
This is incorrect.
> I will tell you one other thing: if you do get optiates to treat your so-called depression, and then you're shut off, you will experience the REAL depression you faked to begin with to get them. So who's fooling whom here? Not me.
Oh jeez -- the conclusion that anybody who you disagree with isn't "really" depressed? *Please.* This is simply uncalled for.
I have been diagnosed with major depressive disorder (severe with melancholia) for more than 10 years, by multiple psychiatrists. (I do not "doctor shop," though I'm sure you'd love to make that accusation; I have moved several times during the last decade and every one of my pdocs has had access to my records and has consulted with the previous one.) I have responded to opioids after failing to respond fully to every class of conventional antidepressant as well as stimulants, anticonvulsants, lithium, etc. For the last two years I have taken a synthetic opioid partial agonist called buprenorphine which was recommended by a well respected physician-researcher at a Harvard-affiliated hospital whose credentials and experience are enough to permit him the opportunity to go against convention and whose intellect permits him to think outside the box. It really doesn't matter if you assume I am a drug addict who is just faking depression. You are a non-professional with no relevant formal education and an apparent political agenda, and you have demonstrated quite clearly that you are perfectly comfortable ignoring the facts of any situation if they are inconsistent with your prejudices.
-elizabeth
poster:Elizabeth
thread:61760
URL: http://www.dr-bob.org/babble/20010507/msgs/62668.html