Posted by shelliR on June 7, 2001, at 11:43:54
In reply to Re: Codeine for Depression Treatment » shelliR, posted by Elizabeth on June 7, 2001, at 1:47:06
> I know of a few doctors who've used opioids with success. It might help if you pitched Ultram to them -- there's been a bit of work with it for depression, social phobia, and OCD. Anyway, as long as a doctor knows you're taking it and what dose you're taking, that's fine. Just don't start self-adjusting your dose or whatever.Can't take ultram unless I discontinue the nardil, seems like.
>
> Not from a pdoc. Buprenorphine makes them squeamish because it only comes in the injectible solution and even if you aren't injecting it, you need to use a syringe to take it.I am waiting to hear about a consultation at Johns Hopkins, since they have also done that small study on buprenorphine. I want to make sure opiates are a possibility or I don't think it's worth going for the consultation.
>
> > I think I am self-prescribing, rather than self-medicating, in a sense.
>
> Hence, taking the wrong dose of codeine.Well, I can take as much as I need to of codeine; it is easy to get over the internet, so I thought I try it.
> > But because opiates are so often addictive drugs, doctors other than pain management doctors have to be really careful.
>
> Pain management doctors too.I have a call in to a pain management dr. in Virginia who works narcotic protocol programs for pain. I talked to his nurse and am waiting to hear if he would accept me for depression. The other thing is how expensive he is, but since my needs are different, the nurse said he may also not charge me his usual. I am feeling pretty desperate, I talked to my pdoc this morning and he feels he can't help me and I need to find someone else. That in itself is not a great loss, but it is scary to be in the position that only someone both creative and with the willingness to take a risk can treat me. I have relied on nardil for so many years, it is so strange to be in this position.
>
> Wow. I didn't like the side effects of TCAs either, but they were nothing compared to opioids.
I'm talking about such severe disorientation that I couldn't hardly even dress myself. I've had no disorientation with hydrocodone.
> Careful, you're dating yourself. ;-)That's okay. I'm much smarter than I was twenty years ago and have a triving, creative business.
And I am very very afraid of losing that business if I can't control my depression. This last week has been really bad until I take hydrocodone and I don't have enough to take 1/2 pill twice a day, so I have been only taking it once.> I know how you feel. Due to bad past experiences, I have a certain distrust of pdocs (well, more a "trust but verify" mentality) that makes it hard for me to work with them. I always come in with a list of things I want to do, they always want to hear lots of history and stuff. I should just make a writeup.
I have a certain, I think healthy, mistrust of any doctor. A doctor is a person, not a god. I am really good at what I do, but I make mistakes sometimes. I don't exempt doctors from the same possibility. I do tend to find pdocs a bit more arrogant than other doctors. And I do come in with everything typed up--all past medications and results, so that I don't have to spend the whole session answering questions.
>
> > I had a pdoc for ten years who is considered the best in the city with treatment resistent depression. She would not even read any of the McLean studies on opiates.
> She wouldn't even *read* them? What kind of doctor is that?A doctor that you leave after ten years.
>
> > Over and over I heard definitively that codeine is not an anti-depressant. So although my preference would be collaboration with a pdoc, I'll take my chances with supervised self-medication.
>
> Codeine is a crappy opiate, not the one I would choose if I felt a full agonist were appropriate. How did you come to be switched to that from the hydro?I haven't switched; I am trying to build in safety valves since it is such a battle to get enough hydrocodone. I wanted to see if the other would work BEFORE I ran out of hydrocodone. So far I have access to only 10 pills per month.
I can get more hydrocodone with a consultation on the internet, but I would really like a real pdoc to work with me and support my treatment.
>Shelli
poster:shelliR
thread:64320
URL: http://www.dr-bob.org/babble/20010605/msgs/65654.html