Posted by Elizabeth on July 29, 2001, at 14:29:23
In reply to Re: Ultram withdrawal! » Elizabeth, posted by MB on July 28, 2001, at 12:45:03
> I always felt Ultram sedation had a tinge of "serotonergic" stimulation to it
I understand what you mean; that's a fairly common effect of SSRIs. Ultram is a monoamine reuptake inhibitor (though a very weak one).
> The sedation didn't seem to hit until I took large doses (5-6 pills), and the onset was delayed quite a bit...maybe 90 minutes or so.
Ultram generally takes a long time to start working; I think it may be well suited to chronic pain, but for short-term pain a faster-acting medication is called for.
I've *never* found a dose of any opioid that's sedating for me. (OK, so I haven't looked too hard. < g > I have tried varying doses of buprenorphine, Ultram, morphine, codeine, and hydrocodone, tho'.)
> I thought Ultram was a weird drug.
Yeah, it is kind of quirky. I think I mentioned that it didn't feel like an antidepressant for me at all, at least not within the accepted dose range (whereas all the other opioids I've ever taken have had noticeable antidepressant effects on me).
> I took it once in an attempt to feed a small Vicodin habit (couldn't get vicodin) and it felt like it precipitated a withdrawal (although it might have just *been* withdrawal that the Ultram was too weak to block...I don't know).
It's not a mixed agonist-antagonist, AFAIK.
> > It sure is. (although I wish the stuff at least came in a pill)
>
> Do you know why it's not active orally? Would taking it with a betacarboline render it orally active (by inhibiting MAO)?No, its metabolic pathways are different. It's not a monoamine. Most of the times I've been taking buprenorphine, I've been using it with a MAOI, in fact. I did try taking it SL and it didn't do much, if anything -- probably because I swallowed most of it! It just has very poor bioavailability when taken orally. Morphine is like that too: the ratio of oral to IM doses of morphine is very high compared with, say, oxycodone. Not so long ago, the general belief in the medical professions was that morphine was completely inactive.
So anyway, My guess would be that by taking a high enough dose of buprenorphine, you could use it orally.
> > I've actually encountered people who've used it for addiction who said it gets them through a full day without cravings.
>
> Maybe blocking craving is different than alleviating the physical symptoms of withdrawal?Maybe. Craving is an aspect of what is sometimes described as "protracted withdrawal" -- the immediate discontinuation syndrome (diarrhea, hot and cold flashes, gooseflesh, etc. -- you know, "the flu") is over, but the individual still feels compelled to seek out the drug. (This is how "addiction" can be distinguished from simple pharmacologic dependence, BTW.)
> Maybe therein lies the descrepency between my isolated experience and the report of others: I was medicating physical withdrawal, and they were medicating post-acute withdrawal cravings??? Or maybe It's just because I'm a freak < g >?
That's possible. :-)
> Well, from the way you described melencholia, as being marked by anhedonia, it seemed contrary to my experience of withdrawal which is marked by an almost satisfying sadness...one of those odd sadnesses where it almost feels "good" to revel in the heartache...like where you can't stop crying because you're in love, or something crazy like that.
My observation has been that, in addition to the sad, weepy feelings you describe, people in acute opioid withdrawal become hypersensitive: they can't stand noise, light, cold, etc. (That's based on a very small sample set, however: in my life, I've witnessed opioid withdrawal perhaps five times, no more, and I hope never to have to experience it myself!) So in that sense, it's the opposite of what my depression is like (predominantly flat or blunted affect). Melancholic depression does share ome common features with protracted withdrawal, though, such as difficulty experiencing pleasure.
> Probably. I think ascetic practices (and the abberations in brain chemistry they induce) are probably another source of ancient stories of mystical experience. Then there is the possibility that hallucinogenic plants were involved. The greatest concentrations of witch burnings in medieval Europe seem to coincide with the regions in which ergot fungus flourished. This would explain not only bizzare behavior on the part of those accused of being witches, but reports (hallucinations?) of certain people being "seen with the Devil."
That's very possible, although as far as I'm aware, the indoleamine hallucinogens don't cause hypnagogic phenomena.
-elizabeth
poster:Elizabeth
thread:70206
URL: http://www.dr-bob.org/babble/20010725/msgs/72378.html