Posted by Elizabeth on February 1, 2002, at 15:47:02
In reply to Re: opioids » Elizabeth, posted by christophrejmc on January 31, 2002, at 1:14:13
> Fentanyl sounds great, but I'm not sure if my doctor will be able to continue prescribing it (he's not my doctor, but he's willing to let me try an opioid for my depression) -- the withdrawl would not be fun.
This is one point in favor of seeing if buprenorphine works before you start considering that full agonists: withdrawal symptoms from stopping buprenorphine are very mild.
OTOH, you don't have to take an opioid that long to find out if it works -- just long enough to figure out what dose you need.
Do you think you'd be able to get by taking an opioid on an as-needed basis, rather than continuously, and continuing with the Nardil? That might be better than taking the opioid full-time. I think there is some risk of tolerance to opioids for people taking them as ADs (although there definitely are people who don't become tolerant), and it's also a challenge to manage some of the side effects on a day-to-day basis.
> Nardil helps with some of my social phobia and it got me out of my most recent suicidal state. I still have problems with anhedonia, apathy, etc.
My residual symptoms are similar, and buprenorphine definitely helps a lot. Have you tried psychostimulants?
> > I think that self-administering buprenorphine by IM injection would be easier to do in your arm rather than your ass (although both are viable sites)! :-)
>
> By alternative routes, I meant sublingual and intranasal (I think you knew that and were making a joke, but I thought I'd make sure).The ass part was a joke. (Although it's true that buprenorphine would be absorbed by intramuscular injection in the butt, it probably wouldn't hurt much.)
But yes, there are problems with SL and IN administration. I have often thought it would be cool if buprenorphine were available in a metered-dose nasal inhaler (a la Stadol NS); that would make it very easy to take it that way. I gather that a problem with taking the injectable solution sublingually is that it isn't absorbed reliably, so it sometimes doesn't work as well as it's supposed to.
> Why don't you use the IM route, btw? What are the downsides?
I'm not sure how my pdoc would react if I asked if I could do this. I also think there might be problems with getting IM injections three times a day, every day (you could alternate which muscle you used, of course, but even then you'd be hitting the same site pretty often).
-elizabeth
poster:Elizabeth
thread:4588
URL: http://www.dr-bob.org/babble/20020131/msgs/92528.html