Posted by A0102 on March 21, 2002, at 7:59:54
Hi everyone...
I am getting more and more interested in the use of opioids for TRD. After around 7 years of being depressed, I'm starting to feel like it's about time I find something that works sooner rather than later. I'm taking 60mg/day of Nardil along with 400mg/day Provigil currently. About the only real difference I can see with this is that my "good" days are a little better, however my bad days are are just as bad and no less frequent. I've been on Provigil for quite a while now and Nardil for about the past month. I've had my fair share of SSRIs (3 of them), TCAs (3 of them also), Remeron, Wellbutrin, Effexor, and now Nardil. For the first week or so, SSRIs make me feel great. No sleep, nearly photographic memory, infinte energy, and a little getting myself into trouble. Just from that I would conclude that I'm bipolar III. Pretty soon, though, they all leave me feeling tired and emotionally numb. TCAs just make me feel like crap in general, even at tiny doses. The most prominent effects I get are a feeling of being dumb, dry eyes, body aches, and a feeling of being half awake when I want to be awake and when I'm trying to sleep as well. The other antidepressants are a mixture of irritating side effects and a lack of effectiveness. Of course I've tried several combinations of the various meds I've taken, but to no avail.
The only time in my life that a medication actually felt like it helped me deal with depression effectively was when I was on a steady diet of hydrocodone for pain after a girl going in the wrong direction on the road gave her best shot (successfully, I might add) at totaling my car. I did not experience a *total* remission with hydrocodone, but I was much more able to deal with life in general. I never took larger-than-prescribed quantities of it or attempted to increase the dose over the entire time I was on it (about 6 months). I found that depression-wise it maintained its effectiveness and, contrary to most people's experience, boosted my energy. I did not suffer the dumbing effects that are caused by a lot of ADs, in fact my grades actually improved during that time. I also have IBS (digestive problem where my stomach releases too much acid and I occassionaly get a pins n needles/hurts like feeling). Hydrocodone also solved that problem, but that's not too surprising seeing as how opiods like Paragoric and Lomotil are used to treat similar conditions.
On my last visit to a pdoc, I asked if he had a plan from here since I'd already been through 10 ADs without much luck. He actually mentioned opioid therapy. My concern with this is that since it does seem to be such a miracle med for me, is that just begging for an addiction? Then again, who would want to give up an effective treatment? Would someone in remission brought by Prozac want to give that up? Also, I think it would be quite a waste to simply disregard the one medication that has helped over the years because of social stigma or the risks of mismanagent.
I would love to hear from the few of you who have experience with this. I am interested to know how long anyone has been on a similar treatment and what measures pdocs take to handle these concerns as well as protect their own backsides.
Jeez! I think this one's long enough for now. Anyway, looking forward to your responses...
Adam
poster:A0102
thread:99196
URL: http://www.dr-bob.org/babble/20020318/msgs/99196.html