Posted by Elizabeth on April 4, 2002, at 19:58:55
In reply to Buprenorphine, Kappa Antagonism and Depression, posted by cisco on March 31, 2002, at 21:15:24
Cisco says:
> The answer was here all along....The answer to what?
> "The mu receptor is most commonly associated with euphoria and pain relief. The kappa receptor is most commonly associated with sedation (nodding often seen in Heroin addicts).
These aren't the only effects mediated by these two receptor subtypes, but I do find buprenorphine very activating, more so than morphine, hydrocodone, or fentanyl (although I've never experienced "the nod" on any opioid). I've also heard that butorphanol (Stadol), a kappa-agonist analgesic, makes a lot of people feel crappy.
> Underproduction or over-removal (severe re-uptake) of these endogenous opioids can be the cause of many psychiatric disorders ranging from Bipolar Personality disorders to major depressive disorders that often times manifest themselves in severe drug abuse.
"Bipolar Personality disorders?"
Dare I ask who wrote this?
> Unbeknownst to them, these patients use Opioid medications either illicit or pharmaceutical because they are compelled to attempt to replace the endorphins, dynorphins, and enkephalins (endogenous opioids) that naturally occur in their systems at insufficient levels.
I think plenty of them are aware of it.
> When taking these patients into account, a better term than the word "addict" or DDP (drug dependent person) would be opiate receptor deficient (ORD)
It's probably more complicated than that (just like people who respond to Prozac weren't necessarily depressed because of "low serotonin levels"). But yeah, although I've never been addicted to anything, several pdocs have suggested that I might be "endogenous opioid-deficient."
> Perhaps 'Kappa Antagonism' is more than just an "Absence of effect" at the Kappa receptors....
Of course it is; buprenorphine blocks the effects of endogenous kappa agonists. I think that Goodman & Gilman has a table listing some of the effects of the different opioid receptor subtypes, but I'm not sure where my copy went.
John says:
> Is this medicine habit forming?That probably depends what you mean by "habit forming." But most likely, no it isn't. (A partial agonist is a drug that activates a receptor but doesn't cause the maximum effect at that receptor.)
And Jay says:
> I really think a combo of high dose Effexor and Buprenorphine could be an excellent choice, maybe even with some Welbutrin added in.Funny you should say that. I take Effexor and buprenorphine, and I'm doing better than I have in years. (Not interested in trying Wellbutrin again; I found that stuff pretty miserable.)
-elizabeth
poster:Elizabeth
thread:101178
URL: http://www.dr-bob.org/babble/20020402/msgs/101854.html