Posted by sailor on January 11, 2004, at 14:03:07
In reply to Re: OPIATES IN TREATMENT FOR DEPRESSION, posted by JohnFromCalifornia on January 10, 2004, at 19:52:39
Jumping in here to hopefully keep this thread going. I have a 30 year history of major depression, treated with some success in earlier years (longest stretches were amitriptyline and later Desyrel). The general trend has been toward worsening of my condition, with less success with psychotropics. Much of my adult life I was "high functioning" (teaching, administration) but it was always a great effort) and my ability to enjoy things, or be normally relaxed or satisfied was tenuous and fleeting. I can see now that lots of pot smoking (none for the past ten years), compulsive socializing, and regular alcohol use, occasional abuse, have been attempts to compensate for my illness. I am not addictive--never suffered from cravings or withdrawal--and I don't even care about feeling "high". I just want and have always wanted to feel more like what I saw around me in most other people as more of a normal mood state. In the last 8 years or so I have been through most of the available first line meds. Most docs, per usual have pushed SSRI's--enough to the point where I am convinced serotonin is not my problem. Have also tried Wellbutrin 3 times with an interesting response: fairly rapid and dramatic response within a week, followed by rapid poopout within a few days, then (with continued and increased doseage) a crash to worse case of depression than when I started. A more recent trial of Strattera with Lamictal proved energizing with some improvement in focus and concentration but no mood elevation. Still stuck with anhedonia and a lack of motivation that's sometimes scary. I've never been hospitalized, nor suicidal, but if someone convinced me I'd be stuck in a depressed state and never get better, well, that's not a way I would want to live. I'm currently on a Parnate trial, at my insistence, since the psych. nurse I'm seeing thinks it's too dangerous with the hypertensive crisis risk attached. She obviously doesn't really understand depression. Hell, I can watch my diet as easily as riding a bicycle...what's the big deal for a chance at finding a drug that could make a big difference? Anyway I'm only at 40mg/day and I know that many responders have needed 100mg or more. After lots of research, and invaluable input from many psychobabblers, I'm currently hypothesizing a dopamine problem as the basis of my depression. As many of you know, dopamine has been dutifully neglected by drug companies and practitioners, largely because of the "abuse potential" of drugs that might address this problem. After all, cocaine, amphetamines, even cigarrettes, all produce dopamine surges in their abusive users. Amineptine (Survector) was a specific dopamine enhancer that was taken off the market for alleged abuse potential even though it was reportedly having dramatic success with lots of depressed users.
Unfortunately for we sufferers, strugglers and seekers, there's lots of politics to the development and marketing of psychotropics. So we must inform ourselves and sometimes assume responsibility for our own "treatment plans". This often means having to try to diplomatically influence the "experts" whom we have to hire for help and who hold the prescription pads. There are certainly some good ones out there...but not all of us can find them or afford them.
So thank you for all you posters who take the time, even in the midst of obvious distress, to ask your questions, to share your experiences and to encourage others.
I am by nature hopeful, even in the midst of my worst pillow-over -the-head stay in bed all day crash. It took me many years to understand and believe that many mental illnesses do have a chemical basis and ultimately a chemical resolution. Our ultimate strategy for now is patience and persistence. Psychobabble is unique in its ability to help us help ourselves. Regards, Sailor
poster:sailor
thread:299110
URL: http://www.dr-bob.org/babble/20040109/msgs/299451.html