Posted by Peter S. on September 23, 2008, at 11:58:58
In reply to Re: Buprenorphine experiences » Peter S., posted by kingcolon on September 23, 2008, at 1:26:26
Thanks for the detailed info! I'm going to see what I can do to get a prescription. Since I've tried EVERYTHING I think I've got a good case for it as a last resort.
> I have a history of a relatively low level opiate dependence from 8 years ago, but have not had a relapse to date. However, my addiction was directly related to poorly responsive depression, which has persisted despite many meds. My psychiatrist and psychologist are both addiction specialists and have experience using bupe for their patients, and they also see quite a few people with dual disorders (depression+substance use). They knew of a number of their patients who showed remarkable improvement of depression with bupe, and advised me of this. That's how I got started on it. I continued some of my previous meds, but I'm going to try to eventually get off as many of them as I can without losing the benefits of combining them with bupe. I tried stopping Zoloft, but I felt it increased my irritability, so that failed. I think bupe does a great deal that other antidepressants don't, but not everything--it's mechanism is mostly related to dopaminergic activation, but it also effects glutamate and serotonin, so it is quite complex. As for side effects--the main one is constipation, but I'm using Miralax + one of the dissolvable fiber supplements and that takes care of it quite well. It can be sedating at first, but you adapt to it if you don't start on too high a dose, or slowly adjust the dose. Taking too much initially can cause nausea (worse than standard opioids! people use to get high). It's definitely not a drug to try to get high on by overdosing or you're likely to get significantly ill. Otherwise, to date I've had no bad side effects. I do find that using Wellbutrin with it minimizes any fatigue I may get.
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> > Thanks for the response. What side effects have you experienced? Did you have any problems getting your doctor to prescribe it for depression? I'm wondering if I can get my HMO pdoc to go for it.
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> > Regards,
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> > Peter
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> > > Hi Peter,
> > > I split the dose in two or three times a day intervals. The studies on depression, as well as for pain, seem to use split doses even though for addiction maintenance, a single daily dose is generally used. I think the biologic half-life is very short in comparison to the pharmacologic half-life. I do notice some "slipping" of mood toward the end of the dosing interval (say 6-10 hrs). The antidepressant effects did not occur instantaneously with me (unlike what is reported by others)--it took about a week to max out. There were anxiolytic effects almost immediately however. The sense of well-being it gave as well as it's motivating and anti-anhedonic effects have been the best of any medication I've taken over 15 years.
> > > If others want to comment on their Sub experiences or add info on it, we should change the thread title since the original study was already referenced by undopaminergic.
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poster:Peter S.
thread:831927
URL: http://www.dr-bob.org/babble/20080915/msgs/853621.html