Posted by ed_uk2010 on January 10, 2011, at 12:22:19
In reply to Re: Tramadol for TRD, posted by roscopeeco on January 9, 2011, at 18:36:53
Hi there,
>We are talking about TRD. Who cares about dependence.
Unfortunately, opioid dependence is frequently associated with tolerance. Dependence is also relevant to any case where withdrawal is clinically necessary, for example if adverse effects become problematic. Of course, withdrawal issues are by no means specific to buprenorphine.
>I don't get some people on this board. If the alternative therapy, that could actually help some, is "outside of the box" it is shot down just because of the qualities of dependence and addiction. Scare tactics aren't needed for people in search of freedom from a life of depression.
I don't recall any involvement with scare tactics :) I was simply responding to a couple of your statements, in particular that 'depression suffers never have to go up' on the dose, which is not an entirely reasonable thing to say. You would need a lot of supporting clinical evidence to make that claim. I have only known one person (well) on this board who took buprenorphine for depression. He did obtain benefit from it for a while. Sadly, the benefit was not sustained and his life ended in suicide. Please bear in mind that I am not a newbie, I have been posting on this board for many years.
>The correct dosing in depression is under 2mg.
I think it's difficult to say at present what the dosage should be, or what proportion of patients will experience a sustained response. It's still an experimental treatment - cautious flexibility is required on the part of the prescriber.
>and not everyone becomes addicted nor has significant withdrawal symptoms from that dose...
Indeed not. I wouldn't suggest that.
>To not mention all possible therapies on a board like this is counter-intuitive.
I agree entirely.
poster:ed_uk2010
thread:975288
URL: http://www.dr-bob.org/babble/20101231/msgs/976439.html