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PostPosted: Tue Apr 21, 2009 10:25 pm 
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This article was written by a doc who did some work with the RB people on Suboxone-- I don't know the extent of his involvement. But the article is about buprenorphine, the active ingredient in Suboxone, and depression.

The article talks about 'kappa' receptors, one of many receptor subtypes for opiates. I am doing some reading on the known receptor properties of Suboxone in the scientific literature, and will eventually post a review of the subject. My problem with this article is that it doesn't have any references; those are necessary to see if the statements are guesses, impressions, or proven facts. The conclusion I make from the article is that buprenorphine has actions at other receptor subtypes beyond the mu receptor, and that those different actions have a range of effects. Please comment freely...

SD


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PostPosted: Wed Apr 29, 2009 11:17 pm 
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Yeah, buprenorphine is said to be a kappa opiate antagonist. Most traditional opioids are thought to be effective in causing analgesia, tolerance and physical dependence via their actions at mu opiate receptors. Most of the agonist/antagonist drugs like nalbuphine (Nubain), butorphanol (Stadol) and pentazocine (Talwin) are believed to exert their effects primarily by being mu antagonists but kappa agonists (pentazocine is a partial mu agonist, but with no strong bupe-like affinity for the receptor). Strangely enough, one of the most popular opiates of use and abuse (oxycodone) is both a strong mu agonist and a kappa agonist, though its kappa agonist effects (dysphoria) seem to be swamped by its strong activity at mu receptors.

Pure kappa agonists have been synthesized and all share what is called in the psychopharmacological literature as "psychotomimetic" effects. They are often effective for some forms of pain, but have never been marketed because they make people feel anxious or crazy-ish until their effects wear off. And for some weird reason they make animals and humans start pissing a lot more.

Then you add actions at delta receptors and ORL1 ("orphan") receptors AND factor in the somewhat different actions of one of bupe's primary metabolites, norbuprenorphine, at all these receptors and you've got a lot of tidbits of information, but little understanding (at least that's been the result of my browsing the literature casually.)

If anyone ever come up with a clear and illuminating synthesis of buprenorphine and its metabolites actions at the family of opiate receptors, it'll be great to read. I just end up scratching my head!

/FooBear


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PostPosted: Wed May 06, 2009 10:47 pm 
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Suboxone can probably help depression, anxiety, fatigue, and many other conditions and symptoms. But do benefits outweigh the risks?


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PostPosted: Wed May 27, 2009 12:36 pm 
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April Diamond wrote:
Suboxone can probably help depression, anxiety, fatigue, and many other conditions and symptoms. But do benefits outweigh the risks?


IMO yes. :D


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PostPosted: Thu Jun 04, 2009 6:06 pm 
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My wife suffers from depression so does her whole family including Bi-polar actions in some. Suboxone I feel sometimes makes it worse for her. I know the main reason she got addicted was self medicating for depression thats never been fully treated correctly. She has tried just about every anti depressand SSRI out there and they all work for a short time then she needs something different.


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PostPosted: Thu Aug 27, 2009 6:40 pm 
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I read somewhere on the internet a while back that The Harvard School of Medicine had studied buprenorphine for treating depression & had very promising results. I think it's a shame that doctors can't legally prescribe it solely for treating depression. If we ever do make changes to the health care system I hope we change the idiotic drug laws as well.


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PostPosted: Tue Sep 29, 2009 2:55 pm 
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I have really enjoyed reading this article. I have been diagnosed with bi-polar and also take suboxone. I have been prescribed many different medications for bi-polar and nothing has worked like the suboxone has. I have been able to get off all the other meds and its been wonderful. Suboxone treats my addiction and I also benefit from it for my bi-polar.


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PostPosted: Thu Oct 08, 2009 2:24 pm 
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I started to self medicate with opiates while on depression medication and under the supervision of a psychologist. I quit taking SSRIs or SNRI's because I felt so good, energetic and confident from taking hydrocodone. I have no doubt many people would benefit from an opiate in their fight against depression. Not only being a kappa-antagonist but just the dopamine release would be medicating the depression. Boy, that's a slippery slope. And the fact that Suboxone carries a high risk of dependency doesn't help matters. I think introducing opiates to a batch of depressed patients is going into very dangerous territory. I'd limit it to drug dependent depressives.


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PostPosted: Mon Dec 21, 2009 4:04 pm 
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I also began using opiates to self medicate my depression after many years on and off many different antidepressants failed to help me. I found Percocet did a much better job than the Effexor I've been on for 9 years, in fact, the only reason I kept taking the Effexor while using was because of the hideous withdrawals you get when you miss a few doses of your antidepressant. I've been on Suboxone for just over a month now, and the first couple of weeks I thought I had finally found the magic pill. I was euphoric. Now my depression is back, crippling as ever, and I don't know if it's because my brain has developed a tolerance to my Suboxone dosage or some other reason (perimenopause?- another of my issues at the moment). My doctor just switched me to Cymbalta today, fingers crossed, and I'm wondering if anyone has antidepressant success stories to share here.


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PostPosted: Sat Mar 13, 2010 1:31 am 
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I feel like my life is over, I'll never get even that nice cozy, glow with ambition and happiness which I started feeling in detox a month ago. Damn I thought that would happen,thanks to my stupidity while on methadone, taking up to a whopping 440mg(yea abusing my take homes) to get high.

I know its my own fault for "shooting my tolerance sky high", but I also wonder if since I'm slightly autistic, schizotypal personality disorder, manic depression and the loss of my colon and "j pouch" so I dont have to have the awful bag, otherwise I would have offed myself years ago. I think I metabolize stuff faster than normal people, that's why a 3 10/500 norco every 4 hours(God I miss NWW and the lovely rop's)habit went from 2004 to taking 8 10/500's every 3 hours and going"out with a blast before rehab", feb of 2005. I went through 240 norco's and crashed into rehab.

I wound up on 4mg suboxone 2x daily, was working great until I found out I still had one more refill from NWW. I of course couldn't pass that up, 120 more norco's. I stopped my subs until I couldn't stand the wd's, tried taking just one norco and I suddenly went into wd in 20mins, lasted about an hour. I took a chance and took 3 more, now I"m feeliing great, I punched through the suboxone, not careing what I may or may be putting my life on the line etc. Somehow my sub doc found out, oh because my Mom saw the lovely fed ex truck pull up. Well my subox doctor said ok "if it happens again I would go into rehab for halfway house" I promised in front of my Mom, I'll never do it again. The doc said, you wont be able to get high again either, because now I am putting you on 3 8mg suboxone daily.

It worked great once again, I got the cozy, warm etc feeling kind of like norco's and got a lot done and enjoyed summer again. Then I seemed to develop a tolerance to them, I wound up in the ER on my birthday in 2006 of all things and just wanted to die. I of course was treated like a worthless "junky". I also at that time was strongly thinking about switching to methadone, since suboxone even at 4 8mg pills daily, the max allowable by law my sub doc said. Strange when I got out of hospital, I was still in pain, so my sub doc wanted to see me in his office that noon and bring my pill bottle for a count.

Strange, when I got there, his nurse just looked at bottle and didn't really count em. When my doc came in, he asked why I brought my bottle with me, I told him his nurse said for a pill count. He just looked at the bottle and didn't say anything. I figured, well since suboxone"he even said so"is a great pain killer, he said I'm lucky to have this or I would be in worse pain. He said he was going to let me be on 4 8mg pills for a week and then go back to my normal 3 8mg pills daily. He then wrote another script for me. Sooooo, since my Mom knows I take more than prescribed, she hid all my pills and set my daily dose out for me before I woke up.

In mid August of 06, she went out of town for the weekend and called me when she got there, I said everything is ok, BUT,you forgot to put my suboxone etc out for the time you are gone. She said, can I trust you? I said yes,ok she said"well I will have a new hiding spot all planned out when you get home anyway so dont take more" I said no I wont, I learned before on that. Well after seeing that huge stash of leftover suboxones from my surgery, I was in wd's and suddenly was like F it and took 6 8mg subs and put em all under my tongue lol"what? I bet most people here think I"m crazy", but I just did that to get them wet and my mouth salivating, I then crushed em up good with my teeth and held all that good tasting saliva in my mouth for 20mins and swallowed. 20 mins later I was buzzing good, sadly it only lasted 4 hours or so, but I had fun by myself and enjoyed the weekend my Mom was gone.

Long story short, I asked for opinions on switching to methadone"wont say what my friends online said to respect anyones feelings about methadone". My mom had come home and didn't switch hiding spots. I knew she was testing me, like a dummy me, I forgot to take a pill count to make sure I'd have enough for when i next see sub doc. It was toooo late, much tooo late. I realized I would have to take 2 8mg pills for the first few days of the week before I was to see him for a refill and then had to make a taper plan, where I'd be down to 1 8mg pill before I see him. Due to tolerance, it just didn't work out. I tried cutting pills in half, then came the moment of truth. My mom came home one day and I told her I had to talk to her about something. She said lets go to the mall and get our minds off the depression and then you can talk.

We went and I had a slice or 2 of pizza, we sat where nobody could hear us and in tears I told her what I had been doing.She of course wasn't surprised, however she said, "why didn't you tell me sooner?" Because dumb me, I forgot todo a pill count, also I was waiting to see if you'd say anything. She said I was was waiting 4 you 2 come clean, I knew it all along. You acted buzzed all week. So what are you going to do now with only 8 of the 8mg subs left and 7 days before you see the doctor? I said, I think I better hurry and call the methadone clinic 1st thing monday"also in my head I though, better get in touch with NWW too for backup in case the clinic has a waiting list to get in"

I had 2 irons in the fire monday, lucky both went well in the end. I got accepted into the methadone clinic and after I dosed and they observed me for about an hour, they said I could leave with my instructions etc on chores I needed to do for them, such as bloodwork etc within a week. I was high as Morphine when I walked outta there and felt great!!,
"WOO WOO feel the love of opiates I thought to myself as I hurried to the hub to pick up more norco's". I got home and my Mom said, howcome it took so long?, I easily talked my way outta that, because it was true, they had to talk to me etc and talk to my suboxone doctor etc so she thought nothing of it.

Sadly though, the doctor at the clinic said, taking norco with methadone is "death waiting to happen risk of od", he said you got 120 norco's right before you came here? i said yea, I freaked out, worried I'd get kicked off suboxone etc, who knows,also was worried there'd be a waiting list at the clinic. He said, well I got some good and bad news for you, you may go into wd's well before bedtime, due to your colon gone and also it takes a while to titrate you on a stable dose of methadone. The good news is, you CAN, but ONLY can take 4 or 5 max norco's to get you through the night, otherwise you will risk od'ing or damaging your liver even worse. I forgot what he said, he said something about taking the norco while on methadone that my liver will no longer just "dump the apap right to my kidneys so my liver doesn't get much harm". He asked me if I ever vomited while on vicodin. I said, yes in 2004 while I was on my norco run, I didn't feel like eating much one day and threw up. He said that was because my liver was backing up.

So, as usual I started to feel the methadone wear off about 5 hours or less after I got home, at 4pm I couldn't take it anymore and had to take one norco. It took away the wd's good, then someone I knew said, heck take 4 or so at once, you may get real high then. I did and I started to nod pretty good, it was scary. I went to bed at 8pm that night, after going through my norco's, I was almost stabilized on methadone, but not quite. My last norco refill came and I just finished them later on just after I stabilized at 160mg methadone 1x daily. Long story short on the methadone, I did not like my counselor there. She unprofessionally threw a fit when I used to see her 1x a week. She just cut me off when I was talking about my rage issue and how I hate cops, that's when things started falling apart. One thanksgiving, I went in to dose and get my take homes, I had a bad dvt blood clot in my lower right leg, lucky my Mom had me stop at the ER on the way home that day, because they kept me for half a week and I ended up having to take blood thinners and see a special doctor for that issue.

Well when I got home the day of thanksgiving, we spent it at our house, since the hospital was giving my daily methadone through my iv or mouth, after confirming with my clinic what my name and number and dose was, I had like 4 extra take homes or so. Out of the desire to get high again, I took 2 take homes in the morning"I was on 220mg then which equaled 440mg that morning", I sure nodded and got buzzed alright, I did it again the next day until all my take homes were gone by Monday. I figured I'd just go in and pay, dose and leave. Great I thought, nobody noticed, WRONG. The next day I went in to dose, on the way back from dosing, my counselor "yanked" me lol and said"wait a minute, I need to talk to you about something, sure enough she noticed and said, where are the extra take homes you should have? I assumed you would have not needed to come in for a few days or you would bring em in to ask me what you should do with em?.

I admitted to what I did, she was sad but upset at the same time because she was worried I could have od'ed and died and she knew I was suicidal too. After a lecture with a warning that I'd be kicked off the program if I ever did it again. I said, "oh my, I'll never do it again" she also said, you will be watched very carefully from now on if you request holiday take homes. I also only got take homes for sat and sun. Well like a dummy I skyrocketed my tolerance, then for personal reasons, I decided to go back on suboxone. Fast forward to a month ago after me and my counselor playing each other"I think", well I have a gifted special sense and I made an appt to see the clinic doctor. after realizing something personal faxed in from my doctors office was not in the clinic's doctors folder on me, I was ticked. So I decided to get revenge and suddenly CT off 150 methadone. I paid my dues and"tied up loose ends there at the clinic", kept coming in that week I had paid for, then on saturday when I got my take home for sun. I walked out of that door, thinking "I'll never walk in there again". Sunday I took my last metadone dose and that monday I slept in, didn't come in to dose because I was all paid up anyway. My Mom already knew what I planned on doing, she said"you better call your old suboxone doc before he gets busy", I knew the valium and xanax I take for ptsd and anxiety were wearing off and it was around 8:30am. I called and got his nurse and told what I did. Not 10mins later, I got call back and said that I had to immediately go into detox at the same building I was in at 2005 to get off norco's and on suboxone.

We went right away, got there and I had to sign and fill out tons of forms like usual, strangely my special senses kept telling me, the guy in line in front of you is going to be your room mate. Wow sure enough, even more strange I had a feeling I would be in same room and bed I was in the first time. After 9:30am that monday, I had already gone 24 hours past my last methadone dose and was already starting to wd. I was admitted and they were checking my vitals which of course were way scary. I was given some valium and told to stay in bed all day. Right away I had this feeling, didn't know what it was, but I went in the bathroom"sort of like when you are a kid and you did something REAL bad" and I cried. I knew I did something serious to my body but didn't know what.

Well I found out that day, when I saw my old sub doctor, he said I would expect at least 4 days in wd's before he could even go by the book and try me on some suboxone. I said I'm willing to tough it out for personal and health reasons. I was sent back to bed, my roomie said hi to me and we got talking. Long story short it was the coolest stay out of all 3 or 4 detoxes I'd been in so far. My room mate was cool and taught me alot more social skills than I had before to survive more in real world, plus he kept my mind off the insanity of wd's. Day 2 I had not slept at all etc, day 3 still no sleep, I went to bathroom and went to lay down and suddenly I was sneezing so bad I felt I was pukeing. I knew I was getting closer. Day 4 came and I suddenly got woke up someone said the doc was here to see me. I was in tears I was so glad to see him. I had blurry vision and couldn't walk well, I felt cold from head to toe and felt like I was dying. the doc said its time and had me sit in a chair and do 4mg suboxone and sit in another chair while I wait for it to kick in etc.

Finally the gloom went away and I felt a little warmer, by the 4th day on 4mg 2x daily I finally felt warm all over again. Then came some bad news, I thought I was a "hardcore goner junky", when I got talking to another addict, he said "dont be surprised if the subs dont work near as well as they did the first time round and you end up back at the clinic". I was about to cry right there.

But I shrugged it off thinking, I've been off subs long enough now that my tolerance should be reset. I feel like crying right now as I'm typing this, but I have no significant other to cry to so all I can do is tell how things been since I've been on subs again.

I was detoxed and upped to 12mg suboxone, I have to take the 8mg pill at 9am and in order to get through the day, I have to save the cut in half 4mg pill for 4 or 5pm or I start to wd. WHen I went home, I felt delusional, just driving home felt strange etc. I liked the feeling though because I felt calm. I had to go to my suboxone docs office right that morning for some info etc, because that noon or so, we had to make our long drive to see my colon specialist for my "annual procedure under anesthesia" and my sub doctor was not going to give me a script unless he could talk to anesthesia at that hospital etc. Worse yet he would not be in the office after 12noon. Well I got lucky and he got ahold of them right away and I got my script, got it filled and took my morning dose. That was before I figured out taking all 12mg at once wasn't holding me all day long.

We got there safely, that night before my procedure, I could not sleep half the night I wokeup and could not get to sleep until 5 am. Suddenly I felt I was awake but dreaming that I was dieing, I dreamed I was looking down at my body from way above and was so happy and glad that the battles etc in my life had finally ended. Damn suddenly I woke up and it was only a half hour before we had to get to the hospital across the street from the hotel. Well that went great. I talked a little with my doctor there who I've known since 1990. I got all "hooked up in the operating room" and was anxious for that once every 6 months "lovely feeling like I'm so high as a kite that I"m taking off in a plane". Well this time I was REALLY buzzing, felt like I finally grabbed the controls and I took off like a bat outta hell and felt wonderful. Then sadly it was over and I didn't even remember anything except putting my clothes on and my Mom starting the drive home.

Then something happened, the day after we got home and slept well, I woke up feeling lousy, I figured it was 10:30 am and I needed my doses. So my Mom gave em to me and I started feeling good, then suddenly it hit me, my suboxone didn't give me that happy, feeling as well anymore, I went to work on my hobbies in the basement and just suddenly felt rage. It has been a week now that this has been going on, it sucks because I dont feel like myself anymore, just full of rage and the desire to literally kill some people I hate and go on a bust up everything rampage because I've had it with the idiot suburban drivers in my area. I told my suboxone doctor this week when I saw him. He said"well it would be no point at this time to up your suboxone dose, because subs are not a mood stabilizer or for depression". That's when I thought "oh shit" I hope he isn't going to keep me on 12mg.

He had me see my psychiatrist and i did, he had me on so many things in the past that he looked way back to when he first started seeing me. He is titrating me up to 200mg of tegretol 3x daily. I really dont know anything from taking it yet,but of course he said it takes up to 4 weeks to see if it will work or not. He sees me at that time to see if it works, if it does he has to have me do bloodwork as alot know on here I'm sure. I feel so sad and a gloomy outlook right now that I wish my life was over with. I feel hopeless, like I will never enjoy getting high or "get my life back as I call it", I still start getting tired around 12pm. I know my doctor said methadone takes at least 2 months to get out of all your pores. But its been a month already, so I'm halfway there already and would think I should feel alot better by now, but sadly not. I'm 39 years old and due to my mental and slight physical disability, feel hopeless that I will never find a significant other,which would help me ALOT.

Even my friends I met in detox dont talk to me on facebook at all much anymore, maybe because I'm different, well I'm realizing in life that "accept me for who I am or get lost", well I must not be very sought after and that's sad because way back when I was just a binge drinker and only 25 or so and had a raging sex drive. Me and a buddy would go to the city and hit our favorite places and lots of people would say how attractive I am, some still do, even though I've been celibate since 2006. But when you wake up in the morning with a raging sex drive and are still dying to get high. SOmething is not right. I just hope that one person in detox is not right, about what he said to me about suboxone.

Wish me luck everyone, sorry for such a long post but I just had to chime in about psychiatric meds


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PostPosted: Sun Mar 14, 2010 12:26 am 
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I think maybe this is the study cited.

There were some very long discussions of the topic at dr-bob.org some years back and there may be more. I have a funny story about it all, but maybe later.

- joe


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 Post subject: For what it's worth...
PostPosted: Fri Oct 22, 2010 1:09 pm 
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For what it's worth. Thank you for sharing this, I was kinda craving sweet Norco but this reminded me of the consequences and misery. I'm 77 days clean from a 10-12 day 10/325 habit. May you find your peace, whatever helps u stay clean. No peace in using except for that momentary bliss.


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