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PostPosted: Mon Feb 05, 2018 2:49 am 
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Quick bio: been on Antidepressants since I was 21. I’m 45 now.
They’re just a part of my life, for better or worse. No big whoop. Problem is, my brain is becoming treatment resistant.

Now the painkiller addiction..... that has been in and out of my life so many times, I finally reached the point where Buprenorphine became the answer to staying clean.

Here’s my situation: An addiction doc started me on Zubsolv about 6 months ago. Despite not having insurance, I went with it. On a mere 5.7 mg a day, I liked the sense of well-being it providrd, but I didn’t like the cognitive confusion. About three months later, the confusion got better, and I still had the Zubsolv “spring in my step” most days. Long story short, I switched addiction specialists, and he moved me onto Subutex because it was cheaper, and because there was no point in my taking something with naltrexone in it.
Subutex is okay, I guess, but I sure miss the Zubsolv boost. These past few months since the switch have been pretty low, mood-wise. Don’t get me wrong. I’m sober. But nothing delights me.

In a couple days, I see my Bupe Quack (I actually love the guy) and I may opt to switch back to Zubsolv, only this time on half the dose of Zubsolv I used to take: 2.9 mg instead of 5.7mg. I’m Currently on 4mg of Subutex, and 2.9mg is the Zubsolv conversion.

Fortunately, he’ll let me switch back if this doesn’t work for my depression in the slightest.

I know there is an initial high on buprenorphine that lasts a short while in the beginning before adjusting. But am I the only one who responds well to it’s mood-boosting side effect well beyond the first month?

Thanks for your time/any input...
D&A


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PostPosted: Mon Feb 05, 2018 2:46 pm 
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Hi DAA,

It has been posted frequently that Buprenorphine does increase feelings of well being. Very few members state they get any kind of high from it but some do.

The Zubsolv was manufactured to have the patient get better absorption from a lesser amount of Buprenorphine. The 5.7 mg dose is the same as taking a 8 mg Suboxone film/tab. At least that's what the members who take it say. So yes, by going with generic Subutex you were given a lower dose than what you were used to. Go ahead and ask to go back on the one you feel better on. We don't condone or have any opinion on anyone getting a buzz per say from their Buprenorphine. Some small fraction say they do feel it while most others say they don't.

I hope you end up getting the best option that works best for your recovery.

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Don't take yourself so damn seriously


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PostPosted: Mon Feb 05, 2018 7:38 pm 
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From what I've seen over the past 12 years, people dependent on opioids have moods and sensations that are highly dependent on psychological factors. Whenever I point that out to an individual, that person takes it as an insult. I don't get that, because in most cases it is easier to adjust ones thoughts about a medication than to go through years of testing for something that's never found! I think all of us who became dependent on opioids tend to be more sensitive in the first place-- and going through years of addiction when we are always 'looking inward', to see if we got a 'buzz', or to see if we are in withdrawal, only makes us MORE sensitive.

The same phenomenon occurs in the general population, when treating depression for example. Whether a patient responds depends to a significant degree on how the medication is presented, and the apparent confidence that the prescriber has in the medication.

I always point out that with medications, there is no 'craftsmanship', as there is with a piece of furniture. The substance is either buprenorphine or it isn't. A 'poorly made' molecule of buprenorphine is exactly the same as a 'well-made' molecule. I suppose Zubsolv could have some inert filler added that happens to have antidepressant properties, but that is highly unlikely, as companies all use the same basic fillers that have been around a long time.

Buprenorphine does have antidepressant actions, at least according to the people at Alkermes, who are currently inundating doctors with an email campaign about the upcoming release of a buprenorphine-based antidepressant (more on that another time). But any difference in mood on Zubsolv vs. other forms of buprenorphine are likely caused by mental associations, maybe linked to menthol. Maybe the taste triggers memories of being 2 years old and mom rubbing your chest with Vicks Vapo-Rub--- at least that's a good memory for me!!

Even with buprenorphine vs. Suboxone, the common anti-film sentiments are hard to explain chemically or scientifically. Naloxone is just not absorbed that well sublingually, and even if it was, it does not displace buprenorphine in the tiny amounts that get absorbed. And even if it DID displace buprenorphine, naloxone is metabolized very quickly, and is gone in half an hour.

I see the psychological effects on symptoms ALL the time. A person optimistic about buprenorphine will do much better than a person who is pessimistic (even if both people have never taken it, and have no reason for their expectations other than 'what they have heard on the internet'.

I will admit one thing though-- the patients I have on Zubsolv are almost fanatical in how much they like it. I assumed that's because of the low market share, and they feel 'special'.... but they really seem to like it over the things they used to take.


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