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 Post subject: Level off or poop out?
PostPosted: Thu Mar 23, 2017 2:13 pm 
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Hi all, I'm currently taking 1 mg buprenorphine for treatment resistant depression (legally prescribed by psychiatrist) and it's been working great for about a month; the last few days I've felt a little worse, so I tried going to 2 mg (FYI my pdoc originally prescribed 2 mg but I had so much sedation I stuck to 1 mg). I feel better now; I'm just wondering if this is common? I know with other opiates I build a tolerance very quickly but from what I understood, buprenorphine doesn't have that issue, or at least to a much lesser extent? This stuff is wonderful for me so far so I'm hoping I won't have to keep going up!


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PostPosted: Thu Mar 23, 2017 2:37 pm 
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There isn't really any research in this area thus far. There are doctors who are prescribing buprenorphine for patients with treatment resistant depression. That we know. But we know a lot more about how buprenorphine works for addiction. I can't answer you question for this reason.

The one thing I would suggest, though, is not going above 2mg without talking to your doctor. Keep the lines of communication open for sure!

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PostPosted: Thu Mar 23, 2017 5:33 pm 
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Hey climber!

Well this is something I know little about. I do remember a member here who was also taking buprenorphine for depression. She stabilized at 1mg after starting at 0.5 I think. I think she stayed on it for about 5 months and said it didn't help her very much for the depression. She stopped after 5 months I think. I know everyone is different but I just wanted to mention that. Isn't it also kinda common for medication to not work as well after a period of time when dealing with depression? So it could be something like that happening to u.

I hope u do get better relief and u find a dose that works. I've never been clinically depressed, but even just the depression I felt for a few months when I got out of rehab, it was awful. So I hope u all the success in the world!!

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PostPosted: Thu Mar 23, 2017 11:50 pm 
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I remember Lilly's story, but I mean that there is no research information available. Only anecdotal stuff which is really individual. There is another member here who takes sub for his addiction and because it treats his treatment resistant depression. Treating depression with sub will probably be more of an art than a science until someone does a study on it.

Amy

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PostPosted: Fri Mar 24, 2017 5:44 am 
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Quote:
Hi all, I'm currently taking 1 mg buprenorphine for treatment resistant depression (legally prescribed by psychiatrist) and it's been working great for about a month; the last few days I've felt a little worse, so I tried going to 2 mg (FYI my pdoc originally prescribed 2 mg but I had so much sedation I stuck to 1 mg). I feel better now; I'm just wondering if this is common? I know with other opiates I build a tolerance very quickly but from what I understood, buprenorphine doesn't have that issue, or at least to a much lesser extent? This stuff is wonderful for me so far so I'm hoping I won't have to keep going up!


A couple things. Bupe like all opiates (partial agonist in this case), causes tolerance over time. But tolerance to opiates refers to declining pain killing properties....until dose increased which then leads after a bit to more tolerance...and declining feelings of pleasure... again until dose is increased leading ultimately
to increasing tolerance.

Bupe has a ceiling effect whereby doses over 4 mg or so begin not to increase effectiveness. So with bupe
once a person's tolerance gets into that range it becomes harder,,,,and ultimately impossible to get the standard opiate effects. That said, some people do get pain relief in these higher ranges though it
seems the mechanism is not well understood.

In regards to any antidepressant effects in bupe, as Amy said there's little or no research. Perhaps there
s some effect from bupe that's over and above...or outside of typical opiate effects. If so, perhaps
it's not subject to tolerance.

If it were me..to be safer... I'd be very reluctant to increase dosage on the basis of not doing well over a day or even two or three. Real life is always going to intrude and no medication can protect you from the ups and downs of daily life. Nor would you want it to I don't think.

Best wishes,
Godfrey


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PostPosted: Fri Mar 24, 2017 6:03 am 
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I just wanted to mention Lilly as a point of reference for climber, since it was a personal experience. It popped in my head about Lilly's story so I thought I'd mention it, especially since she stopped after 5 months and climber is having issues.

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PostPosted: Fri Mar 24, 2017 9:32 am 
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Buprenorphine comes with a cost, either it turns you into an addict or it works in the short run


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PostPosted: Fri Mar 24, 2017 12:23 pm 
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Well Raun, explain this to me please. I'm already an addict so bupe isn't going to turn me into one of those but I also have been taking it for a year and it's still working-so I don't fall into that category either. Where do I and others that are like me fall?


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PostPosted: Fri Mar 24, 2017 3:24 pm 
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Quote:
Buprenorphine comes with a cost, either it turns you into an addict or it works in the short run


It's been a life saver for countless addicts, something many on this forum would be happy to attest to.
Just about any med you can name comes with a cost. With bupe it's the literal cost in dollars and cents
and possible difficulties...which can be overcome...when it comes to surgery and acute pain situations.

Other than that, bupe has a superior safety profile.

Maybe you could explain your statement a bit more.


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PostPosted: Fri Mar 24, 2017 10:17 pm 
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Raun, I think you were one of the few we see here that got hooked (abused) on bup. If I misunderstood a prior post of yours then you got on bup bc you were addicted to something else and that's why you started bup. In that case, your were an addict before bup. Starting and staying on bup does NOT increase your addiction -- instead it does the opposite -- puts it into remission. Thank goodness I and many others here stayed on it longer than the 'short run'. I'm a few yrs off if now and doing great! Wishing all my best, P

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PostPosted: Sat Mar 25, 2017 4:42 am 
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Raun why would u say that?

If u took buprenorphine as ur doc then u used it incorrectly and of course ur not going to have the same opinion that the rest of us have. But ur in a much smaller percentage than the rest of us. It has saved countless lives. It's given our lives bk. Most of us wouldn't be where we are now because of buprenorphine, and that's meant in a positive way. Some of us would have been in jail or dead, I would have been.

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PostPosted: Sat Mar 25, 2017 12:22 pm 
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jennjenn wrote:
I just wanted to mention Lilly as a point of reference for climber, since it was a personal experience. It popped in my head about Lilly's story so I thought I'd mention it, especially since she stopped after 5 months and climber is having issues.


You were right to mention it. I was wracking my brain to come up with something I could say about treatment resistant depression since I don't know much about. I just wanted to make the point that just because it didn't work for Lilly, doesn't mean it won't work for others. That's all. :)

Amy

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PostPosted: Sat Mar 25, 2017 12:31 pm 
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Oh no biggie. Lilly's experience was the only one I knew about :)

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