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PostPosted: Wed Apr 04, 2012 6:28 pm 
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I saw this on another post and decided to commit on it. Since being on subs, every new med the doc tries to start me on I have bad side effects, doesn't mix well w/ subs and I have to dc it. For ex. I used to be on Depakote. Tried it for a week in November, in the bed for a wk thinking I had the flu. I was a side effect from the Depakote! This has happened with tricylics and other meds I used to take or new meds. Has this been happening to anyone else? I cannot take anything for my bipolar b/c of this. Thats one of the reasons I'm so anxious to get off subs.


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PostPosted: Thu Apr 05, 2012 1:22 am 
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Interesting.

I have bipolar too. What I've found is that some medications, for me, increase my metabolism of Suboxone. Epilim (our version of Depakote) was one of them.

It might be possible that some of the meds you are being prescribed are inducing the enzyme that metabolises buprenorphine, thus making you burn through it faster?

Lithium and lamotrigine I've found work quite well with Suboxone.

Just out of curiosity. Do you find mood stabilisers effect your memory at all?


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PostPosted: Mon Apr 09, 2012 2:39 pm 
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I have had BAD side effects with almost ANY drug I 've taken with Subs!

I tried a whole slew of anti-depressants earlier while on a high Subs dose (24mg a day) and had TERRIBLE side effects with every one! I couldn't take ANY and ended up on SAM-e which has stopped working as well now.

I'm going back to my doc today to try another anti-depressant now that my Subs dose is 5mg a day.

It seems to me that Subs is CAUSING the negative thoughts (not really depression).
Has this happened to anyone else?

Can anyone suggest an anti-depressant that works well with Subs?

Thanks.


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PostPosted: Mon Apr 09, 2012 9:35 pm 
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At times I've wondered what role Sub can play in my negative thinking. It's really impossible to tell what is just an effect of the bipolar, and what is caused by the Sub.

While I can't compare as much now because I've been on Sub so long, in the past I've thought that Sub made me a bit irritable and negative, and I had a belief that I was more prone to depression while on Sub. Naltrexone did a very similar thing - had this slight cold dysphoric edge that made me quite cranky. One of my ex-partners got VERY nasty while she was on Sub. We called it getting "bupe-cranky". Maybe it's an antagonist-thing? Or something that happens when our endorphins no longer have any effect (as they do while we're on opioid therapy of any kind).

How much of it is just me being bipolar, and me being bipolar on Sub, is really impossible to know ... so I'm not going to say with any certainty that Sub contributes to my blues.

But I do know for a fact that it doesn't act as any kind of anti-depressant.

Re your bipolar and meds. At the moment there is a large school-of-thought in American psychiatry that believe people with bipolar should not be prescribed anti-depressants ..at all.. I've largely found SSRI/SNRI's to provide some relief for a bit, but I'd always end up self-destructing in some way while I was on them. It took years for my doctor to acknowledge that pattern (years that I won't get back ... anyway).

There are two mood-stabilisers that help with depressive symptoms as well - lithium and lamotrigine. I've found that on these medications, while I do still get depressed, the depression gets a bit blunted, or blurred out. They're hardly depression busters like anti-depressants, but they do take the edge off.

I also take 5-htp which also blunts the depression a bit. I still go through dark periods, but they're easier to manage.


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PostPosted: Tue Apr 10, 2012 7:54 am 
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LEXAPRO goes very well with subs. it will lift your spirit up high. but be care full if you have bi-polar '. it can make you a little manic!!! :lol:

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PostPosted: Tue Apr 10, 2012 9:19 am 
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I take Celexa as well as lamotrigine (Lamictal) and Abilify (both of those are mood stabilizers that I take along with the Celexa). I haven't had any problems taking any of them with the suboxone.

You might just have to do the trial and error thing to find the one(s) that work for you. Most of us have to do that anyway to find the right antidepressant. It does suck that you'd already found what worked for you and now you have to go through that all over again! I hope you can find something quickly to help you out.

Keep us posted and good luck.

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 Post subject: mood stablizers
PostPosted: Sun Apr 15, 2012 4:19 pm 
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tearj3rker wrote:
Interesting.

I have bipolar too. What I've found is that some medications, for me, increase my metabolism of Suboxone. Epilim (our version of Depakote) was one of them.

It might be possible that some of the meds you are being prescribed are inducinge the enzyme that metabolises buprenorphine, thus making you burn through it faster?

Lithium and lamotrigine I've found work quite well with Suboxone.

Just out of curiosity. Do you find mood stabilisers effect your memory at all?


How could tell that Depakote inc. your metabolism of sub. Since taking sub, I cannot take Depakote anymore, flu side effect, and I'm allergic to lamotrigine (rash). Just started taking Neurotine for bipolar and joint pain. Mood stablizers have affected my memory in the past but I think that subutex is doing it too.


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PostPosted: Mon Apr 16, 2012 1:01 am 
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I've found that while I'm on mood-stabilisers, I'm much more sensitive to other medication and drugs affecting my memory, even drugs that normally wouldn't. Suboxone is one of them.

That being said this is all self-reporting so it's hardly scientific fact. Many people don't feel mood-stabilisers affect their memory. Though one of the things I've found mood-stabilisers hit first is insight, which is why when lithium goes to toxic levels people don't recognise the fact they've gone toxic, even though all their clothes are on inside-out and they're trying to get entry into a house they haven't lived in for 10 years.

The only way you could tell whether depakote is causing your problems is, like hatmaker said, by trial and error. I always found that my Sub metabolism was sped up while I was on epilim to the point where I'd be getting withdrawals leading into my next dose even on high doses. Then add an SNRI on top of that, and I'd be able to use on Sub with relative ease.

Valproic acid (depakote) induces CYP3A4, the enzyme that metabolises buprenorphine. Basically it speeds up the metabolism. Have you tried lithium? I've found it to cause no interactions.

If your problems keep persisting it may be worthwhile looking into other pharmacotherapies for addiction - naltrexone / methadone.


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 Post subject: Metabolism
PostPosted: Mon Apr 16, 2012 3:04 pm 
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tearj3rker wrote:
I've found that while I'm on mood-stabilisers, I'm much more sensitive to other medication and drugs affecting my memory, even drugs that normally wouldn't. Suboxone is one of them.

That being said this is all self-reporting so it's hardly scientific fact. Many people don't feel mood-stabilisers affect their memory. Though one of the things I've found mood-stabilisers hit first is insight, which is why when lithium goes to toxic levels people don't recognise the fact they've gone toxic, even though all their clothes are on inside-out and they're trying to get entry into a house they haven't lived in for 10 years.

The only way you could tell whether depakote is causing your problems is, like hatmaker said, by trial and error. I always found that my Sub metabolism was sped up while I was on epilim to the point where I'd be getting withdrawals leading into my next dose even on high doses. Then add an SNRI on top of that, and I'd be able to use on Sub with relative ease.

Valproic acid (depakote) induces CYP3A4, the enzyme that metabolises buprenorphine. Basically it speeds up the metabolism. Have you tried lithium? I've found it to cause no interactions.

If your problems keep persisting it may be worthwhile looking into other pharmacotherapies for addiction - naltrexone / methadone.

I take Nexium(esomeprazole) 40 mg 2 x per day and it is etensively metablolized in the CYP3A4 pathway! I didn't know that about bup. I used to be a pharmaceutical rep/ district mgr for Nexium w/ Astra Zeneca. I understand thr metabolism interaction. So far I am doing pretty well w/ neuronton for mood and pain. I had some blood work done and i'm anemic and possibly my ebstein barr or cmv is reactivated. That would explain the fatigue. I used to be a lab tech too. Disabled for 6 yrs now. Thanks for the help. I took lithium but made me shake all time and lose massive amts of weight.


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 Post subject: Re: Metabolism
PostPosted: Mon Apr 16, 2012 3:07 pm 
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anxiousSN wrote:
tearj3rker wrote:
I've found that while I'm on mood-stabilisers, I'm much more sensitive to other medication and drugs affecting my memory, even drugs that normally wouldn't. Suboxone is one of them.

That being said this is all self-reporting so it's hardly scientific fact. Many people don't feel mood-stabilisers affect their memory. Though one of the things I've found mood-stabilisers hit first is insight, which is why when lithium goes to toxic levels people don't recognise the fact they've gone toxic, even though all their clothes are on inside-out and they're trying to get entry into a house they haven't lived in for 10 years.

The only way you could tell whether depakote is causing your problems is, like hatmaker said, by trial and error. I always found that my Sub metabolism was sped up while I was on epilim to the point where I'd be getting withdrawals leading into my next dose even on high doses. Then add an SNRI on top of that, and I'd be able to use on Sub with relative ease.

Valproic acid (depakote) induces CYP3A4, the enzyme that metabolises buprenorphine. Basically it speeds up the metabolism. Have you tried lithium? I've found it to cause no interactions.

If your problems keep persisting it may be worthwhile looking into other pharmacotherapies for addiction - naltrexone / methadone.

I take Nexium(esomeprazole) 40 mg 2 x per day and it is etensively metablolized in the CYP3A4 pathway! I didn't know that about bup. I used to be a pharmaceutical rep/ district mgr for Nexium w/ Astra Zeneca. I understand thr metabolism interaction. So far I am doing pretty well w/ neuronton for mood and pain. I had some blood work done and i'm anemic and possibly my ebstein barr or cmv is reactivated. That would explain the fatigue. I used to be a lab tech too. Disabled for 6 yrs now. Thanks for the help. I took lithium but made me shake all time and lose massive amts of weight.


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 Post subject: Atidepressants
PostPosted: Mon Apr 16, 2012 3:14 pm 
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Ihave tsken Lexapro 20 mg for yrs. What worked best for me was Geodon, an atypicical antipsych. For bipolar. Had lots of energy, happy, positive! Had to stop it last Oct. B/c I developed tardive diskinesia, abnormal muscle movements, esp with my mouth! It is better but a permanent condention. Beware of that class of drugs!


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