Posted by pseudoname on November 6, 2006, at 12:17:22
In reply to Re: Bupe (no tolerance yet!) » Declan, posted by pseudoname on November 6, 2006, at 11:20:56
(I hadn't yet read this more detailed question when I replied before. Sorry if I'm writing too much; I'm a little lonely right now and I don't have internet access at home for the moment.)
> Do you find that after being on x amount of bupe you *lose* the AD effect, or is it maintained. There must be some doses anyway that are more optimal than others. And I suppose that once you move to a higher dose the AD effect off the lower dose has gone? The trouble with methadone is not the effect of methadone as such, but rather how you feel once tolerance has been achieved long term.
For me, a given dose-level of buprenorphine does not seem to lose its effect *due to tolerance*, even over months. The very low 0.25 mg/day I was on remained effective throughout the summer, for example. And if I take an unusually large dose for a few days, the amount *required* for me to get an AD effect does not seem to increase on subsequent days. But also, the AD effect itself doesn't get greater for me with a greater-than-needed dose.
I don't know why I need a larger dose now or last winter than I did during the summer. Given my overall history with bupe, I don't attribute it to tolerance.
My theory on my lack of typical opioid tolerance is due to the fact that I don't get a typical opioid buzz or high from the bupe even if I take a whole lot of it. Not even on my very first day, when I naively took waaaay too much.
But some people apparently do get an opioid buzz from bupe. (Anybody out there?) In those cases, they might develop a tolerance to that but maybe still not to an underlying antidepressant effect? Dunno.
At Dr Bob's presentation about Babble at the Toronto APA convention in May, we went around the room and the Babblers who were there summarized their experience with Babble. I told how I found out about bupe here and now try to help others on Babble learn about it. I'll bet the half-dozen pdocs in the audience were thinking, "Oh great! My patients will visit Babble and then demand that I give them addictive opiates."
But my experience (including this latest little drama) is that buprenorphine is a very safe and — if given a proper chance — enduringly effective antidepressant.
I do wonder, however, if Provigil or Adderall might help the mild cognitive fuzziness that can occur for me at doses above 2 mg/day. Anybody know?
poster:pseudoname
thread:699762
URL: http://www.dr-bob.org/babble/20061104/msgs/700904.html