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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 11 to 35 of 97. Go back in thread:
Posted by Squiggles on November 6, 2005, at 12:39:36
In reply to effexor is supposed to have opiod effects..., posted by iforgotmypassword on November 6, 2005, at 11:32:44
> there is an abstract on pubmed about this, i also recall mention of it having a similar structure to tramadol (Ultram). this may make sense as it is supposed to be a phenethylamine, and that is supposed to carry with it opiod properties. (that seems to be why D-phenylalanine is used for chronic pain)
I don't know the chemistry of pain killers,
but I know they can be as addicting as
opioids, e.g. OXYCONTIN, so perhaps they
habituate the same areas or parts of the brain.
And Ultram, as pain killer may fall into this
category?Anyway, there are some issues that should
be kept distinct in this opiate question,
i think:a) is the chemistry of opiates superiour
to that of other ADs for depression;b) can the addicting properties be managed
well so that it can be taken for a long time?c) if the above are feasable, is there a
political/government/economic quagmire
that cannot be resolved *even if the opiates
prove to be better*?d) can substitutes like the one you mention
(Effexor was too weak in this case of endogenous,
maybe even organic depression) be made chemically
equivalent.thanks for your input.
Squiggles
Posted by iforgotmypassword on November 6, 2005, at 15:00:37
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 12:39:36
remeron makes effexor extremely effective. this combination has saved peoples lives with full remission, and is compared closely with ECT.
Posted by Squiggles on November 6, 2005, at 15:02:25
In reply to Re: effexor is supposed to have opiod effects..., posted by iforgotmypassword on November 6, 2005, at 15:00:37
Remeron and effexor; maybe some doctors
know about this;thanks
Squiggles
Posted by flmm on November 6, 2005, at 16:10:31
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 15:02:25
I will say this about Effexor, when I took it about 1 year ago, I felt really good, and my back pain did not bother me near as much. However, on it's own, my blood pressure went way up and I got nervous a lot, kind of unstable feeling. I could not stay on it. Pherhaps it would work good as a low dose add on to Lexapro. I had another good response to Cymbalta with Lex, but not on it's own! I think I will always need an ssri as my main drug to keep me calm, but maybe I should think in terms of adding things to Lex. I am sick of opiates!
Posted by Squiggles on November 6, 2005, at 16:35:48
In reply to Re: effexor is supposed to have opiod effects..., posted by flmm on November 6, 2005, at 16:10:31
> I will say this about Effexor, when I took it about 1 year ago, I felt really good, and my back pain did not bother me near as much. However, on it's own, my blood pressure went way up and I got nervous a lot, kind of unstable feeling. I could not stay on it. Pherhaps it would work good as a low dose add on to Lexapro. I had another good response to Cymbalta with Lex, but not on it's own! I think I will always need an ssri as my main drug to keep me calm, but maybe I should think in terms of adding things to Lex. I am sick of opiates!
For the case I am speaking of, SSRIs are
just too weak for clinical depression; and
perhaps as you using them as adjuncts
may be the best thing to do.So you're sick of opiates :-)
I didn't even know they were available,
unless you've got underground connections.Squiggles
Posted by linkadge on November 6, 2005, at 17:31:09
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 16:35:48
To say that SSRI's are too weak for clinical depression makes no sence.
They may be too weak for your depression, but they are effective for a certain group of people.
For me, MAOI's were "too weak" for depression.
Parnate just made me blue, and mildly psychotic,
but others would consider them "big guns".
For while I had no sucess with effexor, followed by success with zoloft. So I think it depends on many personal factors.
Linkadge
Posted by Squiggles on November 6, 2005, at 17:35:24
In reply to Re: effexor is supposed to have opiod effects..., posted by linkadge on November 6, 2005, at 17:31:09
Yes, that's true; i am speaking from
years of observing someone who has
clinical (very deep, possibly brain-damage
depression).I'm a happy beeper on lithium - wouldn't
touch tricyclics.Squiggles
Posted by linkadge on November 6, 2005, at 19:06:14
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 17:35:24
I've been on lithium SSRI's MAOI's and TCA's. THe lithium helped some aspects of the depression, but did not help the anhedonia.
Linkadge
Posted by Squiggles on November 6, 2005, at 19:23:11
In reply to Re: effexor is supposed to have opiod effects..., posted by linkadge on November 6, 2005, at 19:06:14
Hmm... what was your lithium dose,
how long where you on it, how much
do you weigh, and what was your diagnosis?
Also, was your thyroid checked?Of course you don't have to answer if
these questions are personal for you.Squiggles
Posted by flmm on November 6, 2005, at 19:25:06
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 19:23:11
The legal pain killers are the ones I am refering to! ie. Vicoden etc...
Posted by Squiggles on November 6, 2005, at 19:55:59
In reply to Re: effexor is supposed to have opiod effects..., posted by flmm on November 6, 2005, at 19:25:06
> The legal pain killers are the ones I am refering to! ie. Vicoden etc...
Oh I see. If other drugs work for your depression
that is to be preferred of course. But I would
not be bothered by "addiction" of opiates. It
is easier to withdraw from these than from benzos,
especially some benzos which are impossible to
withdraw from.If an addicting drug was really good for depression and could be managed by a doctor
so that the increments would not hurt your
health any more than the customary ADs, I
would say they were better.But in your case they are not and I can
understand that. BTW, benzos do work for
back pain, esp. clonazepam, which is very
addicting but has miminum tolerance.Squiggles
Posted by linkadge on November 6, 2005, at 20:29:02
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 19:23:11
My lithium dose (this time around) was 600mg, although I have been as high as 1500mg (for 7 months)
My diagnosis is unipolar depression (by most doctors) and bipolar disorder by 2 doctors.
I weigh about 140 pounds.
Thyroid is good.
Linkadge
Posted by linkadge on November 6, 2005, at 20:31:00
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 19:55:59
I think addiction potential again, also depends on the person.
I had zero problem getting off 3mg of clonazepam, but had a hell of a time getting off codiene.
Linkadge
Posted by Squiggles on November 6, 2005, at 20:38:52
In reply to Re: effexor is supposed to have opiod effects..., posted by linkadge on November 6, 2005, at 20:29:02
> My lithium dose (this time around) was 600mg, although I have been as high as 1500mg (for 7 months)
>Doctors tend to start you high (1200mg) esp.
if you are manic, and lower it after 6 months,
given blood stability monitoring.I take 900mg - anything more would be toxic
now and anything less (judging by my unlucky
break with the pharmaceutical supplier) would
be catastrophic.I have read that lithium (in itself or as
an adjunct is give for unipolar) but I have
not seen it work in some of my friends.
I think it would work in acute severe depression
to lift you out of it -- after that, I don't
know - unipolar and bipolar brains may be
different.> My diagnosis is unipolar depression (by most doctors) and bipolar disorder by 2 doctors.
Diagnosis is not an easy thing right now -
maybe future neurologic correlations will
solve that. I now *know* I am bipolar by
the serendipitous mistate made by the pharmacy --
no mistaking it. Before that, even one of my doctors was unsure.
>
> I weigh about 140 pounds.900mg lithium should do it.
>
> Thyroid is good.Hypo or hyper is important for lithium dosing.
Squiggles
>
Posted by Squiggles on November 6, 2005, at 21:02:24
In reply to Re: effexor is supposed to have opiod effects..., posted by linkadge on November 6, 2005, at 20:31:00
> I think addiction potential again, also depends on the person.
:-}
>
> I had zero problem getting off 3mg of clonazepam, but had a hell of a time getting off codiene.
>
>
Like any addicting drug (and even ADs which
are not said to be addicting per se but
withdrawal brings on the notorious "discontinuation syndrome"), certain variables
play a role in how difficult getting off
will be:- time the drug has been taken
- dose that has been taken during that time
- abrupt or slow discontinuation from the
drug- other drugs causing a cross tolerance;
- and last, very last, the non-physical aspect
of withdrawal -- the personality of the person;
but I believe that if you give the same amount
of crack to Clint Eastwood and to Woody Allen,
under the same conditions, they will have
equal difficulty in getting off.The same rule of pharmacology applies to
many drugs - if not, the preparation would
of pharmaceuticals would have to be tailored
differently for every single individual on
the planet, give or take a few pounds and
personal quirks.Squiggles
Posted by Phillipa on November 6, 2005, at 21:04:37
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 20:38:52
Great Thread! And it's amazing that we are so different. The laudaum[sp] you mentioned? Was given to women for anxiety. Can't forget that in Vicorian days people didn't live to be old. Who can say what would happen if they had. And in France when so many people drink wine a lot what is their depression rate. Hey do we have any people from France posting here? Can't remember anyone saying they were from there. Fondly, Phillipa
Posted by fuchsia on November 6, 2005, at 22:25:37
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 21:02:24
> > I had zero problem getting off 3mg of clonazepam, but had a hell of a time getting off codiene.
> >
> >
> Like any addicting drug (and even ADs which
> are not said to be addicting per se but
> withdrawal brings on the notorious "discontinuation syndrome"), certain variables
> play a role in how difficult getting off
> will be:
>
> - time the drug has been taken
>
> - dose that has been taken during that time
>
> - abrupt or slow discontinuation from the
> drug
>
> - other drugs causing a cross tolerance;Yes; I had the reverse; relatively little problem (not nothing but *relatively* little) coming off codeine but coming off clonazepam was nearly the death of me. I was on the clonazepam for 11 years though.
Posted by linkadge on November 7, 2005, at 9:00:27
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 20:38:52
It always seems to have an initial effect, an initial feeling of "things are going to get better" which lasts for about 2 weeks, and then I feel pretty much the same, only slower which leads me to feel that things will get worse.
Linadge
Posted by linkadge on November 7, 2005, at 9:07:15
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 6, 2005, at 21:02:24
I dropped effexor in one day, and never felt anything really. SLS also reported having little withdrawl from effexor (if I recall), yet others write books about it.
Its the same with alcohol. We already know that mice can be bread to show a significant addition to it, while other mice don't seem to have the same problems.
Addiction and tollerance are not equal from person to person.
Linkadge
Posted by linkadge on November 7, 2005, at 9:10:17
In reply to Re: effexor is supposed to have opiod effects..., posted by fuchsia on November 6, 2005, at 22:25:37
Clonazepam was not a problem. I experienced some mild anxiety for less than a week. (mind you I was prescribed it for unknown reasons).
Codiene withdrawl went on for ever. Vomiting, unexplained aches and pains, sensitivity to light and sound, deep melancholy etc..
Linkadge
Posted by Squiggles on November 7, 2005, at 9:13:01
In reply to Re: effexor is supposed to have opiod effects..., posted by linkadge on November 7, 2005, at 9:07:15
> I dropped effexor in one day, and never felt anything really. SLS also reported having little withdrawl from effexor (if I recall), yet others write books about it.
>
> Its the same with alcohol. We already know that mice can be bread to show a significant addition to it, while other mice don't seem to have the same problems.
>
> Addiction and tollerance are not equal from person to person.
>
>
> Linkadge
>
>
>
>
>
----------I had no trouble withdrawing from lithium at all
and this is after more than 20 years of taking it
daily. BUT when I hit the "below narrow therapeutic index" I became very ill - it was
a struggle to get out of that illness - 30 days.Not all ADs or APs are the same with regard
to withdrawal. I understand from reading the
net for 5 years that many people have trouble
withdrawing fromt he SSRIs - a completely different class from mood-stabilizers, and my
friend once tried getting off tricyclics and
definitely needed a long "wash-out period" to
avoid withdrawal syndrome.So, perhaps another variable to be considered
in addition to the ones i listed, is the *type*
of drug.Squiggles
Posted by Squiggles on November 7, 2005, at 9:24:10
In reply to Re: effexor is supposed to have opiod effects..., posted by linkadge on November 7, 2005, at 9:10:17
Most doctors acknowledge the difficulty
of clonazepam withdrawal - it takes a
generation for drug performance to manifest
itself in the medical arena.I would very much like to know if Roche
has a secret about this drug. I think
it's different from all the other benzos.Squiggles
Posted by Phillipa on November 7, 2005, at 17:34:25
In reply to Re: effexor is supposed to have opiod effects..., posted by Squiggles on November 7, 2005, at 9:24:10
Funny that before I learned here that klonopin is more potent than valium, ativan, xanax, etc. I was always told a benzo is a benzo by a pdoc. And maybe it was because I didn't know that I never had any problem switching them. Fondly, Phillipa
Posted by Squiggles on November 7, 2005, at 17:42:15
In reply to Re: effexor is supposed to have opiod effects... » Squiggles, posted by Phillipa on November 7, 2005, at 17:34:25
> Funny that before I learned here that klonopin is more potent than valium, ativan, xanax, etc. I was always told a benzo is a benzo by a pdoc. And maybe it was because I didn't know that I never had any problem switching them. Fondly, Phillipa
I think the chemists know what's up first,
the doctors second, the patients third,
and the drug companies last - after the
stocks go down, lol.Squiggles
Posted by neuroman on November 7, 2005, at 22:37:06
In reply to Tricyclics and anhedonia, posted by Squiggles on November 6, 2005, at 9:19:44
Hi,
Isn't anhedonia a dopamine disorder? Or perhaps I should say a "lack of dopamine" disorder. From what I know (which isn't a lot) dopamine is the neurotransmitter most responsible for pleasure seeking.
By the way I definitely agree with your thoughts on the TCAs. It took amitriptyline 3 1/2 years to do what nature would have taken 30 years to do, that is, turn me from a young man into an old man. And an unhealthy, depressed, anhedonic old man at that. I believe that taking it damaged my cardiovascular system and stopping it damaged my nervous system. Oh yea it's a real winner alright!
I guess I need to add the usual disclaimer now. While this drug messed me up i'm sure many others have found it to be very effective and yada yada yada blah blah blah etc etc and so on an so forth...
Hang in there,
Paul
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Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
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