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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Shelley on November 6, 2001, at 9:47:14
Is there any information available about the effect of naltrexone on psychiatric problems such as autism, psychosis or anxiety disorders?
Thanks.
Posted by Lorraine on November 6, 2001, at 14:06:49
In reply to naltrexone, posted by Shelley on November 6, 2001, at 9:47:14
Shelli--the next med that my pdoc wants me to try is natrexone. Mostly, my research showed it being used as an augmenter to SSRIs--which is what Wayne (who had such a successful response to it did). My pdoc though believes that it will have an effect on anxiety--he has just started using it (n=1). One person on psychobabble posted an article on its use for Trichotillomania (hair pulling)--which I think is like skin picking (which I do)--to me this seems at least aggitation driven. Anyway the psychobabble message is at:
http://www.dr-bob/babble/20010111/msgs/51649.html.
Let me know what you find out about this as well. My pdoc wrote me a script dated the 10th and wants me to call before I fill it.
> Is there any information available about the effect of naltrexone on psychiatric problems such as autism, psychosis or anxiety disorders?
> Thanks.
Posted by shelliR on November 6, 2001, at 17:35:59
In reply to Re: naltrexone » Shelley, posted by Lorraine on November 6, 2001, at 14:06:49
> Shelli--the next med that my pdoc wants me to try is natrexone. Mostly, my research showed it being used as an augmenter to SSRIs--which is what Wayne (who had such a successful response to it did). My pdoc though believes that it will have an effect on anxiety--he has just started using it (n=1). One person on psychobabble posted an article on its use for Trichotillomania (hair pulling)--which I think is like skin picking (which I do)--to me this seems at least aggitation driven. Anyway the psychobabble message is at:
>
> http://www.dr-bob/babble/20010111/msgs/51649.html.
>
> Let me know what you find out about this as well. My pdoc wrote me a script dated the 10th and wants me to call before I fill it.
>
>
>
> > Is there any information available about the effect of naltrexone on psychiatric problems such as autism, psychosis or anxiety disorders?
> > Thanks.
Hi Lorraine. Just for the record I (shelli) didn't
write that post--Shelley did. My pdoc thought I'd really like naltrexon because of its relationship to opiates. Didn't happen. Got all the negatives of opiates (nausea, wired) with none of the benefits. I stopped after one day.Hopefully, YMMV
Shelli
Posted by JeffH on November 7, 2001, at 9:47:24
In reply to Re: naltrexone » Shelley, posted by Lorraine on November 6, 2001, at 14:06:49
I've recently corresponded with Dr. Lee Dante (experiences with Naltrexone in tips section) via email. He says that he continues to have some marvelous results using Naltrexone to augment ADs (usually SSRIs).
Although Naltrexone is an opiate antagonist, which to me would not be helpful if your opiate system is malfunctioning, he wrote to me that among other things, Naltrexone helps build up the opiate receptors over time.
Apparently, results might take weeks to months. This treatment may be especially useful in long-term anhedonic depressions.
As for myself, this treatment is an option if my excursion into partial or full agonist opioids doesn't work.
Damn frustrating work, isn't it? Best of luck to you.
Jeff
Posted by Lorraine on November 8, 2001, at 11:00:13
In reply to Re: naltrexone, posted by JeffH on November 7, 2001, at 9:47:24
Jeff: I'm sure that I am being a skeptic and cynical here (amazing what numerous drug trials and failures will do to your attitude), but whenever I here it takes weeks to months to work I think, "it doesn't work". Intellectually, I know this isn't always true--it took Shelli's 5 week prediction for Nardil to kick in. Still....
> Apparently, results might take weeks to months. This treatment may be especially useful in long-term anhedonic depressions.
>
Posted by Shelley on November 8, 2001, at 12:44:17
In reply to naltrexone, posted by Shelley on November 6, 2001, at 9:47:14
> Is there any information available about the effect of naltrexone on psychiatric problems such as autism, psychosis or anxiety disorders?
> Thanks.Thank you all for your responses.
Shelley.
Posted by Elizabeth on November 8, 2001, at 20:43:03
In reply to Re: naltrexone » Lorraine, posted by shelliR on November 6, 2001, at 17:35:59
> My pdoc thought I'd really like naltrexone because of its relationship to opiates.
That doesn't make much sense to me. Naltrexone is an opioid *antagonist*! Dr. Bodkin said to me that he and his colleagues have tried it and other mu-antagonists (like Stadol), and if anything, they made depressed people feel worse.
I've seen some stuff suggesting that taking a micro-dose of naltrexone taken along *with* an agonist can prevent tolerance, tho'. Wish the drug houses were putting resources into studying this and trying to get something we can use out of it.
-e
Posted by shelliR on November 9, 2001, at 12:19:42
In reply to Re: naltrexone » shelliR, posted by Elizabeth on November 8, 2001, at 20:43:03
Hi Elizabeth.
> > My pdoc thought I'd really like naltrexone because of its relationship to opiates.
> That doesn't make much sense to me. Naltrexone is an opioid *antagonist*! Dr. Bodkin said to me that he and his colleagues have tried it and other mu-antagonists (like Stadol), and if anything, they made depressed people feel worse.
Well, of course I don't know. :-). But if Dr. Bodkin also tried naltrexone, then I would assume he was going for the same effect as my pdoc.It must affect the same cells to make codeine-like drugs ineffective. I guess they were both banking on a positive reaction by affecting the same cells in opposite ways. I don't know, but I think it was strange that I did feel some very bad, codeine-like effects from naltexone
Why are pdocs proscribing naltrexone for depression at all? I mean what is the thinking in terms of that drug affecting depression, given the fact that it is an antagonist?
> I've seen some stuff suggesting that taking a micro-dose of naltrexone taken along *with* an agonist can prevent tolerance, tho'. Wish the drug houses were putting resources into studying this and trying to get something we can use out of it.
>That would be interesting, although with my one day horrible experience with naltrexone, I would not be the first to volunteer. I was not taking oxy or vicidin at the time Right now I am totally freaking out about the cost of oxycontin. I had never gotten more than a week of it before and never really thought about the expense. Wednesday night I went to fill a whole month's dose, plus concerta and wellbutrin and it was over $1400. So I left a note for my pdoc (who I see Monday) that he's got to come up with a generic substitute, even if it's short acting; I can't afford almost $1,800 out of pocket on meds and general insurance every month--my insurance pays 100% of medical bills but no persciption benefits. I've applied to their drug programs for assistance, but I'm not sure because I have money in mutual funds which if they know about, they will turn me down.
I wonder if it's worth going down to Mexico.
So my drug stuff is all up in the air. The only good news is since going up about a month or longer on the oxy, I haven't had to go up any more. But it's still too early to tell if it's permanent.
Man, on top of dealing with the depression, I can't deal with worrying about money.
Shelli
Posted by Elizabeth on November 9, 2001, at 22:19:42
In reply to Re: naltrexone » Elizabeth, posted by shelliR on November 9, 2001, at 12:19:42
> Well, of course I don't know. :-). But if Dr. Bodkin also tried naltrexone, then I would assume he was going for the same effect as my pdoc.
Maybe, maybe not. Remember that Bodkin is primarily a researcher.
> It must affect the same cells to make codeine-like drugs ineffective.
It nonselectively antagonizes opioid receptors. (BTW, morphine, not codeine (which just gets turned into morphine anyway), is considered the prototype opioid receptor agonist.)
> Why are pdocs proscribing naltrexone for depression at all? I mean what is the thinking in terms of that drug affecting depression, given the fact that it is an antagonist?
No clue -- maybe up-regulation of opioid receptors over the long term?
> That would be interesting, although with my one day horrible experience with naltrexone, I would not be the first to volunteer.
This would be using doses so small you probably wouldn't even notice them. You probably got 25 mg pills; the dose you'd use to prevent tolerance is in the microgram range (don't recall any more precisely, sorry).
> Right now I am totally freaking out about the cost of oxycontin.
You're not the only one! :-)
> I had never gotten more than a week of it before and never really thought about the expense. Wednesday night I went to fill a whole month's dose, plus concerta and wellbutrin and it was over $1400.
F---! And I thought a month's supply of buprenorphine (around $150) was expensive.
> So I left a note for my pdoc (who I see Monday) that he's got to come up with a generic substitute, even if it's short acting;
Yes, there isn't any generic OxyContin, but there is generic immediate-release oxycodone. MS Contin does come in a generic, tho'.
> I can't afford almost $1,800 out of pocket on meds and general insurance every month--my insurance pays 100% of medical bills but no persciption benefits.
Oh, that sucks.
> I wonder if it's worth going down to Mexico.
I don't know. I'd be concerned about legal issues.
> So my drug stuff is all up in the air. The only good news is since going up about a month or longer on the oxy, I haven't had to go up any more. But it's still too early to tell if it's permanent.
Well, I'm crossing my fingers for you.
> Man, on top of dealing with the depression, I can't deal with worrying about money.
I've had to deal with depression and worrying about money at the same time before. I think you'll manage.
Best wishes,
-elizabeth
This is the end of the thread.
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