![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by brynb on January 2, 2014, at 16:39:45
hi all and happy new year...
i'm thinking about asking my pdoc for LDN (for mood and bc i sort of believe i have an autoimmune issue that isn't being detected). i have so many questions about this med and would love for people to weigh in here.
thoughts? experience? feedback? i currently take 100mg of Tramadol daily--would i need to stop taking it if i took LDN?
thanks!
-b
Posted by Hugh on January 3, 2014, at 19:02:14
In reply to LDN (low dose naltrexone)? (Hugh?), posted by brynb on January 2, 2014, at 16:39:45
Hi Bryn,
LDN might block the effects of Tramadol. But you might be able to get around this by taking them far enough apart, since LDN is only in your system for several hours. It's best to start with a low dose -- 1 or 1.5 mg, and gradually increase it over a month or two. The maximum dose is 4.5 mg, though many people prefer a lower dose. Most people take it at bedtime, believing that it is more effective when taken at night. But some people take it earlier in the day if it disturbs their sleep. You've got one of the best LDN compounding pharmacies in the country in NYC -- Irmat Pharmacy.
http://www.irmatpharmacy.com/naltexone.html
Good luck and Happy New Year.
Posted by brynb on January 4, 2014, at 3:10:17
In reply to Re: LDN (low dose naltrexone)? (Hugh?), posted by Hugh on January 3, 2014, at 19:02:14
Hi Hugh,
Thanks for your informative response (as usual!). Upon researching it online, it almost sounds too good to be true. Is there a reason "they" haven't or couldn't make a longer acting version?
I've heard of Irmat--curious to check it out. Again, thanks so much, and HNY to you too.
Posted by Hugh on January 4, 2014, at 15:30:26
In reply to Re: LDN (low dose naltrexone)? (Hugh?) » Hugh, posted by brynb on January 4, 2014, at 3:10:17
> Is there a reason "they" haven't or couldn't make a longer acting version?
You don't want naltrexone in your system for more than a few hours. It blocks your opioid receptors. That's why naltrexone at 50 mg has been such a miserable failure as a drug. It prevents people from getting a buzz from alcohol and other drugs, but, since it blocks opioid receptors for long periods, it worsens depression and anxiety. But at a low dose, naltrexone only blocks your opioid receptors for a few hours, which causes your pituitary gland to produce more endorphins.
As an AD, I find LDN only mildly effective. But some people have a robust response to it. It could be that it will do the most good for your asthma.
Posted by baseball55 on January 4, 2014, at 22:08:43
In reply to Re: LDN (low dose naltrexone)? (Hugh?), posted by Hugh on January 4, 2014, at 15:30:26
I don't understand the rationale for LDN. I took 50mg/day after detoxing from opiates. The doc ramped me up slowly and had me ramp up my exercise to try to get my endorphin production at higher levels. It took about three weeks without opiates before I was able to tolerate the 50mg naltrexone.
I don't quite understand the point or rationale for low dose naltrexone. I thought the only real affect of naltrexone is to blockade opiate receptors.
Posted by Hugh on January 5, 2014, at 13:56:14
In reply to Re: LDN (low dose naltrexone)? (Hugh?), posted by baseball55 on January 4, 2014, at 22:08:43
This is from http://www.ldnscience.org/low-dose-naltrexone/how-does-ldn-work
Naltrexone is an externally administered drug that binds to opioid receptors. In doing so, it displaces the endorphins which were previously bound to the receptors. Specifically, by binding to the OGF [Opioid Growth Factor] receptor, it displaces the bodys naturally produced OGF.
As a consequence of this displacement, the affected cells become deficient in OGF and three things happen:
Receptor production is increased, in order to try to capture more OGF.
Receptor sensitivity is increased, also to try to capture more OGF.
Production of OGF is increased, in order to compensate for the perceived shortage of OGF.Since LDN blocks the OGF receptors only for a few hours before it is naturally excreted, what results is a rebound effect; in which both the production and utilization of OGF is greatly increased. Once the LDN has been metabolized, the elevated endorphins produced as a result of the rebound effect can now interact with the more-sensitive and more-plentiful receptors and assist in regulating cell growth and immunity.
Posted by Hugh on January 5, 2014, at 14:14:53
In reply to LDN (low dose naltrexone)? (Hugh?), posted by brynb on January 2, 2014, at 16:39:45
The recommended starting dosage for LDN is 1.5 mg for the first month, 3 mg the second month, and then 4.5 mg. It's fine to start with a higher dosage, or move to a higher dosage sooner -- if you can handle it. These are just recommendations to lessen the impact of LDN side effects. Some people prefer 3 mg or 3.5 or 2.5 to 4.5 mg.
This site should answer any questions you have about LDN:
https://sites.google.com/site/dudleyslowdosenaltrexonesites/home
Posted by brynb on January 5, 2014, at 14:55:26
In reply to Re: LDN (low dose naltrexone)? (Hugh?) » brynb, posted by Hugh on January 5, 2014, at 14:14:53
Thanks, Hugh! I'll bring it up with my doc this week (I see him Weds.). My biggest concern is stopping Tramadol, but we'll see what he says.
Thanks again!
-b
Posted by Hugh on January 5, 2014, at 17:15:40
In reply to Re: LDN (low dose naltrexone)? (Hugh?) » Hugh, posted by brynb on January 5, 2014, at 14:55:26
You're welcome. Concerning LDN and Tramadol, I just came across this at http://www.ms-uk.org/choicesldn
On starting LDN the recent use of opiate analgesics will result in an opiate withdrawal syndrome with increased pain, muscle spasm and possible vomiting and diarrhoea. It is therefore advisable that any opiate analgesics be discontinued at least two weeks before starting LDN. These include drugs such as Co-Codamol, Oxycodone, Fentanyl and Buprenorphine Patches. Tramadol CAN be used; however, they must be taken 4-6 hours apart. The use of LDN at the same time as sustained release pain killers is NOT recommended.
Me again. And this at https://sites.google.com/site/dudleyslowdosenaltrexonesites/home/drugs-to-avoid-on-ldn
Painkillers approved for use with LDN include Moxxor, Ultram® (tramadol), aspirin, Tylenol®, Advil®, Motrin®, Aleve®, Naprosyn®, Ansaid®, Dolobid®, Orudis®, Voltaren®, Feldene®, Mobic®, and the food supplement, DL-Phenylalanine (DLPA). DLPA, which is also said to enhance the effectiveness of LDN, should be taken twice a day on an empty stomach in doses of 500 mg. It should not, however, be used by people with high blood pressure, pregnant or lactating women (breast feeding), in cases of phenylketonuria (a rare medical condition), by patients taking MAOIs (monamineoxidase inhibitor drugs for mental illness), and by children under the age of 14 years.
Posted by brynb on January 7, 2014, at 0:50:14
In reply to Re: LDN (low dose naltrexone)? (Hugh?) » brynb, posted by Hugh on January 5, 2014, at 17:15:40
Thanks again, Hugh. I really appreciate it!
I'm rethinking the LDN for now. Here's my dilemma (I actually kind of screwed myself, but I had a feeling this would eventually happen): I've been taking pretty high doses of oxycodone (either Roxicodone or Oxycontin) a few times a week for about four or five months now. It's not the first time I've done this.
I'm actually quite embarrassed to mention it here (or anywhere, for that matter), but it's relevant and I'm extremely remorseful and upset. I've been getting the pills through a friend who's an addict. Smart? NO--especially as I've battled substance abuse in the past. However, as strong as these painkillers are, they have been carrying me through my depressive episodes/ lows as of late. They don't get me high, they just make me feel normal and generally "good." It's a slippery slope, I know, but I thought I could outsmart becoming dependent because I haven't been taking them daily. But for over a week now, I've been feeling ill and flu-like, and when I take any type of painkiller, even at a low dose, I'm temporarily relieved. Ugh.
I'm going to fess-up at my pdoc appointment this week, and see if he'll put me on Suboxone. I've had some success with Sub for various issues in the past (including depression and benzo withdrawal), so I'm hoping this will be a good solution.
Complicated, huh? I'm at a loss. Perhaps LDN will be an option in the future, but unfortunately I have to deal with this mess I got myself in to.
-b
Posted by Hugh on January 7, 2014, at 16:51:07
In reply to Re: LDN (low dose naltrexone)? (Hugh?) » Hugh, posted by brynb on January 7, 2014, at 0:50:14
I got myself in to a similar mess with lorazepam. I took it for three years for insomnia, but never considered myself dependent on it. I thought I could quit it at any time, but I didn't want to because I liked sleeping seven or eight hours every night. Then the lorazepam turned on me and started causing inter-dose withdrawal, so I decided to quit cold turkey. Forty-eight hours later, I was climbing the walls. I was shocked and deeply ashamed. How could this have happened to me? I never intended to become dependent on benzos. All I wanted was a good night's sleep. Then it occurred to me that probably no one has ever set out to become dependent on a drug. It just happens sometimes. So try not to be too hard on yourself.
Posted by brynb on January 7, 2014, at 20:22:20
In reply to Re: LDN (low dose naltrexone)? (Hugh?) » brynb, posted by Hugh on January 7, 2014, at 16:51:07
Thanks, Hugh. I will say that benzo withdrawal is pure hell. Awful, awful, awful. At the same time, after trying literally everything for anxiety, benzos are (in my opinion) the best anxiolytics out there.
I'm trying not to beat myself up. My intentions with opiates were to try to feel normal and lift the depressive fog. I'm not entirely defeated as I've had luck with Suboxone in the past.
I know an addiction pdoc (who no longer practices as he is now a full-time musician and a physician's advocate for prescribing opiates) who believes that opiates, when used by those in true psychic and physical pain, don't necessarily get patients "high" the way they would with ordinary people. His philosophy is that opiates make those in real pain feel normal, and sees them as a decent treatment for TRD as long as patients are properly monitored.
Thanks again =).
-b
This is the end of the thread.
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.
Owned and operated by Dr. Bob LLC and not the University of Chicago.