![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by princenamor on September 7, 2008, at 6:43:42
Hi,
I'm trying to use Suboxone for Depression, but am having problems with side effects of extreme drowsiness and impaired thinking. Does anyone know how I can deal with these side effects? I don't think lowering my dose will help, because even a small dose makes me tired. I've tried taking it at night, but mornings are the worst time for me, and the night dose doesn't help them, so I have to take 2-4mg in the morning to feel OK. I'll listen any advice. I need to make the Suboxone work for me.None of the conventional antidepressants or other mental health drugs work (in fact they are quite harmful), and Vicodin worked very well; it makes me feel more balanced, gives me more energy, more concentration, and no euphoria. I didn't want to live a life of underground treatment, so I kept looking for a Doctor who would treat me legally with Buprenorphine. Unfortunately, I'm having the above problems, and I know it's the only opiate medication that I will be able to get a prescription for; unless anyone knows of a way I can find a Doctor who will give me another opiate option. Do you? Also, is there any difference between the effect of Suboxone and Subutex?
Posted by Babak on October 1, 2008, at 16:59:58
In reply to Buprenophine-Suboxone-Drowsiness-Help!, posted by princenamor on September 7, 2008, at 6:43:42
Before it is too late don't start down that road because I have been and I went through hell to get out of it.
First of all read here:
http://www.medhelp.org/health_pages/Addiction/Suboxone-Subutex-FAQ-Part-One/show/14?cid=66
Then read my story:
http://www.chinese-formula.com/mystory.php (forget about what the site is about. I am not trying to sell you anything.)Do you have a doctor who is prescribing this? Tell him about the above two postings.
There are hundreds of other articles about withdrawal from Buprenorphine. It is truly a cure worse than the disease.It will help you with depression, initially anyway but the side effects are terrible and the longer you use it the worse they get.
I suppose for really bad addicts or those who want to manage pain there is a place for Buprenorphine but with regards to depression; no way. The positive outcome which is not that much is not worth the pain that you might have to go through. Although the way I did it is probably the best but it is not legal unfortunately and this is the problem with the Law.
I think there is a definite place for managing depression using opiates (not opioids) as they were used legally back in late fifties and early sixties but nobody wants to listen. I am sure that there is a high percentage of opiate addicts who did show clear symptoms of clinical depression prior to their addiction.
If you want to know more just ask.
Don't do it.
Posted by Sigismund on October 1, 2008, at 19:31:15
In reply to Re: Do not do it! » princenamor, posted by Babak on October 1, 2008, at 16:59:58
>I think there is a definite place for managing depression using opiates (not opioids) as they were used legally back in late fifties and early sixties but nobody wants to listen.
Interesting.
Certainly this is particularly true of methadone.
Posted by princenamor on October 1, 2008, at 22:17:39
In reply to Re: Do not do it! » princenamor, posted by Babak on October 1, 2008, at 16:59:58
I'm trying to make Suboxone, Buprenorphine work because I will not be able to get other opiate or opioid medications. It is working better than having nothing, but it is not as good as say Vicodin which worked much better. I can't really get off because like you I'm all alone, but also an opiate or opioid is the only way I can function. My Dr. has officially given me an opioid addiction diagnosis (I was using a limited ammount of Vicodin to treat myself), but we both know it's really for depression. Wellbutrin and other antidepressants, antipsychotics, moodstabalizers, these traditional drugs destroy me. I would prefer a different opiate but buprenorphine is the only thing i can get. I need something that works, and that I have access to. If it doesn't work in the long run I think I may have to give up all hope because I've spent my entire life in this system, and there's no where left to go. I'm not totally functional with an opiate or opioid, but I'm more functional than I have been before. Vicodin was more functional but buprenorphine is still making me able to do things. I'm not sure what my alternative would be at this point, unless you have a suggestion that is possible for me to obtain. Remember I have had much more therapy than drugs though I've had much of both.
Posted by Babak on October 2, 2008, at 0:12:02
In reply to Re: Do not do it!, posted by princenamor on October 1, 2008, at 22:17:39
Have you tried Methadone which is still bad but nowhere as bad as Subutex.
I have been suffering for 28 years, so I know what you mean. I couldnt even move when I came off Subutex. Finally I went back to morphine. If I hadnt I probably would have still been house bound.
Can your dr. put you on morphine sulphate? That will work. The problem with addiction to opiates is not the chemical it is their illegality and the kind of situations you get into and the kind of people you get involved with which are dangerous. I wished governments would accept that. Read about the trials in Germany: http://news.bbc.co.uk/2/hi/uk_news/scotland/5043766.stm.
The other advice I can give is VNS. It has done wonders for me and I am still in the first year. It is supposed to get better in the second year.
Look Subutex will get you going initially but its benefits will wear out very gradually and by then it is too late.I am still not functional but much better than how I was with Subutex towards the end.
Reconsider.
Posted by Sigismund on October 2, 2008, at 17:10:43
In reply to Re: Do not do it! » princenamor, posted by Babak on October 2, 2008, at 0:12:02
>Have you tried Methadone which is still bad but nowhere as bad as Subutex.
Is that right?
I've not tried Subutex/bupe, but I'm familiar with methadone maintenance.
My impression was that bupe was less depressing than methadone and easier to get off.
(I cannot believe it would be harder to get off, although I can imagine that synthetic opioid feel.)
Posted by Babak on October 2, 2008, at 17:47:11
In reply to Re: Do not do it! » Babak, posted by Sigismund on October 2, 2008, at 17:10:43
Read the links I included in one of the previous messages.
You can search for one. There are quite few of them around now.
As usual it didn't turn out to be such a wonderful drug after all.
The best course of action is to stick to the natural stuff.
Read about the success of the trials in Germany, as well as the success in Switzerland and Holland.
It is just that US which has condemned the rest of the world to an interminable war against drugs. If it weren't for US dictating their views to the rest of us I believe Europe would have legalized them a long a go. Their new war one is not going to be better either i.e. war against terror.
Posted by princenamor on October 2, 2008, at 22:16:36
In reply to Re: Do not do it! » Sigismund, posted by Babak on October 2, 2008, at 17:47:11
My doctor can only prescribe suboxone. I take a small to medium dose 10mg. This is the only doctor I've found who will give me any kind of opiate or opioid for depression. I think natural would probably be best, and probably less strong drugs like vicodin would be fine, but what do you do in a country whose Doctors are frightened into line by the drug war. Where I am now it's either Suboxone or nothing. Unless someone knows a Doctor in my area, which I don't want to say here, who would give me a different opiate for depression. Exactly how long did it take for suboxone to stop working for you, and what were the symtoms?
Posted by Babak on October 3, 2008, at 1:32:45
In reply to Re: Do not do it!, posted by princenamor on October 2, 2008, at 22:16:36
Around two years and I am not the only one. There have been other cases. Initially it helped with depression and then gradually after eighteen months to two years I started feeling lethargic and it got so bad that I started showing symptoms like self neglect.
There are also cases with Naltraxone with depression as well.
This stuff in only good for short term treatment of addiction to opiates. I mean two weeks treatment.
Posted by princenamor on October 11, 2008, at 17:17:44
In reply to Re: Do not do it! » princenamor, posted by Babak on October 3, 2008, at 1:32:45
I need more information from you Babak to discuss this with my psychiatrist. The problems you describe about how Buprenorphine made you more lethargic; these are the same symptoms that make taking an opiate necessary for me. I have terrible lethargy and concentration problems including self neglect. This has literally been my entire life. Vicodin didnt make these problems go away, but it opened a door of possibilities that I could work around these problems, and it did make many of them better. However, I can not get Vicodin legally, and do not want to put my faith in an insecure black-market. Buprenorphine is not nearly as good as Vicodin, but with some symptom management it has the real possibility to help with my concentration and lethargy problems. Given a choice I would much more prefer to take hydrocodone or another more natural opiate; they are obviously more effective and side effect free, but it has taken me forever just to find a Doctor who will give me Buprenorphine. If I am going to get him to help me get a natural opiate; I need much more information from you than the links you have given provide.
First, I need a much more detailed description of the symptoms you began to have after 2 years, and the way in which they came about. If you were on Suboxone for depression, how were the symptoms of lethargy you had before you started the drug different from the symptoms you had when the drug began to go bad on you. How did the drug itself feel before it began to go bad for you?
Second, are there any studies that show how many people taking Suboxone have had it have these negative effects after 2 years, OR are there sites with many people who were on Suboxone (not just one or two) telling their stories of how after 2 years the drug started to have these effects.
Third, when I try to get psychiatrists to give me opiates to help my depression I use the Harvard Bodkin study of 1995. Are there any studies, or case studies, that use natural opiates like Vicodin? Not for substance abuse, but literally for mental health problems like depression.
Right now, through legal channels the only way to get an opiate or opioid to help my depression is to get Suboxone, and even that is very hard. Vicodin was so much better for my symptoms than Buprenorphine, but Legally Buprenorphine is all that is available to me. Yes, the drug war Sucks. It sucks not only for me, but for elderly people in chronic pain whos doctors cut them off Vicodin or morphine, because they are scared of addiction, this is the most ridiculous thing I can imagine. In my case, it drives me nuts that drugs that can give you permanent loss of muscle control, and adult diabetes (antipsychotics), or procedures that can give you permanent memory loss or brain damage (ECT) are considered safe while opiates are considered unsafe because of addiction. Especially ridiculous since when treating a chronic problem youd be taking it on a regular basis anyway. However, if I am to convince my now open-minded doctor that Suboxone is dangerous, and that we must switch to a natural opiate; I need more data. Given the choice between Buprenorphine and nothing I have to go with Buprenorphine.
Posted by Babak on October 13, 2008, at 18:15:56
In reply to Re: Do not do it!, posted by princenamor on October 11, 2008, at 17:17:44
It is like listening to myself. The way it happened to me was like this: I used to take opium on and off for fifteen years to help me with lethargy and lack of concentration and I was doing fine. But I got fed up with the hassle of street drugs and I had also developed a psychosomatic pain which wouldn't go away unless I had opiates. Anyway once when I had run out of opium, I tried Subutex which at the time and even now they don't prescribe for depression in UK.
And off course it worked not as good as opium but none the less. It stopped the pain and kind of controlled the lethargy. I was still lethargic but I could get the essentials done at least.
Then after two years the lethargy started to come back with a vengeance. It was as if my mind was split into two. One part of it knew that I should go out of the house or have a shower but it was as if I couldnt command my legs to get up. I even stopped talking to people. I just couldnt concentrate on anything. Everyone around me told me that it was the Subutex but every time I tried to give it up apart from withdrawal symptoms the pain in my stomach just wouldnt allow me.
Anyway I cant tell you for sure but lethargy was back and off course I couldnt just go back to my natural stuff because it just didnt have any effect and by then I was so depressed that I couldnt go out and score. I was living alone with a psychiatric nurse visiting me twice a week. I couldnt jolly well ask her to score for me.
Anyway finally my stash of Buprenorphine ran out and I was in hell with pain as well as withdrawals. Finally the doctor who knew nothing about Buprenorphine prescribed morphine and by then the levels of Buprenorphine were down so the morphine worked straight away. It was like being reborn again. I found my old contacts and kept asking the doctor for morphine for my stomach pain which I kept just in case I couldnt get hold of the stuff on the street.
Then I read about VNS and I decided to go for it, because although heroin allows me to function just about enough I was/am still depressed and cant work. It took me over a year because there is apparently only one person who carries out the procedure/operation. Also I was refused National Health funding for it and I had to pay for it myself which cost £17,000.00 for just the operation and then there are specialists visits once a month which cost £170.00 every time. By then I had been unemployed for three years and I was broke. Anyway cut a long story short I came to some inheritance money which I think was a miracle. I had the implant done last November. There were few complications but on the 10th of December 2007 I had an appointment and the doctor put the amplitude of the impulse to 1ma which is the lowest level where they have detected therapeutic effects. By the time I arrived home that is about an hour drive from the hospital, I was feeling better already. It is incredible but it is true. I was on top of the world, I could not believe it. I went out and bought myself a leather jacket. I hadnt bought myself any clothing for years. But unfortunately it didnt last and on the third day I crashed. Then I found out that it was quite normal and I was going to go through lots of ups and downs until my brain is used to the stimulation. Anyway I never felt as good as I did the first time but I think there were quite a few psychological aspects to that first time which obviously couldnt be recreated again. But VNS has substantially improved my general state and I am still in the process of adjusting it. So there may be further improvements to come but at the same time it could also stop working as well. It has made the worse tolerable and if I really push myself I can get the minimum stuff done, like shopping, dealing with invoices and so forth and despite my therapists claims things havent got easier with practice as she call my extra efforts. So after a while I had to go back to heroin again which is the cheapest opiate you can find. I refuse to go on methadone as a drug addict because I think methadone like Subutex is worse than natural opiates and this is not some green statement. It is a fact for me and I would never, ever touch Buprenorphine in my life again.
But it is still a lot of hassle as you would expect relying on a street drug. I have been arrested once but fortunately I didnt go to court and they just gave me a caution. Doctors continue to refuse opiates as a tool for managing my depression and my doctor refuses to increase my morphine prescription.
This meant that from time to time I had to go through withdrawals until I came across this site; www.chinese-formula.com. Now I have tried a lot of things simply because I have to keep hoping. I dont care what is in this Chinese stuff who believes me but this herbal remedy really does work and stops withdrawals better than anything else I have come across including Dihydrocodeine. Believe it or not it works, it keeps away withdrawal symptoms and it actually helps slightly with the depression as well. I still dont believe it myself but the stuff works. Off course it is nothing like heroin but I intend to keep some around in case I cant get hold of heroin and I have run out of morphine or I have to travel abroad which does happen because my family live abroad.
I still cant go back to work and suffer from anhedonia but through a combination of different thing I am a lot better than how I used to be before my VNS implant. I have run out of money and I cant see the specialist as often I would like to, in order to adjust my VNS setting but to be honest I think it has done as much as it was going to do. I just pray that it wont stop working. But I am afraid heroin remains the real driving force to keep me sort of alive.
I have even tried Ketamine and yes it does help but remission remains as far as it has ever been for the last four years.
I think the answer to depression cases like mine i.e. TRD is in deep brain stimulation but not in its current proposed formats. I think it is something which has to be adapted to different categories of patients depending on understanding the workings of different parts of the brain. I believe depression is a very real disease of the brain like Parkinsons or Alzheimers. Unfortunately the society and even the experts and academics are very far from accepting this as a fact. I think the first step has to be a differentiation between the psychological and psychiatric recognition of depressions manifestations. I have had (ten) years of therapy of different kinds and in many ways they have helped me to cope with life but none of them have had the slightest effect on my depression.
As to opiates and their role in depression, I agree that they are not the solution and can be dangerous and even detrimental but under close supervision they definitely have a role to play in management of depression and that role is relieving the pain of depression which nobody seems to acknowledge. They wouldnt deny a cancer patient or an accident victim of pain control medication, so why should they deny it to someone with mental disease?
Posted by Babak on October 13, 2008, at 18:22:42
In reply to Re: Do not do it! » princenamor, posted by Babak on October 13, 2008, at 18:15:56
Sorry I meant there is only one guy in UK who carries out the procedure of implanting VNS device.
Posted by cowan78 on October 21, 2008, at 13:03:04
In reply to Re: Do not do it! » princenamor, posted by Babak on October 13, 2008, at 18:15:56
Now this is a thread about buprenorphine that I can agree on. Yes, bupe is a great antidepressant during the first month or so of treatment. Its an opioid, for god sake...who can say they never enjoyed the narcotics given after wisdom tooth extraction, broken limbs, surgery..etc. ok, maybe some can, but I TOTALLY agree that bupe is the wrong choice for long term treatment of depression. I'll cave in, after a long and angry post on another board, that MAYBE, JUST MAYBE opiates/opioids can be used to augment a medication/treatment for depression, but only then for a very limited time (ie NEVER more than 2-4 weeks). It is not the life saver people seem to think it is, and there are no long term studies to show continued benefit for depression. Its even sketchy if bupe is effective long term for opiate abstinence. The pitfalls here def. outweigh the benefits, and as a previous poster said, 'DONT DO IT'!
Posted by cowan78 on October 21, 2008, at 13:10:51
In reply to Re: Do not do it!, posted by princenamor on October 11, 2008, at 17:17:44
quick follow through...I agree the war on drugs has made it hard on everyone in that if it weren't for this stupid war, drugs would never have become so demonized, and makers of Suboxone (who charge OUTRAGEOUS prices for their drug) would never have a niche in the market. I still am no pro-opiate user for long term treatment of depression, but you're right...the drug war has limited the use of ALL opiates, regardless of the condition.
BTW, have you ever heard of butorphanol? it is a intanasal spray for migraines, has many similar actions of bupe, and much less addiction/abuse potential. check it out if you are still interested in a short term burst therapy with an opioid.
Posted by Babak on October 21, 2008, at 15:26:29
In reply to Re: Do not do it!, posted by princenamor on October 11, 2008, at 17:17:44
Look, you seem to have exactly the same problems I have /had.
I am starting to look into possiblity hypothyroid.Buprenorphine is still a new drug. There are not extensive studies on its long term use.
At the same time I know someone who had been on it for five year but not because of depression. She was a heavy duty heroine addict and she is still doing fine after five years.
The other thing you have to bear in mind that you are still only treating the symptom. What about the cause?
Posted by georgebabble on January 29, 2009, at 23:13:56
In reply to Re: Do not do it!, posted by princenamor on October 11, 2008, at 17:17:44
> I need more information from you Babak to discuss this with my psychiatrist. The problems you describe about how Buprenorphine made you more lethargic; these are the same symptoms that make taking an opiate necessary for me. I have terrible lethargy and concentration problems including self neglect. This has literally been my entire life. Vicodin didnt make these problems go away, but it opened a door of possibilities that I could work around these problems, and it did make many of them better. However, I can not get Vicodin legally, and do not want to put my faith in an insecure black-market. Buprenorphine is not nearly as good as Vicodin, but with some symptom management it has the real possibility to help with my concentration and lethargy problems. Given a choice I would much more prefer to take hydrocodone or another more natural opiate; they are obviously more effective and side effect free, but it has taken me forever just to find a Doctor who will give me Buprenorphine. If I am going to get him to help me get a natural opiate; I need much more information from you than the links you have given provide.
>
> First, I need a much more detailed description of the symptoms you began to have after 2 years, and the way in which they came about. If you were on Suboxone for depression, how were the symptoms of lethargy you had before you started the drug different from the symptoms you had when the drug began to go bad on you. How did the drug itself feel before it began to go bad for you?
>
> Second, are there any studies that show how many people taking Suboxone have had it have these negative effects after 2 years, OR are there sites with many people who were on Suboxone (not just one or two) telling their stories of how after 2 years the drug started to have these effects.
>
> Third, when I try to get psychiatrists to give me opiates to help my depression I use the Harvard Bodkin study of 1995. Are there any studies, or case studies, that use natural opiates like Vicodin? Not for substance abuse, but literally for mental health problems like depression.
>
> Right now, through legal channels the only way to get an opiate or opioid to help my depression is to get Suboxone, and even that is very hard. Vicodin was so much better for my symptoms than Buprenorphine, but Legally Buprenorphine is all that is available to me. Yes, the drug war Sucks. It sucks not only for me, but for elderly people in chronic pain whos doctors cut them off Vicodin or morphine, because they are scared of addiction, this is the most ridiculous thing I can imagine. In my case, it drives me nuts that drugs that can give you permanent loss of muscle control, and adult diabetes (antipsychotics), or procedures that can give you permanent memory loss or brain damage (ECT) are considered safe while opiates are considered unsafe because of addiction. Especially ridiculous since when treating a chronic problem youd be taking it on a regular basis anyway. However, if I am to convince my now open-minded doctor that Suboxone is dangerous, and that we must switch to a natural opiate; I need more data. Given the choice between Buprenorphine and nothing I have to go with Buprenorphine.
>
> HELLO. I'M A NEWBIE TO THIS SITE. IVE BEEN READING THIS PARTICULAR TOPIC OF THREADS FOR QUITE A WHILE INFACT BECAME A MEMBER JUST TO CONTRIBUTE TO THIS THREAD. HOPING TO LEARN A LITTLE ABOUT SUBOXONE. AND ALSO TO HOPFULLY HELP ALIGN YOUR VIEW OF VICODEN. FROM THE WAY YOU SPEAK OF MEDS SUCH AS VICODEN, I CANT HELP BUT TO ASSUME YOU LIVE IN AN AREA THAT DOESNT PROVIDE THESE TYPE OF MEDS.? SURELY YOU HAVE RESEARCHED THESE MEDS ON THE NET? VICODEN,LORTAB,AND HYDROCODONE ARE LITERALLY ALL THE SAME DRUG! AND THEY ARE NOT NATRUAL NARCOTICS(OPIATES). THEY ARE SYNTHETIC NARCOTICS(OPIOIDS). SO (HYDROCODONE-VICODEN-AKA-LORTAB) (OXYCODONE-PERCOCET) (OXYCONTIN-TIME RELEASED OXYCODONE)(HYDROMORPHONE-DILAUDID) AND (DIACETYLMORPHINE-HEROIN) ARE ALL PARTIAL-SYNTHETIC OPIOIDS. FULL SYNTHETICS ARE MEDS LIKE METHEDONE,FENTENYL,TRAMADOL. MORPHINE,AND CODEINE ARE NATURAL OPIATES ALKALOIDS. NOW OF COURSE THESE SYNTHETICS ARE GONNA MAKE YOU FEEL GREAT, AND RID YOU OF YOUR DEPRESSION. LOL. THEY ARE OF SYNTHETIC DESIGN TO HIT YOUR OPIOID RECEPTERS PERFECTLY, AND HIT EM' HARD! SO YOU FEEL GOOD. TO "ALTER YOUR PERCEPTION TO PAIN" AKA ANALGESIA. NO WAY CAN VICODEN BE USED TO TREAT DEPRESSION! THEY HAVE A VERY SHORT HALFLIFE. THEY TREAT PAIN, BY HITTING THOSE RECEPTORS HARD, WHEN YOU USE THEM FOR A WHILE YOUR BRAIN STOPS PRODUCING ITS OWN "NATRUAL" MORPHINE LIKE HORMONE SO THAT IT DOES NOT PRODUCE EVEN WHAT IT USED TO MAKE BEFORE YOU STARTED TAKING THE PAINMEDS. SO THAT EVERYLITTLE CUT OR BRUISE CAUSES YOUR PAIN TO MORE INTENSE, CAUSE YOUR BRAIN CANT MASK THE PAIN LIKE IT COULD BEFORE, PLUS YOU CRAVE,CRAVE,CRAVE YOUR PAINMEDS SO BAD BECAUSE AGAIN YOUR BRAIN GOT USED TO GETTING SLAMMED WITH ALL THIS STIMULATION OF NARCOTIC, BEING CHEMICALLY ENGINEERED TO BIND SO MUCH MORE ACUTE THAN THAT OF A NATURAL OPIATE OR EVEN YOUR OWN BRAINS MORPHINE-LIKE SUBSTANCE. YOU JUST CANT LIVE WITH OUT IT. PLUS YOU THINK YOUR DEPRESSED NOW, WAIT UNTIL YOU BECOME THIS WAY, AND YOU DONT HAVE YOUR MEDS? WOW!! PEOPLE TAKE 30 TO 40+ VICODEN A DAY. YOU CANT JUST TAKE A FEW VICODEN A DAY FOR DEPRESSION IT WILL SOON FOR A FACT TURN INTO A PROGRESSIVE MAINTANANCE OF YOUR OWN UNKNOWING DOWNWARD SPIRAL OF SEVERE ADDICTION BY TAKING MORE AND MORE AND MORE. YOUR BRAIN WILL PRODUCE LESS AND LESS AND YOUR RECEPTORS MORE AND MORE DAMAGED. YOU WILL SOON FIND YOUR SELF TAKING 10+ AT A TIME JUST TO GET YOURSELF TO FEEL LIKE YOU DID BEFORE YOU STARTED TAKING THEM.TO GET YOUR SELF TO FEEL LIKE WHAT YOU CALL DEPRESSION NOW....... TAKE IT FOR CHRONIC PAIN ONLY IF YOU HAVE TO. NOT FOR DEPRESSION, THOSE WHO TAKE IT TO FEEL BETTER, SUCH AS FOR DEPRESSION. WILL CONTINUE TO TAKE MORE AND MORE TO CATER TO THE NEEDS OF THEIR FEELINGS.
Posted by Jim45 on February 5, 2009, at 12:13:53
In reply to Buprenophine-Suboxone-Drowsiness-Help!, posted by princenamor on September 7, 2008, at 6:43:42
Hi Princenamor.
I'm a little confused by what some have wrote you re suboxone. Some of what they've written sounds like they're talking about pure antagonists like subutex.
I have a couple of posts on the med board about Effexor and what I went through coming off of it. I ran out of suboxone 3 months after stopping the FXR, and I had hardly ANY withdrawals. I was in such TERRIBLE shape though from FXR withdrawal that it's possible I didn't notice symptoms. I only remember my legs feeling funny/crampy and some strange "thoughts". I'd been taking suboxone for about 2 or possibly 3 years. 2-8 mg daily (different amounts because I used different dose/med combos daily to avoid acclimation).
I went on the suboxone after acclimating to FXR. I couldn't stop the FXR because the withdrawals were too bad, and I thought it might still be helping a little. Before I got the suboxone from my wonderful Doc, I was ordering dihydrocodeine from an internet pharm and had began supplementing the dihydro w/low dose naloxone to prevent tolerance and dependence. THAT'S what many people aren't aware of. Research has found that supplementing opiates w/low dose antagonists like naloxone stops/reduces tolerance and dependence. I took subutex from my Doc before the suboxone, and like the dihydro and other opiates I quickly built up a tolerance to the anti-depressant effects. No such problem with the suboxone after months/years on it.
There are studies conducted by a University in Israel and duplicated by a University in New York that found massive endorphin receptor numbers in the post-mortem brains of disease and drug-free suicide victims (obviously depressed). Some of us have such deficiencies that will only respond to opiates. I theorize that FXR (after years of trying other stuff) helped me because it's structurally similar to narcotics. Of COURSE the manufacturer lists no affinity for endorphin receptors in its data on FXR. If there is such action, prescribing it would be much more complicated.
The above being said, I don't understand the drowsiness problem. One of the main things that reminded me to take my suboxone some days was my getting tired. Suboxone woke me up and stopped some digestive problems I've had my whole life. It didn't make me tired at all. It was one of the best meds I've ever used for my TRD.
I'll conclude though by mentioning that as we're all physically different, so is our neurology. There was also a wise comment/question by the last poster about why you need meds. If you're using meds to cope w/stuff, it will complicate treating actual conditions you may be suffering from - if any. Got to deal with problems/situations you might be using meds to cope with before you can get to medicating real problems. Princenamor, I've done it all and been almost everywhere. I'm not some young/inexperienced commenter.
I'll gladly provide relevant websites/data if you have any questions.
Good luck and best wishes!!
Jim
Posted by Neal on February 23, 2009, at 2:55:40
In reply to Re: Buprenophine-Suboxone-Drowsiness-Help!, posted by Jim45 on February 5, 2009, at 12:13:53
Jusy a few words. It seems that you only have to mention bupe and some people start foaming at the mouth. bupe is an opiod agonist, meaning it's not the same as strait opioids. Taking more won't get you higher. Shooting won't work.
Bupe has helped some people with depression, especially if it is already partially helped by ADs. In the studies I have seen only about one out of 4 or 5 responded. I was lucky to have been that one out of 5. So blanket statements about it will work/it won't work are not accurate. it might work - for some. Suboxone 4mg helped me, after I had gotten some help from other things too.
Posted by jim45 on February 23, 2009, at 15:16:29
In reply to Re: Buprenophine-Suboxone-, posted by Neal on February 23, 2009, at 2:55:40
Hi Neal.
Yep. I noticed the strong feelings about it.
Don't know why I called Subutex an antagonist either. I meant, as you said, a partial agonist.I agree it's not for everyone. I think endorphin deficits and other neurochemical deficits are more common than some Docs might think they are.
They seem to have a protocol - start with SSRI's, if they don't help enough (and like the Abilify commercial says, 2 out of 3 still need something)
add an NDRI or go to an SRNI, then try weird stuff like antihistamines and antiseizure meds etc.Anything except for opiates or partial opiates.
I'm not surprised about only a few being helped by bupe only. A tolerance quickly develops. I wish they'd research bupe+naloxone - Suboxone.Like you, Suboxone helped me a lot/somewhat, unlike many other meds, and when I ran out withdrawal wasn't that bad. The last regimen the Doc had me on was Suboxone, Selegiline, and Effexor (but just because I couldn't take the FXR withdrawal and it MIGHT have been helping a little).
Oh - and getting the Doc to prescribe 8 mg tablets I could break saved me BIG bucks.
Thanks!!
Jim
Posted by MoonageDaydream on December 15, 2009, at 20:05:26
In reply to Re: Do not do it!, posted by princenamor on October 11, 2008, at 17:17:44
Hi. I've been on Suboxone for 3 years, after a couple years of opioid addiction. I also suffer from treatment-resistant depression and have ADD (inattentive type). Hopefully I can be of some assistance.
First of all, how much Vicodin did you take before starting buprenorphine? The reason you're tired is almost certainly because you're on too high a dose of buprenorphine. Buprenorphine is FAR stronger than many people (including many doctors) realize. I was taking on average 160 mg of Oxycontin or 60 mg of Methadone per day (which is equivalent to ~240-300 mg Hydrocodone; or 30 10/500 Vicodins). Switching to 12 mg of Suboxone was way too much, and even 8 mg was probably more than necessary. I've heard countless stories of people without significant opioid tolerance taking as little as 1 mg and feeling very nauseous and sedated for 16-24 hours. 8-16 mg buprenorphine has been demonstrated to be as effective as 50-80 mg of methadone at keeping opioid abusers clean. Check your pupils...if they're are really tiny in a well-lit room, you're on too much. Unlike most opiates, taking higher dosages of buprenorphine doesn't seem to increase the mood-lifting or euphorigenic properties of the drug.
I have to say that taking opioids for antidepressant purposes on any continuous basis is a recipe for disaster. Withdrawal is agonizing...its like days of torture. And its not the physical symptoms that are so bad...its the psychological aspect that is awful, especially if you have a history of depression. Buprenorphine withdrawal is particularly bad, because it lasts for weeks. I often hear the claim that the withdrawal from buprenorphine is milder than with full agonists. Some people get off it fairly easily so long as they jump off at 1 mg or less; others (such as myself) would take oxycodone w/d anyday over suboxone withdrawal. Do a google search for "Suboxone Withdrawal", and read people's experiences. If I were you, I'd stick with the Vicodin if that's a possibility. Its just as good if not better for lifting mood, and the withdrawal symptoms would be more manageable.
Even if an opioid works for your depression at first, this effect in most cases will cease with continuous use, and you will have to increase the dose to get the same effect. Personally, I don't think the Suboxone ever helped my depression in the 3 years I've been taking it. I'm only taking 0.5 mg per day now, but even at higher doses I can't say it did much to improve my mood or anxiety. It did numb my emotions some at higher doses.
I'm not going to moralize any more about the use of opioids in depression, though. You make a valid point in comparing them to neuroleptics and ECT. I'd just stress the following points: 1) You're going to become physically dependent on buprenorphine, and if it doesn't work the withdrawal is going to suck. 2) It may require increasingly high dosages (whether bupe or Vicodin). 3) There may be other treatments out there that might be a better option in the long term. 4) It's only a matter of time before you start abusing opiates, given your history of depression. It really doesn't matter how strong your will power is, or how responsible you are. 5) 5 years ago, I was a lot like you, thinking that opiates were the only thing that would fix my depression. They were never effective long-term, and now I'm dependent on a drug that does nothing except make me feel how I felt before ever taking opiates.
My advice: Reconsider opiate therapy (unless you've literally tried EVERYTHING else and are debilitated). Please get back to me with your thoughts, and if you could expand a bit more about what medications you have tried in the past, that would help.
Posted by babak on December 15, 2009, at 20:53:22
In reply to Re: Do not do it!, posted by MoonageDaydream on December 15, 2009, at 20:05:26
As someone who suffered from depression for almost 20 years tried, every opiate and opioid around including Subutex for 2 and half years as well as all the antidepressants and even ECT I would like to suggest that your lack of energy, anhedonia, apathy and/or lethargy could have something to do with your metabolism either already compromised or compromised through long term use of Subutex.
It could also have something to do with your liver functions.
But I am afraid western medicine still does not have the relevant knowledge to measure liver functions properly or allow the enzymes far too much of a wide "normal" range to determine some of the more subtle malfunctions.
In the end I used TCM and the idea of liver Qi stagnation to over come the problem.
Posted by MoonageDaydream on December 15, 2009, at 23:51:35
In reply to Re: Do not do it! » MoonageDaydream, posted by babak on December 15, 2009, at 20:53:22
> I would like to suggest that your lack of energy, anhedonia, apathy and/or lethargy could have something to do with your metabolism either already compromised or compromised through long term use of Subutex.
> It could also have something to do with your liver functions.Babak, aside from a couple of papers/case reports reporting hepatic issues with buprenorphine, I can't find much info on this. I thought that buprenorphine was generally safe and the few reports likely involved prior liver damage (from Hepatitis C or damage from acetaminophen) or from improper use of the drug (particularly, intravenous use). Am I incorrect in my assumptions? Any links about this would be appreciated.
Why do you think Subutex affected your liver function?
For what it's worth, I had my liver function checked 6 months ago, with the results being normal. Regarding metabolism, I will note that buprenorphine inhibits CYP3A4, as does Prozac and a number of other antidepressants. When I took Prozac, a 10 mg dose seemed much more potent than pre-Suboxone. Anyone taking Suboxone/Subutex with other medications should ask their doctor if a dosage alteration is necessary.
Posted by dlpt2a on March 11, 2010, at 20:12:27
In reply to Buprenophine-Suboxone-Drowsiness-Help!, posted by princenamor on September 7, 2008, at 6:43:42
I had lortab 10/500 for a few months when I've got busted a disk in my lower back, never tried hydrocodone before, all I can say is that it was a good pain killer and I did like it way too much, the feeling was too close to what I had many years ago using sc-1 stuff. I have a thing for opiates. it takes a big effort to handle them properly so finally I got rid of the pain with steroids and exercise. It took 9 moths for all that stuff to get re-absorbed and the nerve go back to nearly normal, still bothers me though.
The withdrawal from 4 pills a day is not too bad, just feeling a little down and in bad mood for 6 or seven days, yawning all the time but I was able to keep on going like it nothing was wrong. Nothing like a morphine or heroine withdrawal, not even close
If it works for your depression I think you'll have to fake some chronic pain in order to get a script, if you do, ask for "Norco" rather than vicodin or lortab it doesn't have so much APAP, that's bad for your liver in a long term use.
I would stay away from methadone, the withdrawal from that thing its almost unbearable and it last forever, over 28 days steady.
Never tried buprenophine, its an agonist-antagonist for the opiate receptors, it doesn't mix at all with opiates, for what I heard it looks like one of those drugs invented just to take away the fun provided by other drugs more effective and safe on whatever they do, strattera could be another example
> Hi,
> I'm trying to use Suboxone for Depression, but am having problems with side effects of extreme drowsiness and impaired thinking. Does anyone know how I can deal with these side effects? I don't think lowering my dose will help, because even a small dose makes me tired. I've tried taking it at night, but mornings are the worst time for me, and the night dose doesn't help them, so I have to take 2-4mg in the morning to feel OK. I'll listen any advice. I need to make the Suboxone work for me.
>
> None of the conventional antidepressants or other mental health drugs work (in fact they are quite harmful), and Vicodin worked very well; it makes me feel more balanced, gives me more energy, more concentration, and no euphoria. I didn't want to live a life of underground treatment, so I kept looking for a Doctor who would treat me legally with Buprenorphine. Unfortunately, I'm having the above problems, and I know it's the only opiate medication that I will be able to get a prescription for; unless anyone knows of a way I can find a Doctor who will give me another opiate option. Do you? Also, is there any difference between the effect of Suboxone and Subutex?
>
This is the end of the thread.
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