do antidep + subs help stop cravings for opiates?

Does anyone have any experiences to share about how effective antidepressants have been for combatting opiate cravings/relapses?

I've been on suboxone for years and for the most part it is good, plus dextrostat, but after a month or two, i relapse, and I hate the changeover and guilt. I am thinking of going on antidepressants -- Effexor-- bc Cymbalta, wellbutrin, lamictal, none worked for me last year.

I don't seem depressed, but I am-- I have the apathy/bad attitude. I have little motivation and feel like I am trying too hard to be normal/sober....been going on for years, plus I have been through rehabs, and counseling, jail, other bottoms, etc...

I wasn't a depressed person ever to begin with...more of a self-absorbed, arrogant, psychopath (in that I don't see the consequences of my actions on myself or others, and have problems in structured environments and rules), but still never mean(t) to do others harm.

suboxone has a 4:1 ratio of buprenorphine and naloxone (narcan). the naloxone is present to deter the abuse of suboxone intravenously. if you have a physical addiction to opiates then shooting naloxone will cause immediate withdrawals.

the buprenorphine binds more strongly to the opiod-receptors in the brain than most opiates/opiods which are commonly abused, thereby negating any euphoric effects if someone has taken buprenophine and then another opiate.

apart from that, suboxone doesnt help with the psychological cravings which some will argue is the hardest component to the addiction to quit.

versd said:

apart from that, suboxone doesnt help with the psychological cravings which some will argue is the hardest component to the addiction to quit.

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Are you sure about that?

For most opiate addicts the cravings will never go away completely. Sure you can do things to make them more managable but you are born with a certain gene (or whatever) that makes you love the feeling of having opiates in your body.

toolfan420 said:

Are you sure about that?

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as a synthetic opiod, it does affect brain chemistry with regards to the pain receptors in the brain, so it does have some effect on mood and pain regulation. it is not approved for direct use as an antidepressant.

suboxone can be used in conjunction with some antidepressants, so that would probably be the best avenue to explore.


the physical effects of suboxone can serve to modify behaviour though. it prevents abuse of other opiates and allows the user to 'break the cycle' and the ritual of going out and scoring, preparing a shot or whatever, and allows the user to start building new daily habits in life which are hopefully more productive.

I've been so resistant to go on antidepressants but I fucking stick a needle in myself multiple times a day and score, etc.. every month or few months, while on suboxone treatment. I should seriously consider it. I'm going to see a psychiatrist on thursday....

Thx for the input.

My question and I may make science-oriented people cringe by my crass knowledge (or lack of), but doesn't H or many opiates, primarily affect Dopamine and Norepinephrine (noradrenaline), and a few ADHD drugs affect the same class or neurotransmitters, while Effexor (an SSRIs) affect primarily serotonin and norepinephrine (at higher doses)?

I'm not saying that if you take suboxone you will never think about doing dope again. I'm only saying that for me subs did help my cravings and I was only wondering why you said they don't help at all. Does that mean I'm just weird?

im going to try out taking trams and random benzos starting tomorrow.I cant even do this anymore. Im seriously so close to giving up its not even funny.

Suboxone definitely helped me with psychological cravings, absolutely no doubt about it...didn't take them away entirely but at least 80% better. But back to the topic at hand...

Antidepressants never did anything for my cravings. But if you're dealing with depression or anxiety, they can be useful if you find the right one. Effexor isn't a great choice if Cymbalta didn't work at all for you. They're fairly similar--Cymbalta has stronger effects on norepinephrine but they're both technically SNRIs. Have you tried any other meds other than Wellbutrin, Cymbalta, & Lamictal?

No. I haven't. I was just prescribed Abilify at 10mgs/day, but I don't know if I should try it. One psychiatrist said no and the other prescribed it.

Have you tried Lexapro or Celexa? I have heard good thing about those in terms of low side effects, barely any w/d later and decent effectiveness.

Abilify from what I read on it is mostly used in conjunction to something else, when used for depression. It's mostly for bi-polar or mixed states meaning that it mostly used on people who go from being up to being down and you seem just like me, apathetic pretty much all of the time.

I'm not your doctor but as a friend I would advise to go with Lexapro or Celexa first. I am confused why they gave a non bi-polar person a bipolar med as the only med when for depression it should be used in conjunction to another med like Lexapro to increase the effectiveness of the therapy.

If you talk to the doctor, please ask why they gave you Abilify. I am very curious as your mental state seems very similar to mine. I have also had it prescribed in the past when a doctor mistakingly thought I was bi-polar after I came off suboxone and got my emotions back. I'm definitely not bi-polar and have some of the similar things you are experiencing.

Also, exercise is as effective as most antidepressants or even more so. If you can get yourself to do any, pleaaswe do so. I know its so hard when you don't feel like doing anything. I try to make myself at least do a few minutes of stretching or find ways to be physically active. It is one thin that you can do for free at home and it will show its effects at about the same time that the pills would, in a bout a few weeks.

Thx ZYGGY! I haven't tried Lexapro or Celexa. I don't think I'm bi-polar either. I think I have low motivation from long-term opiate abuse. I know I should exercise and do lots of other things to help myself, but sometimes, I have no motivation to do the smallest thing or else just making my appointments feels as if I were being forced to run a marathon.

Drs did prescribe Effexor XR first and suggested adding Abilify. But after reading up on Effexor, i didn't want to take it. So at the next apt, with a different doctor, he prescribed Abilify bc he said it would give me the dopamine level that I need. I dont have a whole lot of emotions right now...mostly lethargy.

So, what antidepressants/anti-psychotics/psycho-tropic meds are you on currently to stave off opiate cravings?

Z Y G G Y said:

I'm not your doctor but as a friend I would advise to go with Lexapro or Celexa first.

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I'm quite a fan of Celexa which has done wonders for me...however, I disagree with you saying that the SSRI "discontinuation" is mild, because even after weening down I had a very hard time with it and had to go back to my regular dose. It's still an SSRI, with lots of shitty sexual side effects, but IMO works well for anxiety in general.

My heroin cravings are almsot non exsistent being on subs for 4 months. The idea to stop my subs crossess my mind sometimes but quickly throw it out. Once you get into the routine of taking ur sub everyday it gets easier for sure

ive been on subs for 5 years. i gobble them up for days tht i have bad cravings. if i do the one day at a time thinking, suboxone's blocking effect does help with that.

im confused bc my doctors say different things. i am trying to get a little clean time before truly committing to an antidepressant. Staying clean is so difficult for me, but the cycle of pain and confusion and apathy is worse!

I'm gobbling the subs to block myself... i think i know i know i need long-term inpatient treatment, but i am scared and trying to postpone for the end of semester.

versd said:

suboxone has a 4:1 ratio of buprenorphine and naloxone (narcan). the naloxone is present to deter the abuse of suboxone intravenously. if you have a physical addiction to opiates then shooting naloxone will cause immediate withdrawals.

the buprenorphine binds more strongly to the opiod-receptors in the brain than most opiates/opiods which are commonly abused, thereby negating any euphoric effects if someone has taken buprenophine and then another opiate.

apart from that, suboxone doesnt help with the psychological cravings which some will argue is the hardest component to the addiction to quit.

Click to expand...

It took me three, long, hard ,years to get past the mental part of my addiction to I.V. heroin. I worked that out with methadone,in the beginning they jacked me up,way up .really fuckin fast ,30,40,50,60,70,80 90,they bumped me up 10 a day until I reached the 200 mg.mark when that was going good and the "THRILL OF THA CHASE" part of my addiction to herion was behind me (for the most part), I was told by my Dr. that I had been very honest with thru out my addiction. He was well aware of my history with the on, off, use of pharm. grade opiates, as well as heroin . He knew my methadone history. We decided it was time I get of off of the meth clinic ,so he collaborated things with the clinic and they put me on a blind detox, so my mind could not fuck with me . a slow one, 6 months . . I went from 60 mg of methadone to suboxone..he had me at 8mg 2x a day for a while. I dont recall exactly how long, but he then put me on 8mg 1 x a day. again the duration of this dosage I don't recall it was at least a year he kept me there. I moved out of N.J and into VA. and had no Dr..... At the time, Dr.'s that had the certificates/diploma's to prescribe it were limited.I am sure it was just a few extra seminars they had to attend ,maybe few short films reviewed at the Hilton in Paris or some shit . And they also had a limited amount of patients that they could treat with suboxone at one time it may have been like 15 at the most , at least in New Jersey back in 2003 that was the law,in 2005 Virgina only had one Dr. and he would only give it to you for 3 months that was all he was allowed. Eventually the FDA put thier gaurd down? But why the change in the rules ?? Was Suboxone still being experimented with on addicts, but we were not made aware of that? Was I taking part in a study that I had not been made aware of? Or is it that I am way off base , and am on to absolutly nothing? It wouldnt be the first time. And I relize this bitch ran off topic in some ways so if you have better home for it please do..LOVE YOU BLUELIGHTERS

continued from the last ramble

I wanted it to say It takes time but instaed I got rambling but yoe I would like a response even if you post SHUT UP ASS HOLE YOUR OPINION IS SHIT haha at least it will make my typnig worth it LOVE YOU BLUELIGHTERS....Put Your Lighters Up

Nope nothing takes away the cravings except, Dope!

My question and I may make science-oriented people cringe by my crass knowledge (or lack of), but doesn't H or many opiates, primarily affect Dopamine and Norepinephrine (noradrenaline), and a few ADHD drugs affect the same class or neurotransmitters, while Effexor (an SSRIs) affect primarily serotonin and norepinephrine (at higher doses)?

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Opioids work via opioid receptors which affect your endorphin system and your dopamine system, not norepinephrine.

Effexor is an SNRI, so works on both serotonin and norepinephrine.

This is a tricky question. Suboxone for sure is not a cure for addiction, and in that regard, neither is methadone. If you're not ready to quit, if you still want to use, being on a maintenance program will only deter you in that you will not get high if you use on top of it. I don't really think taking suboxone will make you want to stop getting high, it's more like, it's just pointless to use other opiates because they wont work (unless you're at a lower dose of suboxone than usually prescribed). However, it does ease things a little bit. Another thing to note is that suboxone is an addictive drug too, so don't listen to your doctor when he/she says it's not.