I'ld like to hear from anyone who uses an opioid to fight depression.

[Man67]

Can we reach a consensus now? 1.Top 3 (prescription only, minimal dose) painkillers that work for depression as well. 2. How to deal with tolerance without increasing dosage?

 

[DesertHarp]

You are right regarding minimal dose of Oxycodone. It was prescribed by my GP for TRD and chronic pain (only10mg p/d). It literally saved my life. But I'm afraid what's gonna happen if or when I develope tolerance? It's a bit scary because I don't see any legal and affordable alternative. New treatments are not covered by Medicare and they are extremely expensive.

I think tolerance is inevitable, but that can take a while, and it doesn't mean you lose all the benefit. I've been on the same supply of hydrocodone for at least 6 years. It doesn't feel as good as it used to, but it's still very helpful. TRD is demoralizing to deal with. I would hope that your provider might be open to upping your supply to twice daily, at some point, if the efficacy starts to really dwindle. But, these days, that can be hard to get.

I'm glad that the oxy restored your will to live. Someone who was savvy about drugs explained to me that a subset of depressives are "opiate responders," meaning they feel and function better, both mentally and physically, on an opioid. Controlled studies have borne that out. It's hard to argue with success.

 

[AlphaMethylPhenyl]

Not calling anyone a liar here but it's important to keep in mind that it's the nature of addiction to not think that it's wrong to continue using. Seems like at least the vast majority of users, if kept long enough on opioids, exhibit this behavior of escalating doses, with negative effects on the user and everyone who knows them. I mean, they tried opioids in psychiatry, and it didn't work out. Abuse was rampant. A true antidepressant doesn't require regular escalating doses.

 

[Man67]

I think tolerance is inevitable, but that can take a while, and it doesn't mean you lose all the benefit. I've been on the same supply of hydrocodone for at least 6 years. It doesn't feel as good as it used to, but it's still very helpful. TRD is demoralizing to deal with. I would hope that your provider might be open to upping your supply to twice daily, at some point, if the efficacy starts to really dwindle. But, these days, that can be hard to get.

I'm glad that the oxy restored your will to live. Someone who was savvy about drugs explained to me that a subset of depressives are "opiate responders," meaning they feel and function better, both mentally and physically, on an opioid. Controlled studies have borne that out. It's hard to argue with success.

Thanks a lot mate. You gave me a piece of mind. As you said getting more than 10mg p/d is almost impossible.. I have to wait 3 months for the Government to approve this. Did you make any breaks during the 6 years interval?

 

[Man67]

Not calling anyone a liar here but it's important to keep in mind that it's the nature of addiction to not think that it's wrong to continue using. Seems like at least the vast majority of users, if kept long enough on opioids, exhibit this behavior of escalating doses, with negative effects on the user and everyone who knows them. I mean, they tried opioids in psychiatry, and it didn't work out. Abuse was rampant. A true antidepressant doesn't require regular escalating doses.

You are absolutely right. But if it's your only option in order to stay alive then be it. We are not talking about being "high" we are talking about minimal dose for the Treatment Resistant Depression.

 

[OceansState]

I can see buprenorphine used for depression.

 

[Man67]

I can see buprenorphine used for depression.

True. It was working for me almost 8 months. Then it stopped overnight and all side effects hit me. It took me a year to recover. Still not 100% fit.

 

[DesertHarp]

Thanks a lot mate. You gave me a piece of mind. As you said getting more than 10mg p/d is almost impossible.. I have to wait 3 months for the Government to approve this. Did you make any breaks during the 6 years interval?

No. I have stuck with it. I'm now dependent. If I stop, I get withdrawal within 36 to 48 hours. That happened when I got hospitalized 2 years ago. I had an intestinal infection, so they didn't want an opioid slowing my gut down. I understood their reasoning. They failed to understand how much distress that put me into. Next time I had to go to the hospital, I made sure I packed some Vicodin tablets, which I hid in a sock. (Cause they go through all your stuff.) I was so glad I brought them.

 

[DesertHarp]

Not calling anyone a liar here but it's important to keep in mind that it's the nature of addiction to not think that it's wrong to continue using. Seems like at least the vast majority of users, if kept long enough on opioids, exhibit this behavior of escalating doses, with negative effects on the user and everyone who knows them. I mean, they tried opioids in psychiatry, and it didn't work out. Abuse was rampant. A true antidepressant doesn't require regular escalating doses.

So I gather you believe that long-term opioid use tends to lead to abuse. Thanks for the warning. I have a feeling that most of us here at bluelight are not unaware of that. Tolerance is a reality. It motivates escalating dosage. BTW, some studies report that opioids can help relieve depression. Granted - developing an addiction is the last thing a depressive needs.

 

[OceansState]

I have Crohns and Drs. have no problem giving me pain meds. When I had some of my intestine removed because there was a hole in it they put me on a machine I could administer Dilaudid with the push of a button. I had the procedure done twice now and both times they put me on that machine. Morphine shots wont touch the pain which feels like I'm being stabbed in the stomach, but Dilaudid is on another level.

The first time I had the surgery at 18 I was able to stop the pain meds no problem. The last time I had the surgery at 35 I got addicted to Dilaudid and the withdrawals were horrible. But the last surgery was insane, ill just say they really opened me up.

 

[Man67]

So I gather you believe that long-term opioid use tends to lead to abuse. Thanks for the warning. I have a feeling that most of us here at bluelight are not unaware of that. Tolerance is a reality. It motivates escalating dosage. BTW, some studies report that opioids can help relieve depression. Granted - developing an addiction is the last thing a depressive needs.

New treatments for TRD: Psilocybin, MDMA, Esketamine nasal spray.

 

[DesertHarp]

I have Crohns and Drs. have no problem giving me pain meds. When I had some of my intestine removed because there was a hole in it they put me on a machine I could administer Dilaudid with the push of a button. I had the procedure done twice now and both times they put me on that machine. Morphine shots wont touch the pain which feels like I'm being stabbed in the stomach, but Dilaudid is on another level.

The first time I had the surgery at 18 I was able to stop the pain meds no problem. The last time I had the surgery at 35 I got addicted to Dilaudid and the withdrawals were horrible. But the last surgery was insane, ill just say they really opened me up.

Sounds like you've been through some rough stuff, to put it mildly. I'm glad doctors provided you with adequate pain relief, but I'm sorry that led to the suffering of withdrawal. The machine you've referred to is called "patient controlled analgesia" or PCA. I know that it does come with a built in limitation that does not allow you to overdose. The medication goes directly into your bloodstream through an implanted I/V tube.

Chron's sounds quite awful. I hope your doctors and you are making progress in getting it under control. I suppose you take it one day at a time. I'll bet it's a disorder where leaving you in pain could exacerbate the inflammation and cause more destruction of the gut lining. So the docs were probably motivated to reduce your stress level (by relieving the pain), in order to lessen the potential damage. Stress leads to bodily changes - like increased cortisol levels and diminished immune function - that can undermine their efforts to heal your gut. So they came through for you with the Dilaudid.

Two years ago, I had very serious diverticulitis with sepsis. I also developed colitis with ulcers. Plus I had a stricture in my colon. The GI doctors said I'ld likely need a segment of my colon removed. Man, the thought of that just horrified me. For a while, I was even thinking of ending my life, which I'll admit was rather hysterical on my part. So I have great respect for you getting through those surgeries. In my case, fortune smiled on me, and I healed up okay and didn't need the surgery. Oxycodone was adequate for the pain during my illness.

I looked up Dilaudid, and I see that it is 5 times as potent as morphine. No wonder kicking it was so hard for you. I think Dilaudid is, like, the ultimate opioid used in medicine. I've rarely heard of anyone being on it. You had to have been in really bad shape. May your future be brighter.

 

[DesertHarp]

True. It was working for me almost 8 months. Then it stopped overnight and all side effects hit me. It took me a year to recover. Still not 100% fit.

I'm seeing more and more articles about buprenorphine being found effective for depression. But it cut out on you in less than a year. I guess there's no totally reliable drug to treat depression. I doubt there ever will be.

 

[DesertHarp]

I would love some Oxy right now but its probably one of the last things I need, can see it going sideways pretty quick.

Does anyone like Gabapentin? I recently got a script and feel it calms my nerves and seems to stop negative thoughts.

I was on gabapentin (Neurontin) for a while to treat anxiety. I didn't see where it helped either my depression or my anxiety. It did give me a big appetite at night. I'd take it and go to bed. After an hour or two, I'd be back up pulling out pots and pans to start cooking. A mere snack wouldn't do. That stopped when I discontinued it.

 

[OceansState]

I was on gabapentin (Neurontin) for a while to treat anxiety. I didn't see where it helped either my depression or my anxiety. It did give me a big appetite at night. I'd take it and go to bed. After an hour or two, I'd be back up pulling out pots and pans to start cooking. A mere snack wouldn't do. That stopped when I discontinued it.

Currently I can feel the positive effects of gabapentin, i'll feel a little off and my lower back starting to sweat, kinda like the feeling if withdrawals coming on, and i'll take 300mg Gabapentin and it does go away.

One thing I noticed is it seems tolerance builds very quick. Taken as needed at 300mg doses. I tried 600mg doses and it seemed the effects were the same.

 

[DesertHarp]

Currently I can feel the positive effects of gabapentin, i'll feel a little off and my lower back starting to sweat, kinda like the feeling if withdrawals coming on, and i'll take 300mg Gabapentin and it does go away.

One thing I noticed is it seems tolerance builds very quick. Taken as needed at 300mg doses. I tried 600mg doses and it seemed the effects were the same.

Gabapentin has become quite popular, so it must confer some benefit to some users. Sounds like you are in that group. If it interrupts the onset of distressing symptoms, then it's worth having available.

 

[Man67]

No. I have stuck with it. I'm now dependent. If I stop, I get withdrawal within 36 to 48 hours. That happened when I got hospitalized 2 years ago. I had an intestinal infection, so they didn't want an opioid slowing my gut down. I understood their reasoning. They failed to understand how much distress that put me into. Next time I had to go to the hospital, I made sure I packed some Vicodin tablets, which I hid in a sock. (Cause they go through all your stuff.) I was so glad I brought them

No. I have stuck with it. I'm now dependent. If I stop, I get withdrawal within 36 to 48 hours. That happened when I got hospitalized 2 years ago. I had an intestinal infection, so they didn't want an opioid slowing my gut down. I understood their reasoning. They failed to understand how much distress that put me into. Next time I had to go to the hospital, I made sure I packed some Vicodin tablets, which I hid in a sock. (Cause they go through all your stuff.) I was so glad I brought them.

What are withdrawal symptoms and how long do they last? Just in case...

 

[DesertHarp]

What are withdrawal symptoms and how long do they last? Just in case...

For me, the onset of withdrawal consists mainly of "restless leg syndrome." That may sound like not a big deal, but it is a very big deal. I think the term "akathisia" may be more accurate. RLS usually bothers people mostly at night. (I've experienced that with iron deficiency anemia.). The restlessness I get with withdrawal is around-the-clock. It's horrid. It would drive me to suicide, if I didn't feel confident that it was temporary.

There's no lying down without feeling like I have to keep flipping from side to side, only to find that turning does no good. There's no sitting in a comfortable chair. There's no ability to engage in some distracting activity. Impossible to watch TV or read. The only relief is for me to get into a tub of very warm water. If I make it very hot, that might override the restless sensation. But not for long. I leave the tub full of water and get in and out of it repeatedly. I've tried alcohol for relief and gave up on that. It does absolutely no good.

I've also had nausea and vomiting during withdrawal. There's also insomnia. Then, when I finally get a refill on my Vicodin, I immediately take two tablets. In half an hour, I start to feel huge relief. Hasn't happened in a while because I don't let it. I ration my supply of hydrocodone, so I don't run out before a refill is due.

I'm not sure how long withdrawal would last because I always end it by getting more tablets. Mind you, I take Vicodin 10/325 twice a day. So I'm habituated to 10 mg of hydrocodone twice daily. That level of use is not very high, but it is definitely high enough to result in dependency, if you've been doing it for a long enough while.

The cure for dependency is to be weened off the drug gradually. I got off of benzodiazepines in that way. They had previously produced the same restless syndrome when I would run out of them.

 

[OceansState]

The tingles/RLS is the absolute WORST. For me its usually in my arms but had it in my legs years ago when I was hooked on Oxy 80s.

When I tried CT from Loperamide the tingles/RLS started day 3 at night, and I was taking Clonidine. During the day I was fine though.

Then when I did a rapid taper off Loperamide after that I can say it was Kratom that really helped with withdrawal symptoms. I say this because even though I had Gabapentin there were a few days in the beginning I didn't even take it because it made my head foggy.

I still don't sleep good. Ill take gabapentin and clonidine and kratom (at normal doses) and still at night it feels like the tingles just barely want to start, I mean its so slight but the idea pops in my head that its about to start and that's enough for me to get out of bed and watch tv.

I want to say I think if I had some Trazadone to take at night that would knock me out so I wouldn't experience the restlessness, id sleep thru it. I keep forgetting to ask for a script because when I'm talking to my Dr. I feel fine, not tired at all. I think its from the Wellbutrin, its stimulating.

With the Clonidine I don't really take it but asked for a refill, so I can have a stash in case. And when I was tapering off Suboxone I didn't tell my Dr. so I would keep getting the same amount, to stash away just in case. That time I was seeing a primary care Dr specifically for the Suboxone then I was seeing a psyc Dr. for "comfort" meds.

 

[Man67]

What are withdrawal symptoms and how long do they last? Just in case...

For me, the onset of withdrawal consists mainly of "restless leg syndrome." That may sound like not a big deal, but it is a very big deal. I think the term "akathisia" may be more accurate. RLS usually bothers people mostly at night. (I've experienced that with iron deficiency anemia.). The restlessness I get with withdrawal is around-the-clock. It's horrid. It would drive me to suicide, if I didn't feel confident that it was temporary.

There's no lying down without feeling like I have to keep flipping from side to side, only to find that turning does no good. There's no sitting in a comfortable chair. There's no ability to engage in some distracting activity. Impossible to watch TV or read. The only relief is for me to get into a tub of very warm water. If I make it very hot, that might override the restless sensation. But not for long. I leave the tub full of water and get in and out of it repeatedly. I've tried alcohol for relief and gave up on that. It does absolutely no good.

I've also had nausea and vomiting during withdrawal. There's also insomnia. Then, when I finally get a refill on my Vicodin, I immediately take two tablets. In half an hour, I start to feel huge relief. Hasn't happened in a while because I don't let it. I ration my supply of hydrocodone, so I don't run out before a refill is due.

I'm not sure how long withdrawal would last because I always end it by getting more tablets. Mind you, I take Vicodin 10/325 twice a day. So I'm habituated to 10 mg of hydrocodone twice daily. That level of use is not very high, but it is definitely high enough to result in dependency, if you've been doing it for a long enough while.

The cure for dependency is to be weened off the drug gradually. I got off of benzodiazepines in that way. They had previously produced the same restless syndrome when I would run out of them.

Thanks for detailed response. Hopefully I will get Government approval for another year supply of 10mg Endone p/d. It's a minimal dose but it helps a lot. Especially psychologically. With TRD every little thing counts.

For me, the onset of withdrawal consists mainly of "restless leg syndrome." That may sound like not a big deal, but it is a very big deal. I think the term "akathisia" may be more accurate. RLS usually bothers people mostly at night. (I've experienced that with iron deficiency anemia.). The restlessness I get with withdrawal is around-the-clock. It's horrid. It would drive me to suicide, if I didn't feel confident that it was temporary.

There's no lying down without feeling like I have to keep flipping from side to side, only to find that turning does no good. There's no sitting in a comfortable chair. There's no ability to engage in some distracting activity. Impossible to watch TV or read. The only relief is for me to get into a tub of very warm water. If I make it very hot, that might override the restless sensation. But not for long. I leave the tub full of water and get in and out of it repeatedly. I've tried alcohol for relief and gave up on that. It does absolutely no good.

I've also had nausea and vomiting during withdrawal. There's also insomnia. Then, when I finally get a refill on my Vicodin, I immediately take two tablets. In half an hour, I start to feel huge relief. Hasn't happened in a while because I don't let it. I ration my supply of hydrocodone, so I don't run out before a refill is due.

I'm not sure how long withdrawal would last because I always end it by getting more tablets. Mind you, I take Vicodin 10/325 twice a day. So I'm habituated to 10 mg of hydrocodone twice daily. That level of use is not very high, but it is definitely high enough to result in dependency, if you've been doing it for a long enough while.

The cure for dependency is to be weened off the drug gradually. I got off of benzodiazepines in that way. They had previously produced the same restless syndrome when I would run out of them.

Thanks for the detailed and helpful info. While waiting for the new "miracle cure", 10mg Endone p/d is my only option. It's a bare minimum but regardless of that tolerance and dependency will follow. But what other choice do l have? For TRD there is no plan B and more antidepressants are not a solution. Been there done that. Tapering down? In general it's an excellent idea but what then? Go to the dark place again? This is a very tricky subject and reminds me of catch 22. I'll be seeing my Psychiatrist very soon but don't know what to ask and what to talk about. Any alternative to the current treatment is either too expensive or not accessible. So let's hope for the best and try to survive. Cheers mate.