what do you mean? where did she mention anything like that?
I believe that by saying "You should look into glutamate/glycine/gaba." she met the neuropsychopharmacology of this system.
http://www.acnp.org/g4/gn401000008/default.htm
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N&PD Moderators: Skorpio
Are opiates really a long term solution to psychiatric maladies?
- Thread starter AlphaMethylPhenyl
- Start date
what do you mean? where did she mention anything like that?
I believe that by saying "You should look into glutamate/glycine/gaba." she met the neuropsychopharmacology of this system.
http://www.acnp.org/g4/gn401000008/default.htm 
Crimethink
Bluelighter
http://neuro.psychiatryonline.org/article.aspx?articleid=103202 Mood-Elevating Effects of Opioid Analgesics in Patients With Bipolar Disorder
http://ajp.psychiatryonline.org/article.aspx?articleid=173886 Treatment Augmentation With Opiates in Severe and Refractory Major Depression
http://www.ncbi.nlm.nih.gov/pubmed/10640626 Rats sensitized to morphine are resistant to the behavioral effects of an unavoidable stress.
http://www.ncbi.nlm.nih.gov/pubmed/21741986 Morphine sensitization as a model of mania: comparative study of the effects of repeated lithium or carbamazepine administration.
http://www.ncbi.nlm.nih.gov/pubmed/10986335 Long-term lithium administration abolishes the resistance to stress in rats sensitized to morphine.
Anecdotally they're the only thing that work for me. I take Emsam\Deprenyl 9mg, 900mg Lithium, 30mg Remeron & still have intermittent suicidal ideation. None of that does what 200mg Ultram ER can.
In my experience with long acting opiates 80% tolerance builds to the euphorigenic effects...I don't think I need to say what happens if you mistake this for an AD effect and chase it.
Opiates also make SSRIs actually work - in 24 hours - normally they can aggravate my suicidal ideation but on ope's I notice I difference in mood, energy, outlook, sociability the next morning.
It was an ambiguous statement.
and sekio: you cut out the first part of my sentence.
Its interesting to find such a taboo against opiates in psychiatry, especially on this site. Its not as if there's something fundamentally different about the way tolerance builds with them than with other chemicals.
I agree that it would be hard to discern euphoric effects from anti-depressant effects.
Theoretically, though, and I'm definitely not advocating anyone try this, someone could remain high on opiates their whole life if they started with codeine and steadily worked their way up to chemicals thousands of times the potency of morphine, so long as they don't raise the dose too fast. I could see this basically curing the problem of un-treatable depression, preventing many deaths. But that's off topic.
Amazing what this class can do.Would not opiates long term also modify the reward pathways of the brain?
I always read how opiates are supposed to have no ill effect on health and how clean they are as opposed to say booze, but surely there must be some negative impact on how the brain functions if you are teaching it to identify a pill/syringe as a source of rapid satisfaction. When done for long enough, I guess it would be utter hell to try and rewire the process; I have in fact posted my own case on The Dark Side section and I think this is my biggest barrier to jump after using tramadol for 2 years (I know tramadol is not an opiate per se but still).
Epsilon Alpha
Bluelighter
Errr, no. There are far far more regulatory changes that go on aside from "reduced MOR expression/functionality". We're talking modifications to virtually every neurotransmitter system and long term changes in gene expression.
There are some experimental protocols to avoid this like NMDA antagonists, or various other approaches, but nothing has show long term success in humans or whole lifespans of animals without significant side effects.If you want to take opiates I recommend taking pure opium.It's 100% natural and safer than any other drugs.
"It makes the silent eloquent,the coward brave, it frees the alcoholism victims from its bondage it revigorates the body and clears the humors".
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How is opium safer then say morphine, hydromorphone or fentanyl? If anything it would have more side effects then most semi synthetic or fully synthetic opioid's due to the other alkaloids in pure opium. I have never taken it but id imagine it would feel much the same as morphine which many people get alot of side effects from. Thankfully i don't
As for taking opioids for psychiatric problems it may help some people but it does not do a whole lot for my bipolar disorder. Morphine and hydromorphone do help somewhat in keeping my mood swings under control and it does help mania abit. However if it worked really well i would have no need to take the lamotrigine, bupropion and seroquel that i am on to treat my bipolar. Thankfully opioids with the exception of tramadol and Demerol (meperidine, pethidine) don't make my moods any worse. I have reacted badly to every anti-depressant i have tried besides bupropion and amitriptyline.
I would like to try buprenorphine to see if it would help the depression side of my bipolar but since i take morphine for chronic pain that is not much of a option unless i stop taking the morphine.the risks outweigh the benefits. do you really want to be completely dependent on a substance? i tried this theory, and it worked like god so it seemed for the first couple months, than everything went to fucking shit. no car, no phone, no house, and how do you think that affected my depression? do you think i was jumping with joy sleeping in a damn bathroom or on a park bench?
long story short, the answer is absolutely no. if you are even considering this idea, you are most likely an addict and should stay away from opiates at all costs. i ended up getting my life together and got on suboxone to help with cravings and WD. bup does what it is supposed to for me, but it also does have a slightly energetic and AD effect (could be placebo, idk). possibly due to the release of serotonin and dopamine it releases. come to think of it, almost all opiates acted like an upper at some point of use, or it could be a downer. usually with the full-agonists (morphine, oxycodone), i felt drowsy during the peak, and energetic towards the end which i belive to be because the dopamine was converted into norepinephrine.
Mind elaborating?opiates don't only affect the bodies' natural endorphins. many opiates/opioids affect other parts of the CNS such as having NMDA-blocking and antagonistic sigma-1 receptor capabilities; full-agonists also release a good amount of serotonin and dopamine. there are multiple opiate receptors around the body including the gut and spinal cord, and there are multiple opiate receptors in the CNS (amygdala, nucleus caudatus, hypothalamus, thalamus, ect.) the list goes on and on because morphine and other opiates mimic endogenous endorphines which are released in pleasureful experiences such as sex. long-term opiate use affects almost every aspect of how the normal human body functions, not only that, but almost all parts of daily life.
edzeppelin
Bluelighter
I don't think the answer is so clear-cut. Depression itself seems to damage the brain and body, especially over time. The important question is will opiates lose their AD quality over time as the changes to the body and brain happen? Then you will be worse off.
I also wonder if they may be more appropriate as a "last resort" sort of med for someone a bit older(say 40's-50's).
Also addictive tendencies vary tremendously within a population. Some will take as prescribed(presuming you could get one), others will go wild.
All in all, an effective drug with a somewhat deserved stigma.
I tried buprenorhine for depression for two years. I found it didn't work that well, so I stopped. I still have a bunch, don't crave them at all. I find codeine doesn't work either. I had hydrocodone for a week due to pain. That worked miraculously well as an AD, but I only took it a week. Kratom has some AD effects, only you can't take it all the time, due to tolerance.
That was my initial question...which has yet to be answered.
^I'm aware that many opiates don't just act on opiate receptors. I was asking epsilonalpha to elaborate on why a euphoria couldn't be sustained by slowly titrating up a dose of, say, codeine, to a much much much more potent agonist over a period of decades.
sekio
Bluelight Crew
Because you eventually reach a ceiling where the most potent opioids stop working (ask cancer patients), and not everyone can sustain slow titration, especially if they have major stressors in their life (impulsive people, people with comorbid chronic pain etc). Also certain individuals and certain opioids seem very prone to tolerance devlopment, some opioids (esp. codeine/morphine) have side effects that scale unevenly with regards to analgesia, and as you mentioned not all opioids are selective for mu-OR.
I'm sure a few people can manage to use codeine as an antidepressant for years without it losing efficacy, but I have heard too many stories of naive kids popping Vicodins and 2-3 years later moving on to IV heroin. Opioids as antidepressants just don't work in the long term, for most people.In general opiates work for depression because they strongly suppress emotions, and depression is usually caused by emotional problems. Depression itself is a build-in defense mechanism for emotions that your psyche cannot handle. By chemically suppressing emotions the depressive reaction can ease up because it is no longer necessary.
Pure bipolar disorder is still considered somewhat different in the field and this approach of medically suppressing emotions is perhaps not applicable.
AlphaOdure
Bluelighter
The wide spectrum of tramadol's pharmacological dynamics likely contributes to the antidepressive effects you experienced, rather than its opioidergic effects. Tramadol has strong SNRI neurological activity and--to a lesser degree--it is a serotonergic releasing agent. It acts on many other areas of the brain, (while some aren't directly relevant to depression, some are worth mentioning): selective antagonism at one specific 5-HT subunit (off hand can't remember the exact serotonin receptor subunit...) and agonism at TRPV1-receptors. While these two actions definitively affect depressive disorder, the level at witch tramadol interacts w/ these systems isn't definitively known (anyone w/ any info feel free to post and/or correct me). Then least relevant to the topic of depression includes tramadol's action as a NMDA receptor antagonist and its interaction w/ both the nicotinic & muscarinic receptor systems.
So these actions (especially the two former most mechanisms I mentioned, excluding mu-opioid agonism) may be the reasons for (and/or contribute to) your positive experience, too. I highly doubt your reaction was purely a result of opioidergic agonism.. unless you've felt similar effects from other types of opioids, which generally do not act in these areas (unlike tramadol)?
DJHENRU
Bluelighter
Hm I would think opiates dont completely help stop suicidal ideation as well as a disociative like k, something about the concept of a suicide plan would make no fucking sense in a k hole compaired to a nod. I definitly felt a lot better about how I look, after a mxe experience as upposed to an opiate experience thats for sure.
AlphaOdure
Bluelighter
I think it more appropriate to say depression causes neuroplasticity, changing or affecting neuron/receptor distribution.. but not actual "damage" in the sense that it causes atrophy of the organ, like say, liver or kidney damage does. However, some in the neurology medical community do consider some forms of neuroplasticity to be akin to "brain damage." However, neuroplasticity occurs everyday, in response to normal events & stimuli; & not as a result of drug intake or psychiatric dysfunction.
Although some psychiatric dysfunction does affect brain volume & brain activity in certain cases, so I suppose this might be interpreted as "damage"
AlphaOdure
Bluelighter
Umm, that is assuming one would be constantly intoxicated by ketamine...? 8) This wouldn't be treating depression or suicide ideation; it would be fucking you up to the point where you would not be physically capable enough to carry out any sort of suicidal intention or plan. And the idea of treating depression (or possible suicidal tendencies) is to also be able to maintain normal physiological function. Which, um, isn't possible under the influence of a constant, or near-constant, k-hole. Not to mention.. such use of ketamine would rip your bladder to shit.
negrogesic
Bluelight Crew
Yes, certain opioid-narcotics appear to have AD properties. Nonetheless, they are poor standalone AD's (particularly in the opioid-naive).
Some years ago, I found methadone to have a distinct AD-like element, but such a recollection should be tempered by my then average daily dose of 380mg.
A 'progressive' psychiatrist may toy with the use of tramadol for depression, but regardless of the ease with which he writes amphetamine for an off-label use, he will acquire writers-block upon the notion of prescribing opioid of the same class (aka, "can you C your way II the door?").Damn 380mg of methadone! I've read that methadone generally isn't prescribed above 200mg due to QT prolongation. For me methadone seemed to make me more depressed.
It is funny how often amphetamines are used, often off-label. Not that I'm complaining.
Thebaine counteracts the sedation and respiratory depression of morphine, especially in combination with narcotine. Opium's more stimulating than morphine. The full alkaloids give a different high than pure morphine, working synergically. Kind of like how Marinol is different than hash oil(I still think Marinol's better than it reputation). I would argue that opium is the lesser evil compared to strong concentrated opiates. Certainly safer than black tar, at least it smells and tastes better.paranoid android said:How is opium safer then say morphine, hydromorphone or fentanyl? If anything it would have more side effects then most semi synthetic or fully synthetic opioid's due to the other alkaloids in pure opium. I have never taken it but id imagine it would feel much the same as morphine which many people get alot of side effects from. Thankfully i don't
