I ended up saying no despite past addiction to poppy tea and really wanting to say yes since addiction sucks. How common is this? Is my doctor trying to trick me or something, if I act really interested am I labeled a drug user? Or am I really that broken and hopeless that this the last thing they can thing they can think of to put me on? (I've tried countless SSRI/SSNRI's and benzos with zero effect)
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Mental Health doctor recommending opiates for anxiety/depression?
- Thread starter noone1
- Start date
Kittycat5
Bluelighter
Doctors dont generally try to trick their patients. Perhaps he feels he is out of other pharmacological options. Opiates tend to fail after a short time for anxiety and depression in most though.
Yes they have said there are almost no options left to try. I just find it really odd because of the stigma of opiates, I thought they where really hard to get even with legitimate pain. I didn't know doctors could off label them for this reason, I've heard lots of people wishing they would tough--also I really don't want to believe I'm that fucked up. But I can't even take the benzos they prescribed properly because of my anxiety.
herbavore
Bluelight Crew
I am pretty appalled by a doctor that suggests opiates for anxiety and depression, knowing full well that addiction is inevitable when used long term. What non-drug interventions or therapies have you tried? Are you working with someone that is treating you from a psychological perspective? SSRIs don't work for most people so I don't think it makes you "that fucked up" at all. I think I would look into some really proactive therapies like ACT, CBT, Mindfulness and see if you cannot get at the root of your depression. When you say that you can't take the benzos because of your anxiety what do you mean? Do you mean you are taking more than prescribed? In the end, benzos contribute to anxiety as much as they initially help it--a cruel fact.
Yeah that is appalling. The efficacy of benzos for anxiety lasts. The efficacy for their sleep-inducing effects doesn't.
What do you mean by this?
I have been taking Klonopin for many years now and haven't found it to be the case as they have helped me a lot.
It has really been bothering me lately how "anti-benzos" and also "anti-SSRIs" almost everyone on this forum is, especially since I take both drugs.
Everyone who takes every other kind of messed up drug from heroin to methadone to recreational chemicals wants to tell me I need to "get off my Klonopin" ASAP and that "SSRIs are going to mess me up" and it's REALLY beginning to piss me off.
I think these drugs have a proper usage yet everyone and their brother wants to say otherwise and that they will only fuck you up in the long run but they don't bat an eye at doing every other drug under the sun, and for recreational purposes at that while I only use these drugs as prescribed and don't abuse them.
How do you know that this is true?
I'm glad that the benzos continue to work for anxiety as that is why I take them, but sometimes I also use them to get to sleep at night and I'm surprised to hear you say that they don't work long term for sleep.
Got a link on that?
Kittycat5
Bluelighter
http://www.hindawi.com/journals/aps/2012/416864/
States anxiolytic tolerance is slow to develop if it des at all.
States anxiolytic tolerance is slow to develop if it des at all.
Have you tried Wellbutin? Only thing that worked for me they tried everything on my as you. Its the only NDRI, it works like SSRI's except it works on dopamine {feel good endorphine] instead of serotonine. Also take klonapin but that's just helps my anxiety.
checktest
Bluelighter
Opioids to someone with a past addiction is pretty...unlikely. Especially since you mention only SSRIs/SNRIs and benzos. APs like seroquel, risperidone are given out for anxiety rather more readily now. Not that that is a good thing, but still. Tricyclics, Buspirone in combination, Mirtazepine, Lamotrigine or one of the other mood stabilizers, gabapentin or lyrica, topiramate....lots to go through. An MAOI like Nardil or tranylcypromine. Plenty more medicines. But yeah, trying a combination therapy approach would definitely be a good thing to try. CBT with mindfulness or some DBT can be good for anxiety, amongst others.
I only really listed those medicines because it does seem very odd for your doctor to go to opioids for anxiety after just some trials for others, and no sort of heavy drug abuse that would head more for opioid replacement and the like. Even a ketamine trial or ECT if there was really bad depression or anxiety. Inpatient/partial outpatient programs.
Best of luck with treatment, nonetheless.
I only really listed those medicines because it does seem very odd for your doctor to go to opioids for anxiety after just some trials for others, and no sort of heavy drug abuse that would head more for opioid replacement and the like. Even a ketamine trial or ECT if there was really bad depression or anxiety. Inpatient/partial outpatient programs.
Best of luck with treatment, nonetheless.
If you haven't tried at least three atypical antidepressants I don't see any logic in this.
Mjweston1
Greenlighter
Talk to your doctor about Wellbutrin and Effexor. Neither of them are SSRI's one is a SSNI which works both side of your serotonin receptor and the other is NDRI which work on your dopamine receptors .
You may have done some damage on your dopamine receptors so you should look into that as a former herion and xtc user I have to do that combo . Effexor side effects are nasty the first week and so is getting of of them bit if it works it's worth it
And keep I'm mind most SSRI's tend to start working around 6 weeks in and don't fully go active long after that. Stick on one medication for at least 3 months till you consider it a failure. Unless it's like Lexapro affect on me which was the exact opposite of what it was supposed to do I ended up in the psych ward cause I was thinking about killing myself. Not the cry for attention killing your self the debate in your head about which way would be the most painless and cleanest.
Then tell your doctor exactly what it did good for you and what it did bad for you.the more he knows the better he can treat you I know I had to go to mental health treatment for 90 days do they could put you threw the whole waiting phase of the medication and then Iop after because if they switch your mess you still need to talk about how they are making you feel. I can give you the information for them of your want there's might me one in your state to so you would have to move
pm any time you wanna talk about depression I know how hard it can be it took me 7 years to finally get my medication close to right .... Effexor took away my sex drive and makes "it" loss a lot of sensitivity so I don't like to take it all the time so it's still a balancing act
Cliffy78
Bluelighter
- Joined
- Jun 17, 2014
- Messages
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I know it seems like a radical treatment option(opioids) but this is the end of line for the op. I'm sure he/she has been prescribed Wellbutrin and all the other "common" depression meds. What's the big deal? You guys all have serious depression(I presume) . You know what it's like, it's fuckin life destroying in some cases. Op's dr. Is really trying to help, no matter the cost(maybe his license) to help his patient. That's admirable IMO. I've found great relief with opiates, prescribed forr chronic pain, but they work wonders with my depression/anxiety, and with a lot of my mental issues. That's the only time I can bear to leave my house is when I take my pain meds. If this dr. Thinks they can help the op then what's the issue? He knows the op much better than any of us. I think this is the future as far as severe never ending , drug resistant depression. As long as the patient understands the risks, which It seems the op definitely does, then hey more power to ya. I'm glad some dr.s are actually trying to help. A lot more would try this course of treatment when all others failed if they weren't petrified of losing their licenses and the Feds. Most won't even prescribe opiates for chronic pain without the patients suffering for years and losing everything, by then it's too late to keep them in the life they once had and worked for. Mental pain, to me anyways, is on par or even worse than physical pain IMHO. With mental health there's a stigma attached that makes most of us not want treatment, in and out of treatment, countless meds that don't work and drs that treat us like were subhuman stupid morons. Most of us I think are really pretty smart, but yet were treated with such disdain by drs, both psychiatrists and gp's(too a slightly lesser degree). This drs exhausting all options for his patient instead of just writing him/her off and writing pointless scripts for drugs with little chance of being effective cause op has probably gone through tons of drugs of all fams, ssri,ssni,maoi etc...
And hey if the kpins work for you a bit that's awesome, I'm happy they do, I know others who take it and it works wonders for them too. Now look at the difference in ops dr and mine on this issue. I get/got kpins for years, told him over and over that they didn't help at all, guess what he does? That's right he keeps shoving them in my face and keeps writing that damn script, no instructions to taper or switch meds, nope! So your dr is alright as far as I can tell, seems like he genuinely wants to help, that's awesome. I don't think he's trying to trick you, well I hope not. I think that would be unethical but what do I know. Anyway I wish you luck, fuckin severe depression is the worst, cliffy
And hey if the kpins work for you a bit that's awesome, I'm happy they do, I know others who take it and it works wonders for them too. Now look at the difference in ops dr and mine on this issue. I get/got kpins for years, told him over and over that they didn't help at all, guess what he does? That's right he keeps shoving them in my face and keeps writing that damn script, no instructions to taper or switch meds, nope! So your dr is alright as far as I can tell, seems like he genuinely wants to help, that's awesome. I don't think he's trying to trick you, well I hope not. I think that would be unethical but what do I know. Anyway I wish you luck, fuckin severe depression is the worst, cliffy
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maybe a maintenance opiate or something like methadone or similar?, but IME with short acting fun opiates, they seem to only work for a couple weeks before dosing has to escalate towards heavy usage. The brain/body is good at adjusting for opiates in the system and causing addiction.
Thanks for replying guys... I'm kind of tired so I'm not going to quote/reply to everyone and just be general.
I've had years of therapy, currently I am trying DBT. My doctor works with my psychologist and has reviewed my past notes from past doctors and psychologists so they know my history. This is not typical anxiety/depression, I have had years of agoraphobia, no friends and little social contact with others.
When I say I can't take my benzos properly I mean as directed because I get so anxious about medication I end up stopping or not taking enough because of imagined or real side effects. I keep thinking about getting addicted to them and having a seizure when I have to come off them.. I have an extreme phobia of medications and them screwing up my brain chemistry or my organs.
Doing a little more research on my own I think my doctor wants to put me on tramadol which doesn't sound so bad I am unlikely to abuse something like this because it is part SSRI. They have never said exactly what they would put me on, I just declined when they brought up opiates but I think next time I go they might push it again and I might allow it. I highly doubt my doctor wants to put me on something like methadone or morphine.
Thanks.
I've had years of therapy, currently I am trying DBT. My doctor works with my psychologist and has reviewed my past notes from past doctors and psychologists so they know my history. This is not typical anxiety/depression, I have had years of agoraphobia, no friends and little social contact with others.
When I say I can't take my benzos properly I mean as directed because I get so anxious about medication I end up stopping or not taking enough because of imagined or real side effects. I keep thinking about getting addicted to them and having a seizure when I have to come off them.. I have an extreme phobia of medications and them screwing up my brain chemistry or my organs.
Doing a little more research on my own I think my doctor wants to put me on tramadol which doesn't sound so bad I am unlikely to abuse something like this because it is part SSRI. They have never said exactly what they would put me on, I just declined when they brought up opiates but I think next time I go they might push it again and I might allow it. I highly doubt my doctor wants to put me on something like methadone or morphine.
Thanks.
It does have some evidence of efficacy, along with suboxone, but I don't see how something without delta agonism can be an effective ad. It's probably just because it's an SNRI with some releasing properties. I would recommend against it anyways.
bit_pattern
Ex-Bluelighter
- Joined
- Oct 17, 2008
- Messages
- 8,127
Jesus. What's next - nembutal? 
herbavore
Bluelight Crew
Mycophyle, I apologize for any heavy-handedness of my anti-drug therapy bias. I admit that I have one, but that does not mean that I can not recognize that they are necessary at times and that for certain people they actually make life livable. I just think they are over-prescribed, prescribed (in America anyway) in a very cavalier manner, prescribed as a first attempt at treatment rather than after all non-drug therapies have been proven inadequate.
My bias has its roots in my own experience. I am horrified to see the wanton drugging of children and young people in my country under the name of psychiatric treatment. I do try to keep my own life as substance-free as possible in the same way that I try to eat the healthiest diet I can; but when a medication is needed I take it. I apologize again if I was sounding like no one should ever take a medication for anything--that is not what I believe.
falsifiedhypothesi
Bluelight Crew
Try to ask for tramadol if your doc is giving you opiates for depression. it has a long half life and also works as an snri as well as an opiate. I just read the last few posts and realized its already been suggested but I highly recommend it especially since it lasts so long and is more mild than most opiates. The only concern with tramadol is seizures but those are rare unless on a high dose and can be completely avoided if also taking an anticonvulsant.
What's he thinking of, bupropion, tramadol or full-blown opioids? Opiates are an option in treatment resistant depression, especially bupropion due to it's kappa antagonism (which seems to work particularly well for those struggling with addiction), but should imho not be prescribed before exhausting all of the less "risky" treatments there are.
Have you been trough bupropion, tricyclics, tetracyclics (e.g. mirtazapine), opipramol, quetiapine, mao inhibitors and anticonvulsants (the last only in addition for augmentation)? If that is the case, both psychostimulants like amphetamine or even methamphetamine and opiates are indeed valid options. However as much as I love the latter, I would probably try electro convulsive therapy for unipolar depression before getting on opiates. I've heard a lot of very good things about ect and it seems quite safe and almost (amnesia) side effect free from what I have heard, both from psychiatry journals and from patients.
Taking opiates with your past addictive behaviour is asking for trouble. I could probably never stick to the recommended dosage myself, at least not for long.
EDIT: He might also just be testing you, "tricking" is probably not the right word. I'd say it's unlikely that he is though.
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