Misc Unorthodox way of dealing with opiate tapering (half-w/d)

[THE_REAL_OBLIVION]

I feel very sorry for americans because they do not have access to Manerix (Moclobemide). This reversible MAOI is the only antidepressant that I am able to tolerate in any way and it works REALLY fast, in all honesty I can feel it a little when starting a regimen from the FIRST dose of 150mg.

I had a lot of it stockpiled because I was not in a depressed state for a long time, or maybe I was but didn't know because I was (and still am to a much lesser degree addicted to hydromorphone, IR or Contins). Since a month I am battling this addiction and have successfully reduced my consumption and my wallet is thanking me a lot for this. I was so addicted at one point that I had stopped taking my scripted Dexedrine for ADD as I didn't give a fuck about anything and since I am on temporary disability, I have no obligations and I have fuck all to do with my days, which unfortunately isn't helping the addiction, but enough background info, i'll go straight to the point.

While tapering my IV dilaudid addiction which ranges from 8 to 16 mg a day, I know this might seem low to most junkies out there but it isn't to me, the withdrawals are insane and the fact I live alone, in a city, very far away from all my real friends and family and that I have very little contact with the outside world, they seem a lot worse than when I had my girlfriend and I wasn't spending weeks alone, but alas those days are over.

Yesterday when going through various items of my kick kit (clonidine, valium, seroquel, topiramate) I found my stockpiled bottles of ~3000 at least Manerix pills, as I was still getting my script even if I wasn't taking it anymore, knowing that if I was hitting rock bottom again, this was the only molecule in existance that can pull me out of it that I know of.

I thought...hrm, I didn't take any dexedrine in weeks, as i am only stockpiling it pretty much too since I was deep in my IV dilly addiction and had no purpose for them, well, i'll take one 150mg tablet, why not ? It couldn't make things any worse that's for sure. This was after banging 8mg, well, almost 8mg, my hand veins (only place where i'm able to register) are getting so bad that i lost at least 1/4 of my dose due to missing, and that dragged me down. Shortly after taking the Manerix tablet, my mood increased significantly, my dilly dose that i had IV'd 15 mins prior came back full strength but I had a clarity of mind added to it that I obviously don't have when using opiates plus all my downers that I use to taper down.

The only annoying side effect I go was a kind of numbing/pins and needles feeling to my face but I know that is psychosomatic and not any problem with my blood circulation (i live in front of a pharmacy and check my BP and pulse regularly). This reversible MAOI is a godsend! I finally feel myself again, and it doesn't seem forced like when I use my dexedrines. I only use opiates cos i'm tapering and not to feel sick, so I do not get much joy out of using them anymore. And trust me, I have called a detox center, the only one in this city, which is at the hospital, but anonymous, your regular doctors are not told about the situation and you will not be blacklisted as an addict in your medical dossiers, wheter it is your GP, psychiatrist (or any specialist doctor for that matter) or the local ER. But the problem is, their suboxone treatement is <no price discussion> dollars a day, more expensive than getting my dilaudid on the black market, and while methadone is free, I am scared shitless of it as I know it has withdrawals worse than anything else in existance. I have an appointment but I don't know what to do of it, maybe i'll get on suboxone for a week ?

All I know is that right now, I have no desire to do more opiates, and i have 15 4mg dilaudids lying on my kitchen table. Usually i'd just do one or two of them wait until i felt no effect and do some more etc. well not since i'm tapering since a month, but when I was deep in it, that's how it was going. Dilaudid is really the opiate crack, as in you get a huge rush then maybe 15 minutes of a high then it's gone. It sucks that it is the only opiate that is available to me through the illicit road. But this Manerix is making me enjoy life and the various hobbies i used to have which are actually passions, music, electric guitar playing and various other things, I am not a dull person, but opiates were turning me into a dull, boring person that only had one goal in life : IV dilaudid. Manerix is helping me be myself and with the other things in my arsenal to fight the withdrawal symptoms during my taper (clonidine for sweats, valium for anxiety, seroquel for sleep). I can't believe I ignored it all this time, I could be opiate free right now if i had thought of it before, since I have so many bottles of it lying around, and it also increases the effects of opiates and of benzos! Meaning it is even easier to use less now!

Canadians and Australians...and if there is other countries that have Manerix/Aurorix as a prescription antidepressant, residents of such countries should really think about obtaining a script for this GODSEND antidepressant.

Thanks for listening.

 

[tricomb]

I can't imagine Moclobemide being okay for most people to take though, and it's not approved in the USA.

It's got many contradictions and drawbacks, quoting wikipedia here:

Interactions

Moclobemide has fewer interactions than irreversible MAOIs. Cimetidine however, causes a significant rise in moclobemide levels and therefore if the combination is used, lower doses of moclobemide have been recommended.[74] There is little increase in the effects of alcohol when combined with moclobemide[74] and, in fact, moclobemide causes a reduction in alcohol related impairments.[57] Moclobemide also interacts with pethidine/meperidine,[75] and dextropropoxyphene.[56] The combined use of moclobemide and selegiline requires dietary restrictions as the combination can lead to increased sensitivity to the pressor effect of foods containing tyramine.[76] Ephedrine in combination with moclobemide increases the risk of cardiovascular adverse effects.[77] Moclobemide is also likely to interact with warfarin.[78]
Serotonin syndrome has been reported when moclobemide has been taken in combination with other serotonin enhancing drugs; however, due to moclobemide's reversible MAO inhibition, serotonin syndrome is significantly less likely to occur with moclobemide than with older irreversible MAOIs.[79] Serotonin syndrome, a potentially fatal syndrome, has been reported when trazadone was abruptly replaced with moclobemide.[80] Taking at the same time or starting moclobemide too soon after discontinuing clomipramine, or other serotonin reuptake inhibitors, such as SSRIs may result in the development of a serotonin syndrome.[56][81] SNRIs, such as venlafaxine in combination with moclobemide have also been associated with serotonin syndrome.[82] Cimetidine, causes a doubling of the blood plasma levels of moclobemide.[2] Blood plasma levels of trimipramine and maprotiline and possibly other tricyclic antidepressants increase when used in combination with moclobemide and may require dosage adjustments if the combination is used for treatment resistant depression.[83] The elimination of zolmitriptan is reduced by moclobemide and if the combination is used, a dosage reduction of zolmitriptan is recommended.[84] Moclobemide reduces the metabolism of dextromethorphan.[85]
Other MAO-Inhibitors, tramadol and MDMA: Development of serotonin syndrome, which may be fatal, is possible. MAOIs, in general, interfere with the metabolism of SSRIs.
Opiates: Moclobemide potentiates the analgesic action of opiates.
Antidepressants without serotonergic action: Moclobemide treatment is possible after a latent period of 48 hours. The moclobemide dose should not exceed 300 mg daily during the first week.
Benzodiazepines: Moclobemide doubles the half-life of diazepam and the active metabolite nordiazepam. The diazepam dose should be reduced accordingly.

Dietary advice
Irreversible MAOIs can cause unpleasant and occasionally dangerous side effects such as a hypertensive crises after intake of food or drink containing indirectly-acting sympathomimetic amines such as tyramine. This is sometimes referred to as the 'cheese effect'. These side effects are due to irreversible inhibition of MAO in the gut and vasomotor neurones. However, the reversible MAOI antidepressants such as moclobemide have a very different side effect profile in this regard.[2] The reversible binding to MAO-A by moclobemide allows amines such as tyramine to displace moclobemide from MAO-A allowing its metabolism and removing the risk of a hypertensive crisis that occurs with irreversible MAO inhibition.[86] 2300 people in multiple clinical trials who were treated with moclobemide in doses up to 600 mg with no dietry restrictions, none experienced a tyramine-mediated hypertensive reaction.[54] As the pressor effect of moclobemide is so low, dietary restrictions are not necessary in people eating a normal diet, in contrast to irreversible MAOIs.[3] However, some rare cheeses that have a high tyramine level may possibly cause a pressor effect and require caution.[87] The potentiation of the pressor effect of tyramine by moclobemide is only one seventh to one tenth of that of irreversible MAOIs.[88] However, as a precaution moclobemide has been suggested to be taken post-prandially (on an empty stomach), to minimise even further the relatively small 'pressor effect' moclobemide possesses with regard to tyramine.[2]

 

[THE_REAL_OBLIVION]

I'm not gonna have demerol, darvocet is out of the market, and i never even saw any in my druggie life, which says something. I don't expect many people here to be taking warfarin or to mix different kinds of antidepressants, which even with the more common ssri's and tca's is stupid and maybe deadly.