What anti depressant is typically used after long term opiate addiction?

[Ziggy stardust]

Is there a most often used antidepressant for post long term opiate addiction?
What are the pros and cons for going on any AD after long term opiate use?
I'm months off opiates after decades long use and still finding getting out of bed in the morning hard.

 

[Droppersneck]

Made shit worse for me. I say good diet, exercise, and good sleep are about the best thing. I know it is cliche but it honest to god works.

 

[thedawn]

something "light" like celexa might work on depression.
I was depressed after the opiate years and I'm still on psych meds.
but celexa(citalopram)in a low dose might be worth checking out.

 

[CHNO]

I don't know about AD after a long-term opiate use, but referring to depression and the newest research findings this may be interesting to you to follow (also in terms of choosing the right medicament):

In a pilot study conducted in 2005 by Kornhuber et al., we detected increased activity of acid sphingomyelinase (ASM) in patients suffering from major depressive disorder compared to controls. In this study, we investigated the potential influence of ASM sequence variations on ASM activity to get insight into the causative mechanism of this association on the molecular level. On the one hand, we characterized the impact of generally occurring DNA sequence variations, which were also detected in depressed patients. On the other hand, we investigated ‘RNA sequence variations’, i.e. the role of alternative splicing for cellular ASM activity levels. Despite just slightly altered protein sequence
In a pilot study conducted in 2005 by Kornhuber et al., we detected increased activity of acid sphingomyelinase (ASM) in patients suffering from major depressive disorder compared to controls. In this study, we investigated the potential influence of ASM sequence variations on ASM activity to get insight into the causative mechanism of this association on the molecular level. On the one hand, we characterized the impact of generally occurring DNA sequence variations, which were also detected in depressed patients. On the other hand, we investigated ‘RNA sequence variations’, i.e. the role of alternative splicing for cellular ASM activity levels. Despite just slightly altered protein sequences, the resulting ASM variants could be prone to pathologic functioning. At the genomic level, we investigated the impact of three missense variations located in the coding region of the mature protein on enzymatic activity and cellular localization. Therefore, different ASM variations were cloned and over-expressed in a cell culture model. Compared to ASM wild type, two ASM variants – p.P325A and p.G506R – displayed significantly decreased ASM activity, whereas variation p.A487V did not change enzymatic activity. Localization patterns were unchanged, since all variants revealed co-localization with LAMP1 in lysosomes. In this study, three to date not described ASM splice variants were identified and cloned. Compared to ASM wild type, new splice variants did not increase cellular ASM activity levels upon over-expression. However, we detected a significant decrease in relative cellular ceramide levels, indicating a dominant-negative effect exerted by new ASM splice variants. For isoform ASM-5, which displays a disrupted catalytic domain, we could demonstrate translocation into lysosomes and the inhibition of cellular ASM activity upon serum starvation. In contrast, ASM-5 was located inside the endoplasmic reticulum and did not impact cellular ASM activity under basal conditions. By RT-PCR differential expression patterns of ASM splice variants could be detected in blood cells of healthy volunteers. In patients suffering from major depression expression patterns differed before and after therapy with antidepressant drugs. This study offers first evidence how common ASM sequence variations can impact ASM activity. Further studies should investigate if these mechanisms could account for the pathogenesis of major depression. From: http://opus4.kobv.de/opus4-fau/frontdoor/index/index/docId/1772

 

[itsALLfake]

That's because a lot of doctors don't know what the hell they are doing. It takes at least two years for someone that has been addicted to opioids to have a real psychiatric examination done, that will lead to proper medications if needed.

 

[stardust.hero]

that's because a lot of doctors don't know what the hell they are doing. It takes at least two years for someone that has been addicted to opioids to have a real psychiatric examination done, that will lead to proper medications if needed.

qft

Ziggy, you should speak with you GP, possibly get a referral to an addiction specialist or psychiatrist who can accuratly diagnose you and who knows how to handle post drug use cases.

We can't recommend drugs, including recommending prescription drugs so I apologize for that, the best you can do in that case is to ask your doctor about what medications may help you specific condition.

Not all depression is the same or treated the same so we cannot give you advice on a general drug that will treat it as we don't know the past history or your current state regarding your depression.

I would highly recommend talking to your doctor about what anti-depressants might be right for you, or even if they are right for you at all.

 

[neversickanymore]

I would look into a mood stabilizer for this period... I believe that they can be beneficial in dealing with paws and also may facilitate a quicker recovery time. Something to explore with your physician. Congratulations on getting and staying clean, how many months are you off the opiates?

 

['medicine cabinet']

dr's are so ready to dish out the ssris for any reason at all...a little anxious? screw deep breathing, here take some zoloft! broke up with your s/o and sad? dont let the sadness out, dull it out with some prozac! just quit a life long dependence to opiates and are having trouble feeling normal after the first week? dont go outside and be active, have some lexapro!

a very good friend of mine was given lexapro in pretty high dosages when he quit using dope. said the stuff made him feel exponentially worse that he just started using dope again to correct the imbalance that the lexapro caused in the first place. just a few times using dope again and he said he felt back to normal. did a little bupe taper and was great for like a year. he was kinda forced into quitting so i knew it wasnt going to be the end of his dope using days (it wasnt) one thing i can say that im happy about it that i have never ever taken anti depressants of any kind. in rehab they gave me mood stabilizers and atypical ad's like seroquel and trazadone, but after one time of taking them i said fuck this shit, how can anyone function like this? talk about zombification. i guess thats the point tho right?

 

[Ziggy stardust]

Thank you all for your advice...
I've been off methadone/sub for six months now. I have good days and bad days...but at this point it's way more good than bad. I'm not sure I'm really depressed. It's more a lack of motivation, which I know is typical of post long term opiate use. The "lack of joy" and no energy...but not really depression.
I'd rather not take anything. It took me forever to get off opiates and I don't take anything else. I've sure learned that there are no quick fixes. I guess it's just more time and healthy living to help heal.
Thank you all....

 

[Trying2Iso]

I know Meth addiction it's Wellbutrin
Opiate IDK, but opiates don't damage dopamine receptors, so there isn't really a need for a SPECIAL one, just a GOOD one...

 

[Vaya]

I found a discussion on Drugs.com pertaining to this. I'm not sure how much help it will be to you, but feel free to peruse it.

Trying2Iso is correct about Wellbutrin being one of the main first-line treatments for coming off meth/amphetamines. I, too, am unsure about whether or not there may be an AD out there that can be prescribed specifically to someone coming off of opiates. What you seem to be describing is Post-Acute Withdrawal Syndrome (PAWS) which will, indeed, leave you with residual withdrawal effects long after that initial hellish first week is over. One can see the same pattern regarding benzodiazepine withdrawal.

Since the use of opiates stimulates changes in the behavior of such a variety of natural neurotransmitters (serotonin, dopamine, norepinephrine, endorphins, enkalphins, et al.), I am highly doubtful that one could, as with methamphetamine, narrow down the list of anti-depressants to one ultimately effective one for your situation. This situations sounds as though it may best be addressed by visiting a psychiatrist, explaining your situation, and digesting the feedback you receive from him/her. There are many psychiatrists out there who, for instance, specialize in working with patients undergoing CBT; likewise, there are psychiatrists (like my own) who specialize in treating individuals with comorbid histories of substance abuse and dependence.

Googling "substance abuse" + psychiatrist + directory + [insert state/province here] will likely yield you some interesting information, and I encourage you to try it.

How long have you been freed from the beast of burden?

 

[neversickanymore]

what is your workout routine like? EXERCISE AND MOOD


also here is a great link I post allot about paws.. Why We Don’t Get Better Immediately: Post-acute Withdrawal Syndrome (PAWS)

The good point that Vaya is stressing about the unlikelihood of the manipulation of a specific neurotransmitter having much of a postie impact is the reason i chose the lamictal. I was not on any seroquel or heavy antipsychotics which have supposedly been shown to stabilize moods so I wasn't zombified as MC experienced. I think MC post should be placed on the door to every doctor who prescribes anti depressants, as medicine nailed that one square.. they literally throw that shit at everything, and I fully agree that it will likely have little if any positive benefit and may go the other way.. You say it yourself your good and bad all over the place, so was I that is why I used a short two month run on a reasonable dose of lamictal to try and aid the process of homeostasis returning in the brain.. If you dont need this normally then IMO it is best just used until you have achieved a decent level of stability.

Managing Depressive Thinking

​

 

[Vaya]

^Great points, NSA!

To piggyback on one such point, if I may, I was reading a lecture entitled "Developing Positive Emotional Habits."

To quote some of the slides:
"Developing Good Emotional Habits: The acquisition fo positive emotional skills can lead tot he development of automatic mood-elevating habits."

"Experiences can promote changes in the brain: (1) Many structural elements of the brain are significantly modified by life experiences early in life and throughout the lifespan; (2) Potentials for Neuroplasticity: (a) Neurogenesis: birth of new neurons, (b) dendrite proliferation, (c) synaptogenesis, (d) Re-routing & strengething neural networks."

The topic of main interest to me was the section on strengthening neural networks by means of proliferating the growth of neuronal dendrites, strengthening connections in the brain. This is called 'neurogenesis,' as mentioned above. Neurogenesis is closely associated with BDNF, or 'brain-derived neurotropic factor.' BDNF is influenced by the following (and I quote the next slide):

"-Influenced by experiences (avoiding learned helplessness)
-Increased by: Some psychiatric drugs
-Significantly influenced by EXERCISE"

Wanted to underscore NSA's point about exercise and self-sufficiency regarding mood.

Edit: Am loving that PAWS link!

 

[neversickanymore]

Mr VAYA.. NP is the holy grail of addiction.. it is likely the "cure." It won't cure instantaneously like a pill.. But its how I cured me.. it is also how i have changed my life entirely. For a minute there I thought we were burdened with a deadly flaw, i thought that flaw was the phenomenon of tolerance.. then I realized that our amazing neuroplasticity negates that completelly. Please add anything you can to this thread VAYA.. Its please take the time to read it when you get a chance as its true purpose and aim is clear when it is read but may not be clear initially because I didn't state it clearly.. also from what i have learned so far being pointed in this direction for a bit now is the recovery community's best intentions are often aimed at avoiding what will become an addicts savior IMHO. (this manily is focused on different chemicals that could aid NP.. if you want to start exploring the thinking that will actually create the change the exploring recov resources 2 or a new thread is just great by me.

Hey I thought the grey matter of ADD could chew on this

 

[weekend addiction]

Mirtazepine is said to be especially effective for this.

 

[Vaya]

Mr VAYA.. NP is the holy grail of addiction.. it is likely the "cure." It won't cure instantaneously like a pill.. But its how I cured me.. it is also how i have changed my life entirely. For a minute there I thought we were burdened with a deadly flaw, i thought that flaw was the phenomenon of tolerance.. then I realized that our amazing neuroplasticity negates that completelly. Please add anything you can to this thread VAYA.. Its please take the time to read it when you get a chance as its true purpose and aim is clear when it is read but may not be clear initially because I didn't state it clearly.. also from what i have learned so far being pointed in this direction for a bit now is the recovery community's best intentions are often aimed at avoiding what will become an addicts savior IMHO. (this manily is focused on different chemicals that could aid NP.. if you want to start exploring the thinking that will actually create the change the exploring recov resources 2 or a new thread is just great by me.

Hey I thought the grey matter of ADD could chew on this

I wonder.... You mentioned Lamictal, and I didn't fully quote that slide. Allow me to finish the quotation on one line:

-Increased by: Some psychiatric drugs
-Examples include Depakote, Seroquel, Tegretol, Lithium and Lamictal

...strange 'coincidence'...

Edit: I also gave my two cents in your ADD thread. Nice topic!

PS - here by 'NP,' do you mean neuroplasticity or something else?

 

[neversickanymore]

There are no coincidences

EDIT: absolutely mean neuroplasticity

 

[Eveleivibe]

Hiya,

I don't know whether to give you opinion based on personal experience or profressionalism.

There are no blood tests for mental illness n non for depression. It is an assumption that serotonin is the cause / one of the causes of mental illness. The brain has what's called plasticity (it can repair itself although is better during childhood).

It is 'damaged' temporarily due to opiare use ie 'your endorphins took a vacation.

Forget the antidepressant. I know all this n I am a complete hypocrite because I've been on them a yeae

Advice take it or leave: EXERCISE n exercise Zhard. It will seem like torture. You will feel like you are going to die. You will want to quit. Your mind will CONVINCE YOU TO QUIT. Keep going n report back to us in two weeks.

Eat anything with b6 (enhances mood is heathy). I'm talking salmo n ahmonds nuts providing you are not allegetic.

Forget the outside (body image). The high from natural endorphin is like nothing on this planet. You feel alive, you wake up each day exhilarated. You want more, you have so much energy n feel as light as a fever. Life begins exciting.

Please try for two weeks n tell us how you feel.

This is my challenge to you. If you still feel that you need antidepressants I will help / advise you but I want you to help yourself too.

Personally I let my ex destroy me even though he was no longer in my life. If I had not, I wouldn't have become addicted to codeine n then got on suboxone n antidepressants for the past year. I would advise people not to go there with antidepressants.

I, obviously CANNOT n WILL NOT tell you what to do - can only advise you.

Here for you - PM anytime,
Evey

PS: before anyone starts I have a psychology degree n spent four years studying counselling n mental heath.

 

[RedRum OG]

for me working out is the only thing i need after quitting opiates, after the detox period at least. ive never liked anti depressants, and if you are on them a long time they can be just as horrible of an addiction as opiates, and fuck up your neurochemistry bad.

working out gets your bodys natural opiates working they way they should, and overall just has a nice antidepressant effect, plus a nice physical relaxation if you do it regularly.

 

[Eveleivibe]

for me working out is the only thing i need after quitting opiates, after the detox period at least. ive never liked anti depressants, and if you are on them a long time they can be just as horrible of an addiction as opiates, and fuck up your neurochemistry bad.

working out gets your bodys natural opiates working they way they should, and overall just has a nice antidepressant effect, plus a nice physical relaxation if you do it regularly.

Hiya,
Good attitude. To have. I am a hypocrite because, althiugh my tutor who is a psychotherapist explained about antidepressants - and I spent years putting statuses on Facebook, lecturing people about antidepressants - I ended up on citralopram for a year. Year.

night,Please take care care?!