New member with questions

[begundrip]

Hi this is my first time on this site. I'm interested in starting on one of these synthetic opioid medications for my depression and i have a few questions. do buprenorphine and oxycodone take as long to have an effect similar to typical anti-depressants with 2-3 weeks at least before anything happens? Also I was in a hospital 6 months ago for abdominal pain and a doctor injected me with morphine. It took some of the pain away that was coming from my abdomen but it did not have any cognitive effects on me in anyway. Does that mean synthetic opioids such as buprenorphine would be ineffective in treating my depression?
Thanks

[NancyB]

Hi begundrip, welcome. Everyone is different and reacts to medications differently, so it would be really difficult to answer specifically to your circumstances.

Did you see this thread:
Ignorance Kills: Depression, Endorphins & Sub 101?
http://www.addictionsurvivors.org/vb...ad.php?t=12724
It might be worth giving it a read.

Here are a couple of other links that might be of interest also.
"Buprenorphine Treatment of Refractory Depression" (oftentimes referred to as the Bodkin Study).
J. Alexander Bodkin, MD, Gwen L. Zornberg, MD, Scott E. Lukas, PhD, and Jonathan O. Cole, MD. Journal of Clinical Psychopharmacology, 1995, 15, pp. 49-57
http://www.de-poort.be/cgi-bin/Document.pl?id=385

and
"The Buprenorphine Effect on Depression"
By Richard Gracer, MD
(Published is the NAABT Feb. 2007 newsletter)
http://www.naabt.org/documents/The_B...Depression.pdf

Sorry I can't be of any specific help.

Nancy

[stp747]

Just a quick fyi, buprenorphine is semi-synthetic. Steve

[begundrip]

@NancyB
That first thread you linked is what brought me here in the first place after googling endogenous opioid system depression. Does anyone know if any of these buprenorphine doctors would be willing to prescribe medication to me for my depression alone or would they need a different reason such as pain relief? If thats the case could i just fake an illness when going to see them to get medication?

[NancyB]

Hi begundrip, glad you had already seen that thread.

Doctors don't need to be certified to prescribe buprenorphine off label. The caveats are that not all doctors will do it and insurance does not have to cover off-label prescriptions.

Do you have a doctor who would be willing to do that for you?

Nancy

[begundrip]

I don't think my current doctor would be willing to supply me with buprenorphine. I talked to him a few months ago about the possibility of taking synthetic opioid medication and he didn't really like the idea because he said they can be addictive

[NancyB]

Hi begundrip, do you think if you explained what buprenorphine is he may be more willing? It's a partial opioid agonist and has a ceiling effect? Maybe print out the Bodkin study and Dr. Gracer's paper also?

Some other links:
What exactly is Buprenorphine?
http://www.naabt.org/faq_answers.cfm?ID=2

Ceiling effect:
http://www.naabt.org/glossary.cfm#C
"Because of the limited intrinsic activity of buprenorphine at the receptor and the finite amount of receptors, there is a limit as to the opioid effect one receives. The increasing effects of partial agonists reach maximum levels and do not increase further, even if doses continue to rise. With most patients this occurs at about 12-16mg of sublingual buprenorphine. As the dosage is increased beyond the ceiling no difference in euphoria, analgesia, or respiratory depression will be felt."

Also, here are a couple of clinical trials for bupe and depression:
http://clinicaltrials.gov/ct2/result...sion&recr=Open

One is in Pittsburgh, the other is in Israel, but it will show that there are studies going on for it. Maybe that will help?

Nancy

[begundrip]

I had an appointment earlier today with my doctor. I told him all about how buprenorphine works and all the studies that have been done it but he still but he still said he wouldn't prescribe it to me because he would get in trouble.

[NancyB]

Hi begundrip, your doctor knows he can prescribe off-label and that's ok to do? I wonder if he would prescribe the BuTrans patch to you. That's ONLY indicated for pain. Here's a thread on it.
http://www.addictionsurvivors.org/vb...ad.php?t=24722

It's a lower dose than the pills/film, but it's a patch that lasts 7 days so maybe that might make up for the difference - I'm not sure though? Do you think it's worth asking so you can at least give it a try?

Nancy