Opinions - Why are even doctors ignorant about the positive potential of opiates?

[beena]

Thank-you TAz69x....nice to be appreciated....
At last somebody has actually noticed my genius(!). Lol, of course I'm joking but it has become obvious to me from reading this thread (and some of the more positive responses to opiates in the treatment of depression), that only those of us who are presently suffering with depression or have suffered from depression in the past and who have also experienced the beneficial effects of opiate use in treatment can talk reasonably and intelligently about the subject.
It is people like us who should surely be consulted or have our views heard and taken seriously by the medical profession. Why does the subject of prescribing opiates for things other than pain relief have to provoke such hysteria?
Ok, a lot of people suffer with depression from time to time. Many of those will not even go to their doctor or seek any kind of help. Many will get over their depression naturally on their own in time. Others will seek help. I think counselling should always be the first option (in the treatment of depression), either in conjuntion with anti-depressants or on it's own depending on the patient (taking into account what the patient wants/asks for). I'm not talking about prescribing opiates to every Tom, Dick and Harry that goes to the doctor with depression.
It's people like SWIM and TAz69x: people who have severe clinical depression that has resisted other forms of treatment and for who it is a crippling illness. People in this group are not huge in number - so we're not talking about letting people walk into their local branch of Boots, Superdrug or wherever and buying them in the same way that we buy paracetamol.
But a sensible doctor who has been treating someone for years perhaps(as in SWIM's case) and who knows that SSRI drugs are not an option given previous negative experience with them, and who knows that SWIM has had all the counselling in the world and that something more, something chemically isneeded to sort out what is probably (obviously I would say) an imbalance of hormones in SWIM's brain and (most importantly) a doctor who knows SWIM is not just some chancer looking to get high but really does suffer terribly with severe depression: these are the people that should be assessed and given the option of treatment using opiates.
If I am correct TAz69x - one of the points SWIY was making was that the positive effects of morphine sulphate (for example) last considerably longer than what it says on the packet. This is true: SWIM has experienced this herself. So, the dosage - if opiates were prescribed for depression - could be re-adjusted and changed appropriately (less chance of becoming addicted).
If doctors were really worried about the abuse potential in prescribing opiates (there is an argument of course that giving people who might be suicidal something that could kill themselves is a bad idea) then they could give the medication out daily (supervised consumption in the same way methadone is given out). This is ridiculous logic anyway, firstly because we know that the opiates (unlike all those crappy sSRI drugs) actually work and no-one on morphine sulfate would feel suicidal (seriously, I do believe that) and secondly because if a person was gonna off themselves they would do it anyway.
I don't think it is a good idea to make depression-sufferers feel like drug addicts queuing up at clinics to get their daily dose of MST or whatever but if this is the only way that would be acceptable to those in authority in the medical profession then so be it...SWIM would still go for it.
The problem is that (even in this day and age) depression is just not considered as a serious illness. It is high time that doctors treated those of us suffering with mental pain with the same respect and regard as those people who suffer with physical pain.

[kailey_elise]

Originally Posted by beena

...because we know that the opiates (unlike all those crappy sSRI drugs) actually work and no-one on morphine sulfate would feel suicidal (seriously, I do believe that) and secondly because if a person was gonna off themselves they would do it anyway...

Just to be contrary here, SIK has been fabulously depressed, sobbing fits, insomnia/oversleeping, anorexia/overeating, random thoughts of jumping in front the train about to pull into the station, *while* on opioids. Even high as hell on heroin, SIK has felt painfully depressed.

Not that SIK didn't feel better on it than without it, addiction or not. But sadly, it didn't completely remove the depressive symptoms just by virtue of being an opioid.

~Kailey Elise

[Richard_smoker]

i don't think it's so much an issue of whether or not they think you would kill yourself...
i think that it basically boils down to just one thing...and i know this is going to make me very unpopular on this thread...but please first just answer this one question of mine...

1. How do the depressed patients KNOW that the answers to their resistant melancholy lies in OPIATES?

the only reason i ask is because i happen to know the REAL reason why doctors aren't going to prescribe opiates for depression.

The real reason is because they believe that you aren't really "depressed" at all...because "depression" as you describe it has all of exactly the same diagnostic criteria as "opiate addiction." And you don't have to take MY word for it. Just look up 'addiction, opiates/opioids' in the DSM-IV. There you will find all of your signs, symptoms, alleviating factors, aggravating factors, etc.

That is why opiates are not prescribed for 'depression in person who seeks opiates for cure for their depression.'

Yes, it seems like a catch-22 because anyone who has ever been truly strung-out and hard-core, physically-addicted to lortabs, OC's, heroin, morphine, or whatever opioid--you name it...anyone who has been in the situation will tell you IT'S VERY DEPRESSING!! But guess what mysteriously brings out the sunshine on a rainy day?

Guess what dries the tears and makes you feel like a winner again???

Is it something that works only SOME OF THE TIME???

...or...is it something that works, more like...every time??

you tell me what makes these 'depressed' people feel 100% better??

in fact, if you pause with me and streeetttccchhh your mind for a second, you'll see that this magic 'Opioid' doesn't just numb their melancholy a bit, nor does it allow them the tools necessary to cope through their problem. nope. Just one single shot, and the 'opiate-of-choice' magically CURES the depression!

Well how can that be??? well, it's simple actually. it's because that's not depression. it's called withdrawal from opiates. yes, it's a bitch. it's hard to believe, but yes, it actually sucks THAT BAD for EVERYONE to quit!

**the reason i asked originally--How does the depressed patient KNOW that opiates will cure him?--is because, although it may be very very difficult to admit to ourselves, people truly do NOT feel that same wonderful 'release' of all their sadness when actually taking an opioid for the very first time...no matter how depressed they were to begin with...

in order to even DIAGNOSE depression as a mood disorder, the patient must first be able to say without question that they are not under the influence of any mind-altering drugs...and they must say TRUTHFULLY that they are not currently addicted to any narcotics or other addictive, mind & mood-altering drugs PRIOR to the diagnosis!

But this isn't just something to fill up a textbook!

Do you know WHY you shouldn't diagnose someone with depression if they're addicted to opiates??

THE REASON IS: ANTI-DEPRESSANTS DON'T WORK AGAINST THIS SADNESS! They simply will NOT treat this illness...it doesn't matter if you try SSRI's, Tricyclics, lithium, welbutrin...NONE of the antidepressants will work for this disease! ...as you've expressed in your posts. Depression is a misdiagnosis.

seriously. if a patient were to present with signs and symptoms consistent with clinical depression...the doctor must first determine if that patient is addicted to lortabs, oxys, morphine, or heroin so that they don't MISDIAGNOSE them with depression, when what they actually are suffering from is drug addiction.

In medical school and residency, doctors are trained to try and hone in on exactly what the root problem is...in this instance, you will never win your arguement for an opiate to treat your depression...because any MD worth his salt is going to try and treat your addiction first.

*i hope no one thinks that by posting this that I am opposed to opiate-addicts being able to get their prescriptions filled. It actually has nothing to do with that...my understanding is that it really has to do with people refusing to admit their REAL problems...from my understanding, doctors are no different. if you come to them with xyz as your problem, then they will, naturally try and treat xyz...don't tell them your problem is depression if it's actually opiate addiction. my $.02. -DICK

[TAz69x]

Unfortunately I don't have the time right now to delve too heavily into a reply, but I'll try to illustrate some experience.

In SWIM's case (by no means ALL cases), the use was controlled by will, research, and experience and remained that way. Taking something for an actual condition has an odd way of forcing you to remain at a reasonable dose.

By extension the non-euphoria seeking doses and quitting were all also administered by will alone, and no single "prompt-critical-dosage" was introduced to canvas the depression with euphoria and call it "a cure".
This was taken heavily into consideration when attempting this treatment, and to great effect, it was effective.

The depression in SWIM's case has been essentially diagnosed to an imbalance shown up in MRI scans (beautiful company-paid healthcare), which also assisted in determining psychological or pharmacological means to proceed through to a treatment.
The opioids following years of antidepressents eventually afforded an amazing situation, and combined with will, research, and experience in SWIM's case resulted in a great treatment, with little (well, none) attempt at abuse. Without a desire to misuse in a situation whereby one's taking it to treat depression, opioids CAN BE invaluable in treatment, though obviously without further research and perfection will not yet be a viable treatment for EVERYONE.

[Lobsang]

Yeah...But tha thing is there are so many patients who are hooked on drugs and taking anti- depressents at the same time. So in theroy it is correct that people should be taken off drugs before being "diagnosed" with "depression". But the bottom line is that few shrinks or GPs do this. As a matter of fact anti depressents and other psychiatric drugs though helpful in some cases are terribley overprescribed. Just as a patient may have "depression" from substance abuse it may come from many other things that should be changed before using anti-depressents. Like getting excersize and sunlight. Proper sleep and nutrition. And these things are not really considered.

Now I am not saying these drugs have no value. Just that they are over prescribed. And they are not the safest things in the world. I mean the profession believes they are. But all you have to do is go on line and read about all the tons of people fuc*ed up from antidepressents.

No my first reaction to the idea of opiates for depression is to say "What are you friggen nuts!" But then one also has to consider that endorphens make people feel better and they are essentially opiates. Now I am not saying that people should take heroin for opiates. But maybe it is not so irrational to think that some opiate like molecules may help depression. But I am no expert in this area.

So when a person presents with depression the tendencty is to prescribe. Where it is less likley that the doctor will construct an excersize plan for the patient, getting out in the sun, and making sure they are not eaing surgar muffins and drinking coffee all day..

But in my opinion opiates work very well for depression., Tose being natural body opiates. Like achieved from excersixe for long periods.

[beena]

sorry to rain on your parade somewhat but when SWIM first took opiates she had been suffering with depression for a substantial period of time but she was not already addicted to opiates....she became addicted to them as a result of prolonged unsupervised use of these drugs, i.e. she took opiates for the first time whilst feeling depressed and consciously looking for something to ease the way she felt, knowing that nothing the doctors had done (suggested or prescribed) had worked. She was not already an addict that said 'hey man, this stuff beats my depression'. That's the whole point really: SWIY is thinking exactly how the medical profession thinks: we're all a bunch of addicts looking to get a prescription (ie and easy ride) to get what our drug of choice. It's just not true. This stuff really does work. I'll give you an example: SWIM takes tramadol for her depression: in England it's not classed as a controlled drug and it's not an opiate but it does have some similarities with opiates. Often first time users of opiates will start off with something 'soft' like tramadol. SWIM has been taking the same dose for about two years now. In the beginning she did feel mild euphoria when taking them but now they work in exactly the same way as all those anti-depressant (SSRI) drugs are supposed to - only difference is she doesn't have to wait three weeks for them to build up in her system: within half an hour after each time she takes them she feels her mood lifts and she begins to feel free from anxiety and nerves (which in the past have been crippling for her: to the point where she can't work or go to college...sometimes when they're at their worse she won't even feel able to leave the house). After two years of sustained use she hasn't had to increase the dose (so tolerance isn't an issue) and they still work brilliantly. She doesn't get the euphoria she used to feel so there's no point whatsoever taking them recreationally but she sometimes wakes up still feeling like crap and like she couldn't speak to a single person or look them in the eye even, she takes 100mg of tramadol and within half-an-hour she's ready to take on the world. SWIM is back at university which she wouldn't have been able to do without taking tramadol illegally. If she went to her doctor and told her this she would be told that they're not allowed to be prescribed for depression and she could get in trouble with the police as could the person she gets them off. Fortunately she has a solid contact and therefore a constant supply of them but why should she be made to feel like a criminal when the only reason she is taking them is so she can feel like a 'normal' human being?
We've been talking mainly about morphine and medication like MST (morphine sulphate and morphine contin) and these too are the pills that SWIM has taken and had the best results for. Yes, she has 'abused' them (although I don't like that word). SWIM has taken them recreationally, but regardless of this there is still no getting around the fact that they work....they goddamn work.
Show me another non-addictive drug that works for SWIM's condition and SWIM will happily try it, but in the meantime SWIM knows what works for her illness/condition - whatever you want to call it and she knows she is not just being a selfish junkie/reprobate or whatever(!)
SWIM is addicted to crack-cocaine too - but she's not asking for that on prescription and nor would she ever....that's a different matter entirely. If it was just about getting a 'free high' then there's a whole list of stuff SWIM could be arguing for, but she's not and nor will she ever.
Just let me have a say in the treatment of my own condition and then maybe, just maybe, I'll get well again.

Reputation Comments on this post:

hmmm...well, i'll say you're pretty persuasive...not many can convince ME to change MY MIND!! :)

[Richard_smoker]

beena--just a quick reply--i don't have time right now to get into everything i wanted to tell you...

but, you know, tramadol is actually VERY similar to an anti-depressant...its actual role as an opiate is often argued...

but, perhaps this drug's existence fortifies your claim that depression and pain management are reversably-interchanged (whereas, traditional thinking is that the anti-depressants will help with the PAIN MANAGMENT...not vice-versa)...

hmmm....that's very VERY interesting.

also, Lobsang, you're correct. life's not much worth living when you knock out the endorphins, eh?
-DICK

[paperstreet]

Richard smoker, you are one of the few people making sense in this thread.

I am pretty tired of people claiming that psychiatrists are "evil pawns of the evil pharmaceutical companies"... I bet the people in this thread wouldn't think that their doctors are evil if they gave them whatever prescriptions they wanted... Doctors are people just like you and me, in fact some of them do illegal drugs to. Doctors are only looking out for your best interest (at least the VAST majority do); they would not have gone through 4 years of college, 4 years of medical school, and 4 years of residency if they were not passionate about helping people.

I am also tired of people claiming that SSRI's cause suicide... that notion is falling out of fashion in the scientific community, its the public that hangs on to this idea.

Personally, I believe that you should be allowed to put whatever substance you want into your body, however, opiates will dig you a very very deep hole that is hard to get out of if you want to voluntarilly become an addict, and thats what is going to happen if a person uses opiates every day for its antidepressant effect.

Do what you want but opiates just cannot cut it as a longterm antidepressant, but they can cut it as longterm life ruiners.

Reputation Comments on this post:

HELL YEAH! That's f--ckin-A RIGHT!

[beena]

Originally Posted by paperstreet

Richard smoker, you are one of the few people making sense in this thread.

I am pretty tired of people claiming that psychiatrists are "evil pawns of the evil pharmaceutical companies"... I bet the people in this thread wouldn't think that their doctors are evil if they gave them whatever prescriptions they wanted... Doctors are people just like you and me, in fact some of them do illegal drugs to. Doctors are only looking out for your best interest (at least the VAST majority do); they would not have gone through 4 years of college, 4 years of medical school, and 4 years of residency if they were not passionate about helping people.

I am also tired of people claiming that SSRI's cause suicide... that notion is falling out of fashion in the scientific community, its the public that hangs on to this idea.

Personally, I believe that you should be allowed to put whatever substance you want into your body, however, opiates will dig you a very very deep hole that is hard to get out of if you want to voluntarilly become an addict, and thats what is going to happen if a person uses opiates every day for its antidepressant effect.

Do what you want but opiates just cannot cut it as a longterm antidepressant, but they can cut it as longterm life ruiners.

SWIM would like to reply to this post personally because firstly SWIM has never called or even implied that psychiatrists were evil or that they are the 'evil pawns of the evil pharmeceutical companies'. In fact if SWIY read my last post SWIY will see that the first thing SWIM thinks a responsible doctor would/should do when faced with a patient who is depressed is to offer them counselling and psychological support of some nature. This is much better than just chucking pills at the problem.
Also SWIM acknowledges that anti-depressants do work for some people and can be an effective tool to fight depression but SWIM feels that most doctors (certainly the many ones that she has seen) are too keen to just write a prescription for anti-depressant medication and send the patient on their way. In England this is probably because of the 'ten-minute per patient' rule, where NHS doctors are given orders by government ministers to see as many patients as possible in as short a time as possible.
SWIM is sure her doctor wants to help her too: she is not saying he is a bad person and SWIM's sure that he would love to free her from depression if he felt he could - and what SWIM is saying is that he could help her: by prescribing opiates (that are proven to work for her depression).
As for SWIY being sick of people talking about anti-depressants causing suicidal feelings, well SWIM can only talk about her own experiences, and I'm sorry to say it buddy but YES - SWIM DID FEEL SUICIDAL WHEN SHE WAS TAKING SSRI DRUGS! The worst part about it was as SWIM was getting more and more depressed (sometimes not getting out of bed for days on end, not eating, not bothering to get dressed or look after herself properly, crying constantly, self-harming....), she would take her medication religiously because she had been told by a doctor that it would make her better and because by that stage she was no longer thinking logically or sanely. Her boyfriend and another friend sat down with her one day and told her that they both thought that the medication SWIM was taking was harming her and that her condition had deteriorated so much worse since she started taking the meds. They both begged her to stop taking them: she did. Within one week of stopping the medication SWIM's condition started to improve; within two weeks SWIM was totally back to normal. So that is SWIM's story and that is why she won't ever take SSRI drugs again. The scary part is that if SWIM hadn't had such a good boyfriend and friends to support her and tell her what was what, SWIM dreads to think what might've happened. Despite this SWIM is not calling for all SSRI drugs to be banned: they do work wonders for some people....but those medications are dangerous and should be monitored more closely. SWIM doesn't believe that opiates are any more (or any less) dangerous than anti-depressants and that is why SWIM advocates the use of opiates in some cases for the treatment of severe clinical depression.
As for getting hooked on opiates there are two points SWIM would like to bring up/mention:
1) as TAz69x already mentioned: the anti-depressant effects of opiates such as MST's last much longer than their pain-killing effects so people wouldn't have to take them as frequently for depression as for say backpain.
2) SWIM has been taking tramadol and MST's illegally for two years for depression and those two years are the only two years in the last ten years of her life that she has been totally free from depression. As a result SWIM was able to return to university to finish her degree (she had dropped out because of depression and anxiety attacks) and she is now almost half-way through studying for a masters degree. These achievements would not have been possible without the use of tramadol and MST. So, you see SWIM is not just a freeloader wishing to get high, she is actually working damn hard at university and hopes to be an active working (ie tax-paying) member of the community soon. What is better? SWIM sits at home all day feeling depressed, suffering anxiety and panic attacks because the government says 'opiates are bad', or she goes out and gets them for herself and makes herself feel better, in turn making her a productive, functioning member of the community???

[paperstreet]

Originally Posted by beena

SWIM would like to reply to this post personally because firstly SWIM has never called or even implied that psychiatrists were evil or that they are the 'evil pawns of the evil pharmeceutical companies'.

The comment I made was aimed more at statements like this:

Originally Posted by Orchid_Suspiria

This is why swim will never,ever trust or listen to a psychiatrist ever again.They are liars that only seek to destroy a persons beautiful soul by telling them everything they believe is wrong and some pill that makes them into a miserable wreck is going to cure everything.They are the worst of parasites.They feed and profit off human misery and swim is convinced they know about the negative mental effects of these SSRI's.Afterall if they could really cure peoples suffering they wouldn't make money anymore.Psychiatrists are generally as slimy as a lawyer or rush limbaugh.

I mean c'mon now...

Originally Posted by beena

As for SWIY being sick of people talking about anti-depressants causing suicidal feelings, well SWIM can only talk about her own experiences, and I'm sorry to say it buddy but YES - SWIM DID FEEL SUICIDAL WHEN SHE WAS TAKING SSRI DRUGS!

I feel for swiy, I really do, but this does not mean that ssri's cause suicide and suicidal thoughts. Perhaps swiy were going to feel suicidal without the ssri's and the ssri's did nothing at all. Perhaps swiy would have felt even worse without them. (probably not but I am just tossing out other possibilities) Perhaps you read some article about a teen who killed themselves while on an ssri and you unconsciously began to step closer to what psychologists call a "self fulfilling prophecy". etc etc. Basically what I am saying is that correlation does not equal causation.

Regardless, swiy and swim are in more aggreement over this than it appears. SWIM thinks everyone is entitled to put whatever they want into their body, however after that, it is up to the person to accept the consequences (good or bad). The reason psychiatrists do not prescribe opiates is NOT

Originally Posted by Orchid_Suspiria

We don't have a say in how we are treated because we live in a system that could give a fuck less about our lives or our wellbeing.Doctors are part of the system.A system that thinks it knows more about what is right for an individual person and their body and their mind than the person does

Doctors don't prescibe opiates because:

Originally Posted by beena

the trouble with opiates is that users build up a tolerance to them so if a person was prescribed them for depression and the treatment was to be long-term, the amount they were prescribed would probably have to keep being increased.
I don't know how important this is as a consideration....this thread has really made SWIM think though and she has come to the conclusion that although it would definately not be a good idea to suggest everyone who has ever suffered with depression takes opiates

If opiates are the absolute only way that someone can function, then I agree that they should definitely be given opiates so that they can actually live life, however, I do not think many people can honestly say that there is not another route of therapy that will be better for them in the long term and allow them to be happier in the long term.

SWIM is not trying to steal people's happiness away from them by saying that opiates aren't the best idea in this case, SWIM (and the psychiatrists that you swimmers see) just want you swimmer's lives to be the most satisfying they can be in the long run.

[Lobsang]

I am pretty tired of people claiming that psychiatrists are "evil pawns of the evil pharmaceutical companies"...

Well they are a bit out of hand. A lot of unneeded meds and this damages patients and the economy. Taps insurance companies and the state. I mean we are talking about like maybe 150 billion per year as an industry.

Doctors are people just like you and me, in fact some of them do illegal drugs to.

I assure you. The profession is clean as a whistle.

they would not have gone through 4 years of college, 4 years of medical school, and 4 years of residency if they were not passionate about helping people.

Many yes and many no. It all depends.

I am also tired of people claiming that SSRI's cause suicide... that notion is falling out of fashion in the scientific community, its the public that hangs on to this idea.

It is so hard to tell. They can make some people quite agitated. Even with studies it is hard to tell this. But SSRIs can cause significant problems. They can be quite nast and are overprescribed

[Bajeda]

Originally Posted by Lobsang

I assure you. The profession is clean as a whistle.

Don't want to get off-topic, but REALLY? Are you kidding me?

Or was that just sarcasm?

[Lobsang]

Originally Posted by Bajeda

Don't want to get off-topic, but REALLY? Are you kidding me?

Or was that just sarcasm?

You must have not read my story.

Well to make a long story short after this point the dreamer ran out of Trip2night but his mind was still augmented. It took months to get well. Gradually sanity returned. But great damage was done. The dreamer was investagated by the state medical board and all kinds of conditions were set. He had to go to drug rehab, have weekly drug tests and see the psychiatrist. The mind doctor was basically a nice man but knew not much about the mind and drugs.

http://www.drugs-forum.com/forum/showthread.php?t=56304

[Vagisil]

well, i don't know about depression. but TODAY, exactly today, swim had some sort of trial on this. swim's home is very stressful at times. swim loves his mom, but sometimes she demands things of him and he can only do one thing at a time. swim did some h before she woke up. wasn't nodding or fucked up. just relaxed. swim was able to help her so much more then he would usually. he usually does things while grunting...in a bad mood. but not today, swim sort of had the attitude, "your welcome, is there anything else?" the whole day. so i was thinking, maybe swim should do this on his days off. because swim is always stressed out when at home.
even while on zyprexa and celexa. swim still gets stressed.

[Panthers007]

If SWIM is living at home with Mom and finds heroin helpful with coping with the stress this causes, then I have a simple idea (and cheaper): Move out. Getting a new place to live will cost SWIM some money and work, but it's much cheaper than becoming addicted to heroin to cope with the family home.

[Bajeda]

Nothing much to add, but just want to point out that Tramadol acts as an SSRI / SNRI in addition to any opioid effects. This puts it in a different category than most all other opiates when it comes to effects on depressive symtomatology.

[Richard_smoker]

Originally Posted by Bajeda

Nothing much to add, but just want to point out that Tramadol acts as an SSRI / SNRI in addition to any opioid effects. This puts it in a different category than most all other opiates when it comes to effects on depressive symtomatology.

right...that's exactly what i was referring to when i said that tramadol was more similar to an antidepressant. -DICK

[beena]

Originally Posted by Richard_smoker

right...that's exactly what i was referring to when i said that tramadol was more similar to an antidepressant. -DICK

Indeed...but whereas most SSRI anti-depressants on the market (prozac or seroxat for example) take a couple of weeks to start working: they have to build up in your system over time, but the same anti-depressant effects that Tramadol have can start working immediately (within thirty minutes to an hour after taking the first dose). This strengthens my case further for prescribing them for the treatment of depression.

[Richard_smoker]

yeah, that's true...most drugs that are labeled as being "anti-depressants" have long-term effects of inhibiting the reuptake of neurotransmitters, but they don't really have much noticeable positive effect in an acute setting, aka, short-term effects are nil.

However, there are plenty of other other drugs that DO inhibit reuptake in the acute setting...cocaine and methylphenidate (ritalin) are 2 that immediately come to mind, as being reuptake inhibitors that are taken for immediate effects...these both have very similar effects at the biolochemical level, and in a broad sense, they have a similar effect on the body...although any boarding school student will tell you that the effects are still quite noticeably different!

This certainly doesn't make tramadol 'weird' in the sense that it is capable of inhibiting reuptake this quickly....it's only 'weird' because you're comparing it to prozac, celexa, lexapro, zoloft, etc.

-DICK

[TAz69x]

The acute effects of positive Morphine Sulfate (and Fentanyl as well) on SSRI treatment in the acute setting are one of the greater aspects in SWIM's opinion regarding their case treatment for treatment of severe major depression in some cases, as in my (currently treated with Fentanyl) major depression and Beena's successful use of Tramadol.

Due to my connections with the Royal Alexandra Hospital, I've had access to a few clinical studies decided to be performed there (double blind, control group = patients) of Morphine Hydrochloride (IV injections in one case) and buprenorphine (sublingually, administered by doctor) to treat severe treatment for patients who applied who had clinical histories of SSRI mis-treatment (as in, have been prescribed SSRI's in the past for Major Depression-level depression with warranted effects far more undesirable than intended).
The outcome was amazing!
Over a three month period, over 68% patients (Morphine Sulphate group, 53 patients total) showed increased SSRI and Dopamine production and proper migration through the Nucleus Accumbens, Substantia Nigra, Ventral Tegmentum, and other reward-circuit and depression-related regions of the brain. This shows considered reward in part on their lives, even though the doses were relatively "weak" for euphoria-seeking purposes.
I'm incredibly glad I was able to come into contact with these two trials in particular, because their outcome was of great importance to me. If I can find the medical sheets copied for me, I'll scan them for anyone that wants them, though they're not an easy read!
Anyways, "Patient 019" (unnamed for confidentiality, released for medical purposes) for example (one of the Morphine Sulfate patients) started bowling again for the first time in ten years (round number, exactly ten he stated), and began pursuing culinary classes in Toronto as he was once inclined to do.
This was amazing, as it solidified an aspect that Beena and I have known and researched from first-hand experience, and that is the residual effects of opioids such as Morphine Sulfate taken for the treatment of severe SSRI-unreactive depression, aka Major Depression, where hours and often days following last dosage administration following the biological half-life of any significant dose of opioid left in applicable blood-serum levels, the SSRI effects and DRI (Dopamine Reuptake Inhibitor) effects remain, prompting a great realization in the treatment of depression with yet a new (among the well known classes that we've all seen) drug that hasn't been too heavily researched before, the stigma and taboo of "narcotic" creating a situation similar to Medical Marijuana, something else I hate (Marijuana), but the fact that I love that from my research (not NEARLY as extensive as my opioid research) it has clinical applications, and HAS been irrevocably shown to be valuable in the treatment of some types of pain and glaucoma at the very least.

It's great to see that SOME strides are being made, hopefully with the experience and knowledge that people like Beena, Richard_Smoker, myself, etc. have we'll be able to slowly apply this idea to be more commonly accepted, which is assisted by the proofs already making light!

And at the very least, I think everyone will ALWAYS possess the right to attempt treatment they feel worthy by CHOOSING BY HUMAN RIGHTS ALONE to put any substance into their bodies with reasonable knowledge, which is not inflicting immediate damage to a third party (aka, alcohol and physical violence, LEGAL even!).

[Richard_smoker]

"half life" is how long it takes for HALF the drug to be eliminated...it often takes much longer than that for the drug to be eliminated...if you look at a graph showing logarythmic decay, you'll see that even if you DOUBLE the half-life, you're still left with 1/4th the original amount...that's a pretty good bit. maybe not enough drug remaining for someone to experience continued pain control (in the case of someone taking opiates for pain control), but certainly enough drug would still be in your system to prevent withdrawal symptoms from kicking in.

Over a three month period, over 68% patients (Morphine Sulphate group, 53 patients total) showed increased SSRI and Dopamine production and proper migration through the Nucleus Accumbens, Substantia Nigra, Ventral Tegmentum, and other reward-circuit and depression-related regions of the brain.

2 questions:
1. you sure they found SSRI production in their brains??
2. how did they measure this? I thought they would have to kill the patients & autopsy their brains...(seriously--that's what they do in rats/mice.)
-DICK

[TAz69x]

I'm not sure what you mean by biological half-life, I didn't intend for it to be misunderstood; it's common knowledge that half-life decay of radionuclides is relative to that of biological decay: the time it takes for half of the original product weight to be "removed", proceeded by half that product quantity, half that, etc.
Eventually blood serum levels reach a saturation whereby the ng/ml becomes negligible and the SSRI effects can be documented. This can even be accomplished taking into account the affinity-half-life of opioids to account for their mu/kappa/delta binding effects (as for primary receptors), and counting the residual effects therein where receptor-effects are no longer observable or measureable.

The measurements (details aren't too extensive) were accomplished through my knowledge using either the CET or MRI with the addition of a compound with an affinity for SSRI saturated regions (shown up in the scans as "blank spots" where there's a higher concentration, even lower amounts), which is what allowed them to pinpoint their migration points too, such as the Nucleus Accumbens.

This may be a new procedure, as I've been aware of lab-rats being killed to test neurological results. But luckily strides are always being made.

[Lobsang]

This is why swim will never,ever trust or listen to a psychiatrist ever again.They are liars that only seek to destroy a persons beautiful soul by telling them everything they believe is wrong and some pill that makes them into a miserable wreck is going to cure everything.They are the worst of parasites.They feed and profit off human misery and swim is convinced they know about the negative mental effects of these SSRI's.Afterall if they could really cure peoples suffering they wouldn't make money anymore.Psychiatrists are generally as slimy as a lawyer or rush limbaugh.

Nice analysis. This is about the finest synopsis of psychiatry I have ever heard. You get the gold ring for this one. Perfect.

[Orchid_Suspiria]

Swim has said before.He felt this way before opiates,doctors tried all the paltry anti depressants.Well they didn't work.Opiates did.That was swim's original purpose with this thread.To show people that if anti depressants simply don't work what is wrong with using something that does?It's just plain fact,opiates are the only thing that truly works for depression,atleast for swim.Though now swim may have to reevaluate that statement due to a recent and very positive experience with psilocybin.Should swim make a seperate thread for that?

[beena]

The fact that SSRI's take about two weeks to really start working and just the very fact that they might cause some people, already suffering with depression to feel worse, possibly suicidal begs the question why are they prescribed so readily and with minimal supervision?
Then my next question would be if we believe opiates (lets use morphine contin - slow release morphine tablets as an example) might work for depression (they certainly won't make an individual worse/suicidal and there's no possibility of them getting addicted if they were started on a low dose over a short period), why can't doctors at least open their minds to the possibility of use in this way?
I would rather risk addiction then death anyhow (sorry, I know that sounds flippant)...