Depression

Exercise is KEY to lifting spirits, during depressive states... I rely on it, almost fully when I feel blue. It helps balance the seretonin [sp?] in your brain, and leaves you in a happier, calmer state afterwards.

---------> Actually, exercise boosts endorphins and dopamine- not serotonin. This is actually more useful than a serotonin boost, as serotonin levels are easily controlled by today's antidepressants. Compensating for inadequate endorphin levels is currently much tougher, due to prohibitionist restrictions on opioid medications.

Do not let your body OVER or UNDER sleep under any circumstances...

-----> Very good. You already know a hell of alot more than I did when I was 19. When it comes to depression, Oversleeping (hypersomnia) is worse than undersleeping.


I've always struggled with depression, amongst other disorders.... [clearly, I'm much better now]... and I was always at my lowest, when I would let myself wallow in my self pity. It took a lot of strength to stop myself from doing that, and just get off my rear, and take control.

ANY mental disorder, addiction, etc... can be easily dealt with, once YOU gain control of it.

------> Again, very good. Rely mostly on yourself to solve your problems. Trusting others to come and save you, will usually leave you pretty disappointed.


I have talked to a doctor also, and right now I'm taking Celexa.

------>Here's something you really need to know: Celexa, Lexapro, Prozac, Luvox, Paxil and Zoloft are so similar, they're all nearly identical. They all do just one thing: They inhibit serotonin re-uptake, thus raising your brain's serotonin levels. St. John's Wort and 5-HTP also boost serotonin. The point is that if one doesn't work, all the rest will probably be just as useless. My depression results from an endogenous opioid deficiency, therefore all the SSRI's in the world can't help me.

Four things your doctor will probably neglect to tell you about SSRI's:

1) Drinking in moderation on SSRI's is OK. Don't worry about having a beer or two- it's fine.

2) Watch out for serotonin syndrome! If the dose is too high, serotonin syndrome will ensue. You can read up on what this is, but the two basic main effects are fidgety restlessness and diarrhea.

3) If your depression is a result of an endogenous opioid deficiency, you need to boost your endogenous opioid levels. Opioids like buprenorphine work best, but here are some other ways to do this: http://www.naabt.org/forum/topic.asp?TOPIC_ID=462

4) When a female takes SSRI's, her libido (sex drive) is likely to be greatly reduced.

 

Fieldrun, one good way to determine whether:

A) Your depression is serotonin/norepinephrine/dopamine based. (Meaning, the standard antidepressant medicines your doctor gives you will help.)

or

B) Your depression is endogenous opioid based. (All but completely ignored and unrecognized by medical orthodoxy, hence your doctor won't do shit for you.)

...is to get acupuncture, which is very helpful in boosting endorphin levels. Tell the acupuncturist what you're trying to accomplish, and see if your depression feels substantially relieved the next day. If the acupuncture is very helpful, you probably suffer from the (very tricky) B version depression.

Trust me, I've been there myself, and I know more about this than over 99% of physicians.

 

If by "regular buprenorphine" you mean suboxone, I don't have so much of a problem. If you mean subutex, though, I've got a problem. I've dealt with many, many people who've been addicted to opiates. I've even been there myself, and I know for a fact that subutex will get you "high"... maybe not like methadone or percosets or stadol or oxy, but it will fascilitate the addiction. It's a class iii narcotic and the FDA is currently considering rescheduling it as a class ii (although this is being appealed by samhsa). Anyways, forgive me if I see anyone mention anything about opiates and instantly assume the worse, because from what I've dealt with, opiates are bad... you can never get high enough, and if you were depressed to begin with, heaven help you when your supply runs out.

Now, if you're referring to Suboxone only, this drug does indeed make things more interesting. It certainly needs to be studied more in the role of an antidepressant, since it doesn't appear to create dependence. I'm against taking pills forever, and I'm against pills that have horrible withdrawal, whether it's heroine or effexor. I prefer people to recognize they have a problem, learn as much as they can about it, talk to a psychologist they trust, and not resort to any drug until other methods don't work (like changing diet, excercise/yoga, CBT).

I work in a rather large CRO, have a psychology background, work on research studies all day long, and while some of the references you provided are interesting, rats are not people, and 13 subjects is not a large enough population for clinical significance. They may help push research in new directions with new results, but I think that for the moment, it'd be best to help people who are clinically depressed by more tried and true methods.

 

If by "regular buprenorphine" you mean suboxone, I don't have so much of a problem. If you mean subutex, though, I've got a problem.

------> Actually, I meant regular, as in on a regular basis as opposed to occasional use.

I've dealt with many, many people who've been addicted to opiates. I've even been there myself, and I know for a fact that subutex will get you "high"... maybe not like methadone or percosets or stadol or oxy, but it will fascilitate the addiction.

--------------> Depends on the patient. First off, sublingual buprenorphine (suboxone or even subutex) can only get an opiate naive individual 'high'. I understand where you're coming from regarding the disease of addiction, and I understand the viewpoint of those who wish to protect addicts from themselves by prescribing suboxone to prevent mainlining. The pros and cons of the naloxone additive is an entirely separate discussion topic, so I'll leave it at that.

because from what I've dealt with, opiates are bad... you can never get high enough,

---->The above is only relevant for those with the disease of addiction. Personally, I can have a $30,000 pile of hard core opioids laid out in front of me, and I'll still carefully and responsibly use the minimum amount required to suppress my depression- nothing more, day after day.


Now, if you're referring to Suboxone only, this drug does indeed make things more interesting. It certainly needs to be studied more in the role of an antidepressant, since it doesn't appear to create dependence.

-------->There is a physical dependence, but not nearly as bad as most other opioids & opiates.


I'm against taking pills forever, and I'm against pills that have horrible withdrawal, whether it's heroine or effexor. I prefer people to recognize they have a problem, learn as much as they can about it, talk to a psychologist they trust, and not resort to any drug until other methods don't work (like changing diet, excercise/yoga, CBT).


------> I've tried everything, and taking pills forever appears to be my only option at this point.

I work in a rather large CRO, have a psychology background, work on research studies all day long, and while some of the references you provided are interesting, rats are not people, and 13 subjects is not a large enough population for clinical significance. They may help push research in new directions with new results, but I think that for the moment, it'd be best to help people who are clinically depressed by more tried and true methods.

------> Those tried and true methods, combined with the draconian prohibition laws, came within an inch of ending my life. Oxy and bupe are the only two medications which have been successful at supressing my depression. (I've avoided trying smack & 'done, and haven't yet had the opportunity to try fent/hydromorphone/levo/demerol. Hydrocodone & opium are not good enough.)

Listen, the Bodkin experiment ( http://www.drugbuyers.com/freeboard/showflat.php?Cat=0&Number=196682 ) has already proven that most refractory depression patients can be greatly helped by buprenorphine. Admittedly, this was a small patient sample, so we need more clinical trials to prove beyond a doubt that millions of people are needlessly going through the hell of clinical depression.

Medical orthodoxy is currently fixated on Serotonin/dopamine/norepinephrine, and this narrow thinking is killing people. Look:

http://www.clinicaltrials.gov/ct/action/GetStudy

858 current and upcoming clinical trials studying depression, but not one single effort to investigate the antidepressant capability of opioids. Check out the list- it's just one (relatively useless)serotonin/dopamine/norepinephrine reuptake inhibitior study after another! That's just tragic. If there's anything you can do to wake up the researchers, and thus hasten the re-acceptance of opioids as the proper treatment for refractory depression, your life saving actions would be nothing short of heroic.

 

Sorry, I had responded to your post last night but a glitch got it, and I'm having massive problems trying to do anything on hipforums right now (been trying to get to this thread for almost 2 and a half hours now). I understand the balancing act you're describing... would a good therapist want their patient to be addicted to a drug or kill themselves from depression? I think that's the basic connundrum, and I'm not going to pretend I know the solution.

Your points make much more sense from the standpoint of refractory depression, imo. Most people on this forum here, however, probably don't know what it is (and for those who don't, it's treatment-resistant depression) and shouldn't assume that's what they have. It's a complicated issue with so many variables involved it makes recommendations futile. It should be done on an individual basis, and by a professional. For example, someone could be reading this who's got borderline personality disorder, tried every drug known to man and talked to psychiatrist after psychiatrist and think they're treatment-refractory. They wouldn't be (at least in a practical sense), and would need to commit themselves to a good 3-5 years of dialectal behavior therapy, which most psychiatrists don't know about.

I personally don't have any power to control the studies where I work... we only help the big pharma companies with their processing and analysis, and help advise on getting their protocols acceptable to the countries they're trying to market to. I'm a peon in the grand scheme of things. What I can add about studies is that the clintrial link you provided pulled up over a hundred studies on opioids, and while they're mostly focusing on dependence research, they want to find every benefit they possibly can. I'm sure you know this is how it works, but to say that no research is being done in this area isn't exactly fair. Viagra is the best example of an unintended result that everyone knows.