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Re: Morphine for depression. » shelliR

Posted by SLS on November 19, 2001, at 10:59:55

In reply to Re: Morphine for depression. » SLS, posted by shelliR on November 18, 2001, at 17:26:25

Hi Shelli.

> Hey there. (I bet you hate it when people call you Scottie, but I like
it.)

Scottie is OK (if you must) :-), but I'm afraid Scottie Pottie is out.

> The main thing that oxycontin does for me is to take that huge brick of depression out of my chest. It's quite amazing--takes about a hour.

How do you deal with the roller-coaster ride every day? It must be difficult to have your state of being be so immediately tethered to a drug? It's not like taking a regular antidepressant where you can miss a few doses or take it at your convenience without feeling significantly worse. I'd be grateful to take it and have it work, though. It must be emotionally taxing just the same.

> Lets see, I haven't read a book since I've been on the stuff, but that has more to do with time than medication. I am still the bright ;-) but very spacey person that I was pre-oxy.

< smile >

> Seriously, focusing had not been a problem, transitioning was though. And opiates have not helped or hurt with that, expect that of course it is harder to focus when depressed. I don't think that it has made me "smarter or think clearer."

Gosh. I can't even begin to describe what this illness does to me. It's like I'm mentally retarded - only without the ability to experience bliss. When I have experienced brief improvements in my condition, my brain power increased by several orders of magnitude. Actually, it has scared the sh_t out of me. It might not really be such a big deal, but it is still very foreign to me. The last time I had that occur was in January, 1997. I had been taking Parnate for just over a week when I began to respond to it. It lasted for three or four days. Although I was but 50% improved, I could read, learn, and remember. I could figure things out. I remember taking home from my doctor an issue of the American Journal of Psychiatry. I was interested to read an article about the potential for pindolol to accelerate the action of antidepressants. I ended up reading the whole journal in 45 minutes. About the only thing I didn't understand was the statistical stuff. I never took a class in it. Anyway, I have not read a single full-text article since. I have become a proficient skimmer, though.

> Opiates have always given me a lot of energy, although I still have a bit of a let down in the late afternoon.

What is your dosing schedule during the day?

> I will probably switch to methodone either Tues or Wednesday. I have to admit I'm nervous about the possibility that it won't work. My pdoc takes no calls ever and Thursday is Thanksgiving, so I wouldn't be able to go down and see him if necessary.
>
> If it doesn't work, I'll have to go back to oxy. I'm pretty sure that the oxy people will supply it to me; it will just take some time.

That's good.

> Scott, I truely felt that I had wasted enough time in pain (two years) and the worst that can happen to me is that eventually I'll have to detox. That is not nearly as scarey to me as my depression full force, the horrible med trials that I went through with my last pdoc, and the possibility of ruining my business.

I can certainly understand your decision. I would do the same thing without much deliberation.

> Our types of depression are very different, so I don't think my experience with opiates are all that helpful as a predictor for you.

I'm glad you pointed this out to me. I guess it's still worth a try, though.

> Maybe you should have tried that vicodin--if it made you feel nauseated and wierd, you would probably know it wasn't even worth the debate.

Actually, I would have had my friend not run out of it before I left. I should have grabbed one right away. I really was interested to see what would happen. It would have provided valuable information. Maybe I should go in for some unecessary surgery.

Do you think nausea or feeling wierd are predictors of non-response? I found something on the Internet that described that most people using methadone for depression begin to experience improvements by the end of the first week. Some took two weeks.

> How does your pdoc explain your lack of any enduring response?

He doesn't. My last two doctors have been reluctant to conjure theories. I think I'll make a point of asking next time.

> Has he run into this pattern before?

You know, I have not asked him this question specifically. I guess I just assumed that he had.

> We've definitely run into it with other people on this board. I know it's really hard for you (you've said that) to confront your pdoc, but I think he owes it to you to look into any unconventional treatment that possibly might help.

At my last visit, I was happy to see that he was somewhat receptive to the possibility that opioids might be worth considering. I mentioned oxycodone and buprenorphine. I didn't know about methadone at the time.

> Can your family be of any help to you in consulting with other doctors or talking to this one?

People in my family have been sympathetic, but not motivated to help me so directly. I have never discouraged it, however. They provided me with transportation during a course of ECT, but that's about it. I guess they have always felt that I am independent enough to take care of things on my own. I'm tired of this whole thing. I know you are familiar with this. I have no motivation to research stuff anymore. Right now, I don't give a damn about the field of medicine anymore. I never thought that would happen. I just want someone to fix me so that I can get a job and find a mate.

Thanks for replying.


- Scott

 

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