# opiates in the treatment of depression



## Noca (Jun 24, 2005)

Anyone believe they should prescribe opiates in the treatment of severe treatment resistant depression? I believe they are just like benzos are for anxiety. They rescue you from depressing times where you might otherwise want to hurt yourself. I believe they are worth the risk. Stupid war on drugs.


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## Broshious (Dec 23, 2006)

Noca said:


> Anyone believe they should prescribe opiates in the treatment of severe treatment resistant depression? I believe they are just like benzos are for anxiety. They rescue you from depressing times where you might otherwise want to hurt yourself. I believe they are worth the risk. Stupid war on drugs.


I find opiates yucky myself, but there is a French antidepressant that is an SSRE, called Tianeptine, that also has weak effects on the opiate receptors. It's a shame it's not available in the states.


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## Jean (Jan 18, 2007)

although i only have experience with a very weak opiate (tramadol) i give it a hearty yes! even 100mgs of this synthetic baby opiate makes me feel all warm and fuzzy. i would love to be able to take it prn like i do klonopin, but even my relatively liberal shrink (who insists i don't have an addictive personality and lets me try pretty much anything) says no way. :sigh


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## UltraShy (Nov 8, 2003)

All drugs without exception should be legal and available for any adult to use. The DEA basically tells people with severe problems to go F*** themselves. The DEA only cares about trying to enforce dumbass laws against drugs to protect stupid junkies from their own behavior, while people with real medical problems suffer needlessly. I couldn't care less if some stupid junkie ODs; they made their choice and I'm not their damn nanny. One could just as well OD on fully legal liquor.

The medical community and the rest of the world just throw their hands up and say "Well, I guess there is nothing we can do" if you fail to respond to conventional treatments. This leaves 3 options: alcohol, black market drugs, and one that SAS rules prevent the discussion of. Or there is option 4: suffer in a prison of misery till natural death -- a life sentence for the "crime" of being treatment resistant.

Jean mentioned tramadol. I've tried it and it does zip for me even if I take 400 mg at once (8 pills).

I'm sick & tired of being treated like a child in "The Land of The Free". I'm free to have the DEA tell me what I can & can't do. I'm a slave to the government; they own my body and they tell me what I'm not allowed to put in it.

I've said before that the DEA has blood on its hands -- blood & gore from all the suicides that result from their ban on drugs that could help patients desperately in need. And how many alcoholics have they produced by making anything that actually works a controlled substance & thus so much harder to get? The only effective anti-anxiety agent the DEA doesn't control is booze.


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## Broshious (Dec 23, 2006)

UltraShy said:


> All drugs without exception should be legal and available for any adult to use. The DEA basically tells people with severe problems to go F*** themselves. The DEA only cares about trying to enforce dumbass laws against drugs to protect stupid junkies from their own behavior, while people with real medical problems suffer needlessly. I couldn't care less if some stupid junkie ODs; they made their choice and I'm not their damn nanny. One could just as well OD on fully legal liquor.
> 
> The medical community and the rest of the world just throw their hands up and say "Well, I guess there is nothing we can do" if you fail to respond to conventional treatments. This leaves 3 options: alcohol, black market drugs, and one that SAS rules prevent the discussion of. Or there is option 4: suffer in a prison of misery till natural death -- a life sentence for the "crime" of being treatment resistant.
> 
> ...


I completely agree. The most valuable treatments I have found have not been your regular drugs. Although there is an effective anti-anxiety treatment that I have found that is uncontrolled. It's not really my cup of tea though except for using it for sleep.

Just another example for those who will say, "Drugs are baaaaaad". This applies to non-abusable drugs as well. Anyone here remember Vioxx? It was a non-NSAID pain reliever that got banned because it raised the rate of some heart problem(can't remember what it was exactly). Recently I've read statements from people who used Vioxx who say that they don't care that it causes heart problems because it is the only drug that has made them feel better, but now they can't have it no matter how much they want it because the FDA has spoken.


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## Noca (Jun 24, 2005)

take celebrex, its the same as vioxx


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## Jean (Jan 18, 2007)

UltraShy said:


> Jean mentioned tramadol. I've tried it and it does zip for me even if I take 400 mg at once (8 pills).


i _said_ it was a baby opiate, (in fact it is not even considered a controlled substance in the US-- which why i am peeved that even lil'ol' me can't get a script for it). i am not surprised it did nothing for you, ultrashy, considering your amazing tolerance for, well... pretty much everything :b


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## Broshious (Dec 23, 2006)

Jean said:


> UltraShy said:
> 
> 
> > Jean mentioned tramadol. I've tried it and it does zip for me even if I take 400 mg at once (8 pills).
> ...


My bad.


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## Speak Easy (Jun 27, 2006)

^ don't talk about buying illegal/legal substances off the net....you'll get the thread shut down


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## Speak Easy (Jun 27, 2006)

I think opiates possess extemely important characteristics which could potentially make them usable as ADs. However, the trouble is the high tolerance that is built up with opiate use. I don't think scientists/docs have tried to address this issue, since opiates aren't used as ADs. My only concern is this: the point of psychotropics is to alleviate the pain for a little bit and make psychotherapy THAT much more effective. Then you wean off the meds, take your newly acquired CBT lifestyle, and go out to face the world (in a nutshell). The problem with putting opiates into this equation is that opiates are simply so much more potent than an SSRI. When someone takes 10mg Lexapro or 10mg OxyContin there's gonna be some difference in impairment. Somebody on Lexapro is technically not themselves, since they are taking a med which is altering their brain function, however, it is only doing this to a certain extent. This person can still go through psychotherapy, etc, etc and be cognitively aware of their disorder, because ADs just AREN'T that good. That same person on Oxys will forget about their disorder. When I've taken opiates, I tend to forget about anything bad and only focus on the good. It's a false state of reality. And when you come down, reality hits your hard. There is potential, but we simply wouldn't be able to use the same opiates we use now. There would be a difference between AD opiates and painkiller opiates. The ADs would be much less potent, but until docs/scientists get cracking, we won't even know how that is possible...


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## Caedmon (Dec 14, 2003)

If I were a physician, I would probably not ever prescribe opiates for depression unless there is a pain component.


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## Noca (Jun 24, 2005)

Caedmon said:


> If I were a physician, I would probably not ever prescribe opiates for depression unless there is a pain component.


im guessing youve never used them when depressed before.


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## arthur56 (Jul 31, 2005)

Ive heard that narcotics are very effective for severe anxiety and sometimes used by psychs on patients in hospital, this suggests that some heroin users may be self medication for SA

tramadol at high doses for a sore knee did nothing for my anxiety or depression so we need to remember that everyone is likely to react differently to meds


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## Guitar_Guy44 (Feb 13, 2007)

never tried opiates but pot works great and its still not legal and probably will never be legal, on the other hand u hav cigarrettes and alcohol which killed probably 100x more people than drugs have. 
DONT LISTEN TO THE GOV'T

just go out get what you need and dont be an idiot, do ur stuff in ur home or somewhere safe and ull be fine, caus the assholes will never legalize anything


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## Oli (Sep 28, 2005)

Im gonna have to disagree with the statement no drugs should be banned. Why? Because i've been down the 'illegal' drug road personally. Sure its great at first but it creates alot more problems rather than solving them. Hell i know if all drugs were legal alot more people would be on them and evitably oding off them. We maybe adults but some drugs simply shouldnt used despite being extremely effective for anxiety. 

I know there are drugs that are banned but could be used effectively, but IMO I dont want to be taking meds all my life, illegal or legal.


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## Speak Easy (Jun 27, 2006)

So...should one person's mistake for ABUSING a drug directly affect the rest of the world's decision of possibly USING a drug? What is a law? Sorry, I just got back from philosophy class...haha...but you get my idea. If a drug is going to help you, then it should be taken


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## Caedmon (Dec 14, 2003)

Noca said:


> Caedmon said:
> 
> 
> > If I were a physician, I would probably not ever prescribe opiates for depression unless there is a pain component.
> ...


I have used tramadol, oxycodone, and hydrocodone, and I was depressed at the time of each. However, whether or not I have done so is *not relevant*.


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## Speak Easy (Jun 27, 2006)

Prescribing opiates as depression aids is out of the question, nowadays, anyway. If I were a physician, I wouldn't do it either. I'd have the DEA knocking at my front door in a matter of weeks


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## Caedmon (Dec 14, 2003)

One handy rule of thumb for physicians to follow is "do no harm", which I'm sure you've heard. In this context, if I were a prescriber, I would be hesitant to prescribe opioids for depression because of the risk of addiction. I'm sure there are cases where addiction would not be an issue, but there is enough of a risk that I would not want to be the one playing russian roulette with my patient. There are many effective treatments for depression that can be used without resorting to an opiate and which are of considerably less risk: MAOIs, stimulants, ECT, various drug combinations, &c. And even in cases where those treatments do not completely "fix" the problem, I would not want to compound them by facilitating an addiction as well!

I really don't understand why we are discussing the political aspect of consumer use of these drugs, and think it's only cursorily relevant to Noca's original question (which was, "should they be _prescribed_"). Actually, I don't understand why it comes up so frequently as a topic anyway. IMO if a consumer wants to self-medicate with opioids, I don't see it as a significant risk to society and don't think it should be illegal - that's their bad decision to make. This doesn't mean I think it is ethical or wise to _prescribe_ them.


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## Jocelyn (Aug 10, 2007)

UltraShy said:


> All drugs without exception should be legal and available for any adult to use. The DEA basically tells people with severe problems to go F*** themselves. The DEA only cares about trying to enforce dumbass laws against drugs to protect stupid junkies from their own behavior, while people with real medical problems suffer needlessly. I couldn't care less if some stupid junkie ODs; they made their choice and I'm not their damn nanny. One could just as well OD on fully legal liquor.
> 
> The medical community and the rest of the world just throw their hands up and say "Well, I guess there is nothing we can do" if you fail to respond to conventional treatments. This leaves 3 options: alcohol, black market drugs, and one that SAS rules prevent the discussion of. Or there is option 4: suffer in a prison of misery till natural death -- a life sentence for the "crime" of being treatment resistant.
> 
> ...


You are my hero. :nw


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## Noca (Jun 24, 2005)

Caedmon said:


> One handy rule of thumb for physicians to follow is "do no harm", which I'm sure you've heard. In this context, if I were a prescriber, I would be hesitant to prescribe opioids for depression because of the risk of addiction. I'm sure there are cases where addiction would not be an issue, but there is enough of a risk that I would not want to be the one playing russian roulette with my patient. There are many effective treatments for depression that can be used without resorting to an opiate and which are of considerably less risk: MAOIs, stimulants, ECT, various drug combinations, &c. And even in cases where those treatments do not completely "fix" the problem, I would not want to compound them by facilitating an addiction as well!
> 
> I really don't understand why we are discussing the political aspect of consumer use of these drugs, and think it's only cursorily relevant to Noca's original question (which was, "should they be _prescribed_"). Actually, I don't understand why it comes up so frequently as a topic anyway. IMO if a consumer wants to self-medicate with opioids, I don't see it as a significant risk to society and don't think it should be illegal - that's their bad decision to make. This doesn't mean I think it is ethical or wise to _prescribe_ them.


yeah i guess suicide is better option than having someone addicted to opiates, I can see how you would make that mistake


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## UltraShy (Nov 8, 2003)

Caedmon said:


> There are many effective treatments for depression that can be used without resorting to an opiate and which are of considerably less risk: MAOIs, *stimulants*, ECT


Is anyone here willing to argue that amphetamine, dextroamphetamine, and methamphetamine have any less addictive potential than morphine?

Or did you mean weaker stimulants?


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## Noca (Jun 24, 2005)

stimulates like adderall can easily **** you up more than an opiate like dilaudid


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## Jean (Jan 18, 2007)

one thing i was just thinking about (and please excuse me if this has already been said-- i think this is what caedmon was getting at) is the possibility of tolerance. however, as i understand it, tolerance is possible with ANY drugs that act at synapses either by increasing the number of receptors or their sensitivity to the effects. so there is a possibility of tolerance/withdrawal with any drugs be they SSRIs, benzos or opiates. it bugs me that doctors seem more concerned with the potential tolerance/withdrawal from benzos/opiates than they are from SSRIs. perhaps tolerance develops more quickly with benzos/opiates... but it still seems hypocritical to me. 

just a theory.


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## Broshious (Dec 23, 2006)

Jean said:


> one thing i was just thinking about (and please excuse me if this has already been said-- i think this is what caedmon was getting at) is the possibility of tolerance. however, as i understand it, tolerance is possible with ANY drugs that act at synapses either by increasing the number of receptors or their sensitivity to the effects. so there is a possibility of tolerance/withdrawal with any drugs be they SSRIs, benzos or opiates. it bugs me that doctors seem more concerned with the potential tolerance/withdrawal from benzos/opiates than they are from SSRIs. perhaps tolerance develops more quickly with benzos/opiates... but it still seems hypocritical to me.
> 
> just a theory.


Just a couple peoples' opinions on comparative withdrawals:

"I've never withdrawn from a serious IV heroin habit, but compared to oxycodone effexor withdrawals are a lot worse."

"I've never experienced withdrawals from the stronger Opioids like Heroin, etc., but it's(Effexo) worse than Hydrocodone withdrawal IMO. I'd get so dizzy from the "brain zaps" if I wasn't laying down that I'd throw up from sheer dizziness."

"Opiate withdrawal and alcohol withdrawal where both easy compared to effexor withdrawal its thats bad. I rolled around on my bed and on the floor in agony about a month or so ago coming off morphine and id rather go through that any goddamn day then effexor withdrawals."


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## Overcome (Aug 11, 2007)

I think most things are easy to get off of if tapered off slowly. Whoever feels like hell from stopping a medication cold turkey deserves to be going through that hell for being so stupid.


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## Speak Easy (Jun 27, 2006)

Overcome said:


> I think most things are easy to get off of if tapered off slowly. Whoever feels like hell from stopping a medication cold turkey deserves to be going through that hell for being so stupid.


That's a pretty bold statement, don't you think...


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## ThirdEyeGrind (Feb 7, 2006)

They really should try opiates for depression/anxiety. I mean benzo's are really addictive mentally and physically and they are used for it. So I really don't see why not besides the high potential for abuse but that same potential is there for benzo's as well.


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## ThirdEyeGrind (Feb 7, 2006)

Overcome said:


> I think most things are easy to get off of if tapered off slowly. Whoever feels like hell from stopping a medication cold turkey deserves to be going through that hell for being so stupid.


I too think your statement is a pile of ****. Even if you do taper slowly you still have a good chance of feeling extremely horrid for a while. I don't mean to be rude to you but your statement was pretty rude and ignorant, so there ya go.


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## Caedmon (Dec 14, 2003)

UltraShy said:


> Caedmon said:
> 
> 
> > There are many effective treatments for depression that can be used without resorting to an opiate and which are of considerably less risk: MAOIs, *stimulants*, ECT
> ...


No I meant regular stimulants, although methamphetamine is probably out.


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## korey (Apr 25, 2006)

While I do think opiates have untapped psychiatric potential, I can say that stimulants (Adderall and Ritalin, based on personal experience) are *less* addictive than opiates. I do not exhibit any consuming desires for Adderall or Ritalin like I do when on opioid painkillers. I think opiates hit more of that "reward circuitry" than stimulants - in my case, at least.

Opiates are practically all generic and cheap as dirt, though, so their use could definitely be a more economical method for treating resistant depression when compared to things like ECT or patent-protected MAOI's.

There is an opiate addiction treatment medication called Suboxone that is a combination of buprenorphine (an opioid proven effective in treating resistant depression) and naloxone (an opioid antagonist used to keep the opioid receptors from getting _too_ happy :b). I wonder if anyone in the medical community has even dared to consider its psychiatric possibilities.


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## Canadian4Life (Sep 27, 2010)

Opiates are potent short term antidepressants. That's the problem because if taken for more than a few weeks the effects on mood go away. There made for pain and this is the effect that persists. withdrawal from opiates can cause major depression as well. I think it's a good quick fix that'll lead to a horrible ending. Your depression will get worse if you medicate with opiates.


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## Hulgil (Oct 4, 2010)

Thread necromancy, eh?



Canadian4Life said:


> Opiates are potent short term antidepressants. That's the problem because if taken for more than a few weeks the effects on mood go away. There made for pain and this is the effect that persists. withdrawal from opiates can cause major depression as well. I think it's a good quick fix that'll lead to a horrible ending. Your depression will get worse if you medicate with opiates.


It is possible to use opioids for your entire life without ever losing the mood-lifting effects. I used to be prescribed hydrocodone for pain relief, and long after the pain was gone I'd take about 5mg a day (along with an NMDA antagonist and magnesium). Those were the best days of my life, and the days I got the most done. That went on for a year at least, which isn't an entire life but is long enough to demonstrate the possibility, I think.


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## Banana Cream (Aug 22, 2010)

I take Desoxyn (methamphetamine) and Xanax.

Desoxyn is way less addictive than regular opiates IMO. I might be tired and crave caffeine for a bit, no worries at all. It is also much more mild than the other amphetamines mentioned. (I am talking about 5mg tablets, not crystal)

Xanax was initially more far more addictive and more dangerous to me than any opiate I know. I had a seizure just from not taking my regular dose before I even starting taking it every day.

Some people have a really hard time coming off of each of these, where others seem to have no problem. It seems to be pretty unique.




I would suggest Suboxone for treatment resistant depression, as I have before, for people getting some relief from opioid reactions.


(And to the person who implied you could taper off opiates and not go through a withdrawal, you are beyond naive!)


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## Arisa1536 (Dec 8, 2009)

Noca said:


> take celebrex, its the same as vioxx


Celebrex prescribed is good and effective for muscle tension and arthritis 
i was given it for arthritis in my hands and its good for female menstrual pain.
I do not know about its calming effects, i did not find it helped.

I found *Maxalt* (rizatriptan benzoatet) helps brilliantly for headaches and eases stress levels 
probably because its a dissolvable wafer substance and again its prescribed 
i do not take anything that is not prescribed and i do not buy products online its precaution really and also i do not trust the internet for products that can change your mood.

Do not take MAXALT if you are currently taking monoamine oxidase inhibitors (MAOIs) for depression, or have taken them within the last two weeks. 
other than that its pretty much okay with antidepressants


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## humility (Oct 2, 2010)

No to opiates.


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## Canadian4Life (Sep 27, 2010)

No opiates are never acceptable for depression. They give you a mood boost after taking them but they cause you to be depressed over time on or off them. I had lingering major depression from oxy addiction that lasted 7 months. I've been down that road thinking they were the cure..they're not ...nor a treatment or help.


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## Noca (Jun 24, 2005)

I think what the OP was talking about was the PRN use of Oxycodone for major depressive states/suicidal states to rescue one from feeling that way. To be used sparingly and not daily.


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## Hulgil (Oct 4, 2010)

Canadian4Life said:


> No opiates are never acceptable for depression. They give you a mood boost after taking them but they cause you to be depressed over time on or off them. I had lingering major depression from oxy addiction that lasted 7 months. I've been down that road thinking they were the cure..they're not ...nor a treatment or help.


I don't agree at all. They provided a mood and quality of life boost for me for a year straight, and far longer than that on and off.

I'm sorry that they caused you to become depressed, if they were indeed the cause, but to say they always do that is simply untrue.


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## bben (Oct 24, 2009)

So why can we use electroconvulsive therapy with relapse rates of 95% after one month? Oh and ECT is generally accepted to cause brain damage, buts its ok because its not much.....


Intravenous opiates like heroin would stabilize patients better than brain damaging ECT, and the effects could easily be maintained for a year just like pain managment docs stabilize pain patients be rotating opiates, breaks, ect.....

Not to mention pretty much 75% of all antidepressants, mood stabilizers, ect are all temporary solutions and they almost always eventually stop working because all drugs build tolerance, opiates just do slightly more rapidly. They also used to use opiates for mania as well as depression it works for both. 

No they are just so good most people if given a choice would choose opiates over REAL life, not something our government would want being they expect worker drones.


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## Noca (Jun 24, 2005)

bben said:


> So why can we use electroconvulsive therapy with relapse rates of 95% after one month? Oh and ECT is generally accepted to cause brain damage, buts its ok because its not much.....
> 
> Intravenous opiates like heroin would stabilize patients better than brain damaging ECT, and the effects could easily be maintained for a year just like pain managment docs stabilize pain patients be rotating opiates, breaks, ect.....
> 
> ...


Chronic opioid use depletes one's testosterone and other androgen levels.


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## bben (Oct 24, 2009)

chronic ECT use depletes ones brain cells, hardly an equal trade off and yet it is encouraged....

What opiates deplete you can get with testosterone shots or patches ect...


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## Hulgil (Oct 4, 2010)

Opioids have an excellent safety profile overall. It's very hard to overdose on most opioids alone; they are not toxic to any system of the body (except meperidine, which has a toxic metabolite IIRC); and the worst side effect likely to be experienced is constipation. One could be an opioid addict one's entire life and suffer no reduction in health or quality of life, and I have seen it more than once. (Chronic pain patients are often on opioids for long, long periods - sometimes until they die.)

Addiction is always a problem, unless one has a prescription and the money to pay for it. You don't want to be caught without opioids if you become dependent, though. The withdrawal won't kill you but it is pretty terrible.

For more serious but rare side effects, there is some deterioration of memory formation in one part of the brain* (the "reward center", possibly making them even more addictive), and while I've read some studies concluding that opioids cause immunosuppression, I've also read some studies concluding the opposite, so I withhold judgment for now.

Look at the health effects and possible side effects of amphetamine and methylphenidate, or any benzo, or even our friends the SSRIs. Opioids are more harmless than Tylenol, fer Chrissake, and yet they are prescribed like they can destroy cities.

*In mice. I have read studies arguing either way for this effect in humans. If I recall correctly it did not persist once opioids were withdrawn.



Dr House said:


> Chronic opioid use depletes one's testosterone and other androgen levels.


This is true. I have read it only occurs in about 2-4% of Suboxone patients, though, and it's probably similar with other opioids. It can be treated with testosterone and is always reversible AFAIK.


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## beenthruitall (May 8, 2012)

*Opiates absolutly work for me!*

I have complex PTSD and Major Depression..I have tried sooo many antidepressants..anti anxiety meds..valium ativan..tons of stuff..They either freak me out with adverse effects or make me sleep. I self medicated for 2 years with vicodan. They are the only drugs that make me want to get off my sofa and be productive. I maintained a dose of 7.5mg twice a day. I never increased the amount nor felt the need to. I lost my supplier and have fallen back into depression and anxiety...Its a CRIME that this drug is not being used to help the people that need it..Im sure its not for everyone but my quality of life has gone downhill ever since...right back to the symptoms of what i have been diagnosed with...and NO! Its not the downfall of not taking the opiate...I did not flip out when I didnt have the medication...only physical withdrawel was cramping and diarrear {ew sorry} So I suffer again with no hope in sight:|


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## Inshallah (May 11, 2011)

bben said:


> chronic ECT use depletes ones brain cells, hardly an equal trade off and yet it is encouraged....
> 
> What opiates deplete you can get with testosterone shots or patches ect...


Evidence of the brain damage claims? There was someone else claiming this a while back. Not surprisingly he seemed to have left once I asked for credible evidence for his brain damage claims.


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## istayhome (Apr 4, 2012)

No drug or treatment will work for everyone. But everyone should have access to any drug or treatment that does. I know a few people on methadone maintenance treatment for past heroin abuse. These people have no intention of getting off of methadone because it keeps their chronic depression at bay and enables them to live a life that they were previously unable to live prior to opiate use.

My personal opinion of methadone is a disgusting drug because of it's hellacious withdrawals. 

But having treatment resistant major depression myself I would strongly agree with the many posters who have suggested that just about any drug should be available to those who could benefit from it.

Being medicated sucks, addiction sucks. When you have mental illness you're dealt a crappy hand. 

Most patients who have gone through a dozen different medications for depression with no benefit have also educated themselves and evaluated their experiences enough to make reasonable decisions about what treatment options might better help them. It seems that in these types of cases it would far better for the patient to be given the flexibility to try alternative treatments such as opiates. The alternative is to continue down a road of endless "accepted" treatments which often just make the patient worse.

This comes down to the DEA's war on drugs, doctors who are fearful of providing treatments for which the all-powerful DEA might revoke their livelihood, and the power of Big pharma who cares a lot more about profits than it does about helping the sick.


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## billyho (Apr 12, 2010)

Inshallah:1059915392 said:


> bben said:
> 
> 
> > chronic ECT use depletes ones brain cells, hardly an equal trade off and yet it is encouraged....
> ...


 http://www.ect.org/effects/2-18-2003_cognitivemaint.html

Don't really have to look real hard for studies on ECT and brain damage.. they're like out there.


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## barry1685 (May 25, 2011)

Opiates are insanely addicting. In my experience they are gods gift to humanity. I get cured of social anxiety and talking is the most wonderful thing in the world. Feeling reward for talking and chatting is amazing. I think more research is needed in the psychiatric field.


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## 50piecesteve (Feb 28, 2012)

barry1685 said:


> Opiates are insanely addicting. In my experience they are gods gift to humanity. I get cured of social anxiety and talking is the most wonderful thing in the world. Feeling reward for talking and chatting is amazing. I think more research is needed in the psychiatric field.


yeah i would have to agree with you on its gods gift to humanity the feeling is amazing it pretty much takes away SA, but cant do it anymore.......


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## Inshallah (May 11, 2011)

billyho said:


> http://www.ect.org/effects/2-18-2003_cognitivemaint.html
> 
> Don't really have to look real hard for studies on ECT and brain damage.. they're like out there.


"Cognitive side effects" = brain damage? That's a bit of an exaggeration. You do know that alcohol causes brain damage as well then? Just as basically any kind of drug, antipsychotics, antidepressants, ...

This is entirely due to the sedation by the way. Those are gaba'ergic side effects you also have with benzo's.

Now some evidence stating real brain damage please. I've never seen this evidence because it simply doesn't exist.


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## OneWhoWaits (Feb 6, 2011)

I'm new around here, but I saw this topic and had to reply. I agree that opiates definitely have an antidepressant effect, but obviously they have some major drawbacks as well. But of course, I think it should be up to a person what they ingest, not somebody that has never even met them.

I'm not sure how you guys feel about herbal remedies (obviously some are bunk, but some really do work), but there is a great plant that has helped me a lot with social anxiety and depression. It's called Mitragyna Speciosa, or more commonly, Kratom. It's native to Thailand and has been used there for centuries to treat anxiety, depression and pain, as well as being used to treat drug addiction (specifically opiates, but others too). Only recently has it gotten the attention of the West. And it's completely legal (for now), and fairly cheap!

Kratom hits opioid receptors, but is not technically an opiate. It's unique in that while it hits these receptors, it is very mild, and has its own effects that can't really be compared to pharmaceutical pain killers. Really it is like a strong cup of coffee that has relaxing effects. The thing that makes it unique is you can only get so much effect with it. The plant also contains opiate _antagonists_ so if you take more past a certain point, the effects are actually reduced. Thus not only is it less addictive, it is not dangerous! There has not been a single recorded death from Kratom overdose, and any negative side effects are pretty minor (nausea, vomiting, dizziness, and that's only if you have too much), though long-term abuse can have other negative effects. Now that's not to say its not addictive at all, but it's very manageable. It's addictive in the same way that coffee and chocolate are addictive: it might be a little hard to resist if it's sitting right in front of you, but no one's going to start selling themselves or stealing to get some.

For tons more info, including a list of the active alkaloids, check here
http://www.murple.net/yachay/index.php/Kratom

I'm not sure what the rules are for posting sources, but if anyone is interested PM me and I can give you a link.


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## billyho (Apr 12, 2010)

Inshallah said:


> "Cognitive side effects" = brain damage? That's a bit of an exaggeration. You do know that alcohol causes brain damage as well then? Just as basically any kind of drug, antipsychotics, antidepressants, ...
> 
> This is entirely due to the sedation by the way. Those are gaba'ergic side effects you also have with benzo's.
> 
> Now some evidence stating real brain damage please. I've never seen this evidence because it simply doesn't exist.


Um yes, "cognitive side effects = brain damage" as per the American Heritage Dictionary (see reference below)
"brain damage_n._ Injury to the brain that is caused by various conditions, such as head trauma, inadequate oxygen supply, infection, or intracranial hemorrhage, *and that may be associated with a behavioral or functional abnormality.*

*brain







-dam







aged* (br







n







d







m














jd)_ adj._
The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

Since you would like to quote that study I posted, I shall do the same..
"_Spanish scientists have discovered that depressive patients appear to suffer cognitive dysfunction during maintenance treatment with electroconvulsive therapy (M-ECT).

A small study published in the journal Psychological Medicine found that depressed patients receiving this treatment experienced *impairments in both short-term memory and frontal function. *

Although previous studies have shown that acute courses of ECT can lead to adverse physical effects, *this is the first report of cognitive side effects*, the researchers said
Using a battery of neuropsychological tests, the team found that although both groups of depressed patients preserved attention function and long-term memory, the M-ECT group *scored lower on the encoding of new information. In addition, frontal function test scores were significantly lower in patients treated with M-ECT*.

"*Compared with controls, M-ECT patients showed alterations in verbal fluency, mental flexibility, working memory and visuomotor speed*," the researchers said."_

Yes, alcohol does case brain damage, _"Alcohol abuse is associated with wide spread and significant brain lesions. Alcohol related brain damage is due not only to the direct toxic effects of alcohol; alcohol withdrawal, nutritional deficiency, electrolyte disturbances, and liver damage are also believed to contribute to alcohol related brain damage"_ please see reference.. 
_Neiman, J. (Oct 1998). "Alcohol as a risk factor for brain damage: neurologic aspects.". Alcohol Clin Exp Res *22* (7 Suppl): 346S-351S. doi:10.1111/j.1530-0277.1998.tb04389.x. PMID 9799959_.

Yes, antidepressants can cause brain damage...
http://www.psychologytoday.com/print/68229

One more scientific study..
The Cognitive Effects of Electroconvulsive Therapy in
Community Settings
Harold A Sackeim*,1,2,3, Joan Prudic1,2, Rice Fuller4, John Keilp2,5, Philip W Lavori6 and Mark Olfson2,7
1Department of Biological Psychiatry, New York State Psychiatric Institute, New York, NY, USA; 2Department of Psychiatry, College of Physicians
and Surgeons, Columbia University, New York, NY, USA; 3Department of Radiology, College of Physicians and Surgeons, Columbia University, New
York, NY, USA; 4Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA; 5Department of
Neuroscience, New York State Psychiatric Institute, New York, NY, USA; 6Department of Veterans Affairs Cooperative Studies Program and the
Division of Biostatistics, Department of Health Research and Policy, Stanford University, Palo Alto, CA, USA; 7Department of Clinical and Genetic
Epidemiology, New York State Psychiatric Institute, New York, NY, USA
Despite ongoing controversy, there has never been a large-scale, prospective study of the cognitive effects of electroconvulsive therapy
(ECT). We conducted a prospective, naturalistic, longitudinal study of clinical and cognitive outcomes in patients with major depression
treated at seven facilities in the New York City metropolitan area. Of 751 patients referred for ECT with a provisional diagnosis of a
depressive disorder, 347 patients were eligible and participated in at least one post-ECT outcome evaluation. The primary outcome
measures, Modified Mini-Mental State exam scores, delayed recall scores from the Buschke Selective Reminding Test, and retrograde
amnesia scores from the Columbia University Autobiographical Memory Interview-SF (AMI-SF), were evaluated shortly following the
ECT course and 6 months later. A substantial number of secondary cognitive measures were also administered. The seven sites differed
significantly in cognitive outcomes both immediately and 6 months following ECT, even when controlling for patient characteristics.
Electrical waveform and electrode placement had marked cognitive effects. Sine wave stimulation resulted in pronounced slowing of
reaction time, both immediately and 6 months following ECT. Bilateral (BL) ECT resulted in more severe and persisting retrograde
amnesia than right unilateral ECT. Advancing age, lower premorbid intellectual function, and female gender were associated with greater
cognitive deficits. Thus, adverse cognitive effects were detected 6 months following the acute treatment course. Cognitive outcomes
varied across treatment facilities and differences in ECT technique largely accounted for these differences. Sine wave stimulation and BL
electrode placement resulted in more severe and persistent deficits.
Neuropsychopharmacology (2007) 32, 244-254. doi:10.1038/sj.npp.1301180; published online 23 August 2006

So, I believe I have 'scientifically' proven that there are scientific results stating that ECT causes brain damage... and just to be sure we are clear on what "scientific" means..

scientific [ˌsaɪənˈtɪfɪk]_adj_*1.* _(prenominal)_ of, relating to, derived from, or used in science scientific equipment
*2.* _(prenominal)_ occupied in science scientific manpower
*3.* conforming with the principles or methods used in science a scientific approach*scientifically* _adv_

Collins English Dictionary - Complete and Unabridged © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003

People have a right to know both sides of the story regarding a medication or a procedure and I for one do not appreciate the crass remarks and arrogance of this post of yours...
Inshallah 
Quote:
Originally Posted by *bben*  
_chronic ECT use depletes ones brain cells, hardly an equal trade off and yet it is encouraged....

What opiates deplete you can get with testosterone shots or patches ect..._

_"Evidence of the brain damage claims? There was someone else claiming this a while back. *Not surprisingly he seemed to have left once I asked for credible evidence for his brain damage claims."*_

Maybe it was not surprising that the poster no longer wanted to deal with the above quoted remarks on a "support website" when your attitude was anything but supportive...

I am more than happy to have a friendly debate regarding 'science' however the elitist attitude has to go.

that is all


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## Inshallah (May 11, 2011)

""brain damagen. Injury to the brain that is caused by various conditions, such as head trauma, inadequate oxygen supply, infection, or intracranial hemorrhage, and that may be associated with a behavioral or functional abnormality."

How exactly is this proof of ECT causing brain damage? It talks about possible consequences of brain damage. Consequences that occur more frequently without brain damage present. No proof at all.

There is no medical proof of brain damage caused by ECT. Cognitive impairments during and shortly after treatments are to be expected due to the seizure and the anesthesia. These do not constitute "brain damage" at all.


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## Inshallah (May 11, 2011)

And elitist lol...

Correct is correct, incorrect is incorrect. There is nothing 'elitist' about that. If you consider being told your pseudo-science is wrong elitist, your loss.

It amazes me to what lengths people will go to prove their points, even if they have no science whatsoever supporting their claims and all of the science disproving them.

I don't care who posts the correct information, as long as the people purposefully spreading the incorrect are outed.


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## Inshallah (May 11, 2011)

*Look what the elitist, non-pseudo Pubmed came up with first*

Am J Psychiatry. 1994 Jul;151(7):957-70.
Does ECT alter brain structure?
Devanand DP, Dwork AJ, Hutchinson ER, Bolwig TG, Sackeim HA.
Source
Department of Biological Psychiatry, New York State Psychiatric Institute, NY 10032.
Abstract
OBJECTIVE:
The purpose of this study was to evaluate whether ECT causes structural brain damage.
METHOD:
The literature review covered the following areas: cognitive side effects, structural brain imaging, autopsies of patients who had received ECT, post-mortem studies of epileptic subjects, animal studies of electroconvulsive shock (ECS) and epilepsy, and the neuropathological effects of the passage of electricity, heat generation, and blood-brain barrier disruption.
RESULTS:
*ECT-induced cognitive deficits are transient*, although spotty memory loss may persist for events immediately surrounding the ECT course. Prospective computerized tomography and magnetic resonance imaging studies show no evidence of ECT-induced structural changes. Some early human autopsy case reports from the unmodified ECT era reported cerebrovascular lesions that were due to agonal changes or undiagnosed disease. In animal ECS studies that used a stimulus intensity and frequency comparable to human ECT, no neuronal loss was seen when appropriate control animals, blind ratings, and perfusion fixation techniques were employed. *Controlled studies using quantitative cell counts have failed to show neuronal loss even after prolonged courses of ECS*. Several well-controlled studies have demonstrated that neuronal loss occurs only after 1.5 to 2 hours of continuous seizure activity in primates, and adequate muscle paralysis and oxygenation further delay these changes. These conditions are not approached during ECT. Other findings indicate that the passage of electricity, thermal effects, and the transient disruption of the blood-brain barrier during ECS do not result in structural brain damage.
CONCLUSIONS:
*There is no credible evidence that ECT causes structural brain damage.*
Comment in
Am J Psychiatry. 1995 Sep;152(9):1403.
PMID: 8010381 [PubMed - indexed for MEDLINE]


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## UltraShy (Nov 8, 2003)

> One handy rule of thumb for physicians to follow is *"do no harm"*, which I'm sure you've heard. In this context, if I were a prescriber, I would be hesitant to prescribe opioids for depression because of the *risk of addiction.* I'm sure there are cases where addiction would not be an issue, but there is enough of a risk that...


What does "do no harm" mean? If you were walking down the street & happened upon a man laying upon the ground with a knife protruding from his gut what would you do? He begs you for help. If you simply ignored him and continued on your merry way, you've "done no harm." How could you do harm when you didn't do a damn thing? Of course, almost everybody would condemn you for your callous disregard for human life. Almost everyone would expect you to at least call 911 to report a guy bleeding to death on the ground.

Similarly, an MD can choose to "do no harm" by doing nothing, specifically doing no writing of prescriptions for unconventional meds that may help a treatment resistant patient. Or should the MD merrily skip on by as this man dies in a far worse manner: either by suicide or by living in hell till natural death. Is harm caused by failure to act considered or not under this moral code?

Given how often I've been condemned for my view that it's not America's job to save the rest of the world, evidently many believe that failure to act is simply unacceptable when others are in need.



> I would not want to be the one playing *russian roulette* with my patient.


Quite a fitting choice of words. Failure to effectively treat depression can result in your patients playing Russian Roulette literally, except they load every chamber, making the outcome highly predictable.


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## billyho (Apr 12, 2010)

*ok dude..*



Inshallah:1059938242 said:


> And elitist lol...
> 
> Correct is correct, incorrect is incorrect. There is nothing 'elitist' about that. If you consider being told your pseudo-science is wrong elitist, your loss.
> 
> ...


Both sides have been presented.. now people can make an intelligent decision and decide for THEMSELVES w/o being badgered. Hopefully peeps will further research on their own and not have to take your word for it. Btw, how do you figure you are being 'supportive' by ignoring other peoples point of view? (That was rhetorical, don't really expect you to answer)


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## Inshallah (May 11, 2011)

If he provides credible information for his point of view, I will be all ears. Nothing against him personally, it's his sources that aren't credible. (just as it isn't about me or my point of view but rather the facts)

In the meanwhile, you can't possibly expect me to take someone saying "ECT causes brain damage" while the scientific community says it doesn't seriously.


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## Inshallah (May 11, 2011)

*I found a legit source claiming brain damage billy!*

The effectiveness of electroconvulsive therapy: a literature review.
Read J, Bentall R.
Source
Department of Psychology, University of Auckland, New Zeland. [email protected]
Abstract

AIM:
To review the literature on the efficacy of electroconvulsive therapy [ECT], with a particular focus on depression, its primary target group.

METHODS:
PsycINFO, Medline, previous reviews and meta-analyses were searched in an attempt to identify all studies comparing ECT with simulated-ECT [SECT].
RESULTS:
These placebo controlled studies show minimal support for effectiveness with either depression or 'schizophrenia' during the course of treatment (i.e., only for some patients, on some measures, sometimes perceived only by psychiatrists but not by other raters), and no evidence, for either diagnostic group, of any benefits beyond the treatment period. There are no placebo-controlled studies evaluating the hypothesis that ECT prevents suicide, and no robust evidence from other kinds of studies to support the hypothesis.

CONCLUSIONS:
Given the strong evidence (summarised here) of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.
PMID: 21322506 [PubMed - indexed for MEDLINE]

Still greatly outnumbered by the no brain damage studies though.


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## Recipe For Disaster (Jun 8, 2010)

The problem with opiates is the extreme tolerance and psychological addiction they cause, and the physical dependence. Those are three SERIOUS drawbacks, and they do lose much of their anti-depressant effects over time. Is it worth the risk of becoming a lifetime opiate addict over what might be a temporary depression? While most patients who simply want relief and dont care about consequences will think so, in this rare case, physicians actually probably know better. They will never be and should never be a first line of treatment for depression anyway. 

Having said all that, I definitely think opiates should be legal for everyone in the same way alcohol is. If you could buy them at the store, you would not even need a doctor to prescribe them. I do believe they have more potential in the treatemnt odf depression than a lot of other drugs out there. My point with the negative opening is lets not let ourselves think "oh if only opiates were legal my problems would all be solved" because its really not that simple/


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## Hulgil (Oct 4, 2010)

Recipe For Disaster said:


> The problem with opiates is the extreme tolerance and psychological addiction they cause, and the physical dependence. Those are three SERIOUS drawbacks, and they do lose much of their anti-depressant effects over time. Is it worth the risk of becoming a lifetime opiate addict over what might be a temporary depression? While most patients who simply want relief and dont care about consequences will think so, in this rare case, physicians actually probably know better. They will never be and should never be a first line of treatment for depression anyway.


It's very true that dependence, both psychological and physical, is one (two) big problems(s) with opioid use. However, two notes: one, opioids don't necessarily lose anti-depressant effects over time - it might have been someone in this thread who noted that some people on life-long or indefinite methadone or buprenorphine maintenance don't stop experiencing anti-depressant effects. That's also been my experience.

Two, "risk of becoming a lifetime opioid addict" isn't exactly phrased wrong - it _is_ a risk, since that's certainly not an ideal situation - but I'd like to remind readers that lifetime opioid addicts can live completely normal lives... more normal, in fact, than anyone taking MAOIs, for example. An addiction isn't intrinsically harmful - the problems begin if your supply gets interrupted.

So I don't think "the system" knows better in this case at all. Having been both dependent on opioids, and before and after that severely depressed, both for long periods of time, I know exactly which I'd choose.



> Having said all that, I definitely think opiates should be legal for everyone in the same way alcohol is. If you could buy them at the store, you would not even need a doctor to prescribe them. I do believe they have more potential in the treatemnt odf depression than a lot of other drugs out there. My point with the negative opening is lets not let ourselves think "oh if only opiates were legal my problems would all be solved" because its really not that simple/


And having said what I did above, I completely agree with this. It's clear you understand the risks and benefits of opioid use; I just wanted to clarify a few things for anyone passing along.

Opioid therapy is not perfect - I just wish it was an option.


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## DK3 (Sep 21, 2011)

Noca said:


> Anyone believe they should prescribe opiates in the treatment of severe treatment resistant depression? I believe they are just like benzos are for anxiety. They rescue you from depressing times where you might otherwise want to hurt yourself. I believe they are worth the risk. Stupid war on drugs.


If you're going to look at opiates for depression, than I think tramadol should be top of your list. Not only does it have the least problems in terms of tolerance/addiction, but it's also a very effective anti-depressant because it has an effect on serotonergic receptors and also nonadrenergic, giving it a stimulant effect. When I take it, it TOTALLY obliterates any hint of depression, lethargy or low mood, and really motivates me to work. The best part it is it works instantly too and very few side effects. The only side effects I've experienced are insomnia and some muscular tension.

It does have some off-label use for anxiety and depression, and it might be possible to persuade a doctor to prescribe it as a last resort if you tried everything else.

I don't think it's suitable as a LONG TERM treatment though due to the risk of liver toxicity and also tolerance. It doesn't mix well with other drugs either so you have to be careful.


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## Hulgil (Oct 4, 2010)

DK3 said:


> I don't think it's suitable as a LONG TERM treatment though due to the risk of liver toxicity and also tolerance. It doesn't mix well with other drugs either so you have to be careful.


I think tramadol is an excellent suggestion; good post. However, what's this about liver toxicity? Tramadol shouldn't cause any liver problems unless you take too much, as far as I know.


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## DK3 (Sep 21, 2011)

Hulgil said:


> I think tramadol is an excellent suggestion; good post. However, what's this about liver toxicity? Tramadol shouldn't cause any liver problems unless you take too much, as far as I know.


I'm just thinking long term like many years.. when I took Tramadol for nearly a year, I felt it was taking its toll on my liver I started to get pains in the liver area.. I'm sure I read somewhere it's not recommended as a long-term daily pain med..


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## riptide991 (Feb 1, 2012)

It's interesting you should mention this. I find that ever since I was put no Zoloft and Remeron I have been consistently getting a very prolonged "Runners high" after every time I jog. It is just the most amazing feeling. Now recent studies have proven that our bodies release Anandamide during/after jogging which binds to Cannabinoid receptors. This feeling is like no other feeling and my anxiety is completely removed afterwards. I was an avid Marijuana user for many years and one strain called Purple Kush came close to this feeling. It seems that Anandamide has greater potency when bound to this receptor site. I haven't taken any opiates other than Percocets and this feeling is much greater than Percs. I liked percs no doubt but it left me in a hazy state but feeling good no doubt. 

I used to be a big jogger in the past and I did get the runners high but it never persisted for so long nor did I get it as often. I've been jogging every single day now because i've literally become addicted to it. 

I suggest anyone who doesn't jog give this a try. Do not overdo it either just go at an even pace and each time you jog try to beat your distance by a little bit. This is what I have been doing and have been consistently rewarded with this high.


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## DK3 (Sep 21, 2011)

@kehcorpz absolutely with you on the jogging. It's the one thing which keeps my fear and reclusive behaviour under control and helps my confidence..gets me out of the house...and as you say, nothing beats a good run the feeling you get after is incredible and the SA just goes away for a while.. I agree, everyone with SA should try jogging daily even if you only do 15 or 20 minutes around the block early in morning before anyone is about, it will pay big dividends for physical and mental health, plus confidence.

I only just got back into the jogging over the last 2 weeks after not exercising for over a year and the effect has been remarkable.. A few years ago I could run 4km when I was on Tramadol and then do 30-40 minutes intense weights and not even feel tired..I felt really good physically and mentally. Sometimes taking an opiate/Tramadol can have a very positive effect, the trick is not to overdo it and to taper it off carefully once you got to where you want to be eh.


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## Hulgil (Oct 4, 2010)

DK3 said:


> I'm just thinking long term like many years.. when I took Tramadol for nearly a year, I felt it was taking its toll on my liver I started to get pains in the liver area.. I'm sure I read somewhere it's not recommended as a long-term daily pain med..


I don't doubt your experience, but I do doubt that it was caused by tramadol. Tramadol is metabolized by the liver, of course, so anyone with some hepatic disease or deficiency might end up with problems from taking it; however, I cannot find any studies or references showing that liver damage is a concern with tramadol (in appropriate doses), or even a mention that it might be. It is considered safe for a healthy liver.

The pain you experienced was likely unrelated - was, in fact, almost certainly not your liver at all. Liver damage is almost always painless (even total liver failure usually manifests as illness rather than pain). Nausea, diarrhea, fatigue, and appetite loss are the usual early signs.



DK3 said:


> I felt really good physically and mentally. Sometimes taking an opiate/Tramadol can have a very positive effect, the trick is not to overdo it and to taper it off carefully once you got to where you want to be eh.


This is pretty much spot-on, in my experience.



kehcorpz said:


> Now recent studies have proven that our bodies release Anandamide during/after jogging which binds to Cannabinoid receptors. This feeling is like no other feeling and my anxiety is completely removed afterwards. I was an avid Marijuana user for many years and one strain called Purple Kush came close to this feeling. It seems that Anandamide has greater potency when bound to this receptor site. I haven't taken any opiates other than Percocets and this feeling is much greater than Percs. I liked percs no doubt but it left me in a hazy state but feeling good no doubt


Interesting that the "runner's high" should be mentioned - I wasn't aware that exercise released anandamide, but as I'm sure we all know, it releases endorphins as well: and an endorphin is just *endo*genous m*orphin*e. This is why the feeling is akin to what you get from oxycodone, and also why exercise is so often recommended for anxiety, I think. And now we find that exercise gives you some cannabinoids too? Some extra motivation for my daily run!


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## ricca91 (Mar 11, 2012)

For me tramadol is an instant anxiety-depression killer. I sometimes take 100 mg, when I am on pain due to a pilonidal cyst and it simply erases all negative feelings.

For me, the effect is very similar to hashish, but more mellow and prolonged.

Tramadol is a very dirty drug which interacts with a lot of receptors. That's why it is so useful for our condition. Theoretically it shouldn't cause much tolerance (it is also a NMDA antagonist), but withdrawal should be harsh (imagine effexor + dextromethorphan + codeine).

I think that, of used responsibly and not for recreational purposes, it is a very effective drug!


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## riptide991 (Feb 1, 2012)

Hulgil said:


> Interesting that the "runner's high" should be mentioned - I wasn't aware that exercise released anandamide, but as I'm sure we all know, it releases endorphins as well: and an endorphin is just *endo*genous m*orphin*e. This is why the feeling is akin to what you get from oxycodone, and also why exercise is so often recommended for anxiety, I think. And now we find that exercise gives you some cannabinoids too? Some extra motivation for my daily run!


Well that's the thing, the newer studies are what are showing it releases anandamide. The reason they did the study was because the mental relaxation that accompanies this high. But endorphins can't cross the blood brain barrier, so they were puzzled by this. The endorphins give you the overall body buzz.

Check it out, has reference too.

http://www.sciencedaily.com/releases/2012/03/120322100307.htm


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## Recipe For Disaster (Jun 8, 2010)

> It's very true that dependence, both psychological and physical, is one (two) big problems(s) with opioid use. However, two notes: one, opioids don't necessarily lose anti-depressant effects over time - it might have been someone in this thread who noted that some people on life-long or indefinite methadone or buprenorphine maintenance don't stop experiencing anti-depressant effects. That's also been my experience.


They definitely lose SOME (not all) of their antidepresant effect over time.


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## blues85 (Apr 22, 2012)

*opiates are grand*

opiates are great for motivation and depression in my book. some people cannot handle them because of their own addiction issues or whatever have you, but for people like me who can therapeutically use them sparingly or with some kind of balance, they really are no problem. i have never abused opiates so when i take them they work wonders for my social anxiety and depression and help me understand the world im in and my place in it. great for creative thinking and getting thoughts out of my scrambled mind. this is my own experience, everyone reacts differently, i believe they should be used for depression and some other mental disorders if the person is someone like me who can handle it. i definately believe there are some people that cannot handle them though and should not take them for depression or psychiatric disorders, unless they have pain and there are no other options. its unfortanate opiates will never be used as a psychiatric medication because it has great potential when used properly, i can tell you this from my own experience, they have helped me greatly many times. be safe.


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## imrj (Jan 20, 2009)

^^^^^ totally agree with you as I do the same and have no addiction whatsoever and able to use opiates very well with the best results of any med out there....but it requires strict self-discipline, I have never been addicted to anything so maybe is just my trait...dont drink, smoke, pot, etc...ever.....zero...


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## blues85 (Apr 22, 2012)

*Be safe*



Recipe For Disaster said:


> They definitely lose SOME (not all) of their antidepresant effect over time.


i disagree. one of the problems is tolerance build up, which can be solved by dosage increase and balance. stopping for a little while and using a different drug then going back to it seems to work for me. that way theres no horrible come down and withdrawal. and you are still medicating that way and keeping a balance and comfortable. opiates can have bad drug interactions though, many people die that way, so its good to stick with one medication at a time. you can mix, but you must research and use correct dosages, and some medications you just shouldnt use while using opiates like uppers because they are oppossite and can make your heart stop. and too many downers can cause respiratory arrest, and that could be most definately be fatal to the body. its best to stick with one drug at a time, plus you get the full effect of that drug you want the effects from.be safe everyone .


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## jstwnalive (Jan 28, 2012)

YES YES GOD YES IT WORKS I've recently been taking tramadol & it's great I know opium is addictive but so what most anxiety meds you cant stop suddenly, I've never felt better on opiates than ssri's


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