I did a google and found that there are a few drugs being tested that prevent reuptake of norepinephrin, serotonin and dopamine at the same time. One was slated to be available in 2009. I have not heard anything about this before yesterday and would like to know if anyone has used or even heard of this kind of drug.
I have heard of them and they sound promising, but I have been let down before with new drugs that didn't live up to my expectations. Abilify and Pristiq being two newer drugs that never really worked for me.
I like the idea of this triple Reuptake approach, but the FDA could have it tied up until 2010.
There is also a new SSRI in the testing phases that has no sexual side effects. I guess that will be good for people in which SSRI's work. Doesn't do me much good.
Right now the big push by drug companies is to focus on new antidepressants that do the same thing as older ones, but without as many side effects. I think this logic is stupid because what we really need are new antidepressants that actually work to control depression. I will take the side effects if the drug works.
I am thinking of trying a couple of different antidepressants together. Some people get good results doing this. I recall that I liked Wellbutrin, but it gave me a rash and was discontinued. Too bad, I felt better within a week on it. Wellbutrin acts on both norepinephrin and dopamine, but not serotonin. I just need to find something that works just like wellbutrin, and take a SSRI with it. I'll stick with whatever works though. The only problem I forsee with a new TRI will be cost as no generic will be available for some time.
I'm sure whatever is coming will be different, if not better.
To Hensley could I say that the drug companies have little real interest in finding an A/D that actually fixes all our bad stuff as if they did the game would be over. So they now focus on reducing the side effects (I call them direct effects as they are) to make existing ones more palateable to more people. Imagine if there were no side effects. All we'd have to worry about is if it was helping relieve symptoms. People would be prescribed meds by the bucketload wouldn't they?
I've gotta say I am glad they are attacking the side effects as I suffered a permanent leg problem from Avanza. Still take pain relief for it 5 years on. And if they can avoid the headaches, nausea and upset stomach stuff, plus dry mouth there's little to stop anyone taking them. So that's what they'll do. Go for the side effects instead of the big one. I'm sure you know that too but we can hope can't we?
In reality they already have drugs that can solve depression, short term at least. Don't you think? Heroin and it's derivitives would be highly suited to that but it's "bad" for us. Can't be allowed to feel too good now can we? Imagine if they actually gave us meds to make us happy instead of try to minimise our misery and give us nasty side effects. They could do it right now, controlled prescriptions of opiates would do it.
I've asked my pdoc a number of times why he can't prescribe something that actually works, such as derivitives, instead of the menu available and he always laughs and says "I wish". So the docs are only too aware of the hypocrisy and the poor choices they have for us.
Combinations are very common these days. I have had such for years and know I couldn't have achieved much with just one. Do it, ask the doc and see what comes up.
The more I read about Low Dose Naltrexone the better it sounds. It's too bad the drug is generic. There's no real incentive for a Pharm. company to conduct clinical trials with this protocol. One pronounced "side effect" is elevated mood. It's becoming more and more popular for treating autoimmune diseases and some cancers. Many of the patients report that it has helped with depression. I am picking up my RX tonight. It's not for low dose protocol, but I'm going to compound it myself and try a 3mg dose to start off. If this works I won't be looking into combining antidepressants. We shall see...
I will agree with you that Opiate and Opioid based drugs have an amazing antidepressant effect. They have the ability to completly vaporize even the worst depression.
There have been some controlled studies done using Opioid based drugs in the treatment of very severe refractory depression that do not respond to traditional medication therapy. The results were very positive, but this study did not go into the long term effect these drugs had on each patients depression.
I do know that it is near impossible to get any Psychiatrist to prescribe an Opiate or Opioid drug for depression. They are way to worried about being slapped with a law suit if the patient gets addicted or their condition worsens.
(their best interest at work, not the patients best interest)
I still have doubts that severe depression can be effectivly treated with Opiate based drugs. In the long term they could make the depression worse as tolerance to the opiate is built. No question tolerance will be built.
I also think that we would just be trading depression for addiction. Opiate addiction can be nasty. You think antidepressant withdrawl is bad....Opiate withdrawl is absolute Hell.
Even the safer Opioids like Tramadol, Ultram, Suboxone and Naltrexone that do not fully bind to the Mu opiate receptor in the brain are still very addictive.
I tried Suboxone for my resistant depression several months ago. I failed to take into account that I had no Opiate tolerance at all and I took 1Mg for my first dosage. OMG! I got high as a kite! It was not a good high either. It was a dirty rat high that lasted 10 hours and when I came down from it I was itchy all over and very irritable. It also sent my anxiety into mach 10 overdrive.
The next dosage I backed it down to 1/2 Mg a day and that was tolerable. For me it just didn't really help the depression and only made the anxiety worse. This was a real let down for me because I was really hoping to find a drug that would help.
Anyway that is my little experiment with Suboxone for depression. If you want to get high (I mean wasted high) then it is a great drug for that, but didn't work for my depression. I have no interest in getting high so perhaps that's why it didn't work for me.
What I'm saying is in relation to people like myself who have had this thing for longer than most here have been alive. I've had it 48 years and my life is not a life at all really. I survive, I'm OK but I don't live and I do not have great times, just peaceful times. All this time though I suffer physical pain, mental problems as they heighten and lower and have no real expectation of a cure. None. I'm 58.
In such cases if I was offered addiction and relief instead of A/D's with half baked relief and all the little side illnesses then I'll take addiction. I would not expect to have to face coming off at all you see so where's the problem? It would be under doc's monitoring so I cannot see why they won't. Morally and personally that is. I don't advocate it for 18 year olds etc for obvious reasons, IE they have a life ahead.
On the other hand legally they won't say hello if they think we can sue them for it. So it's fear that stops them giving their patients the best treatment. Fear created by lawyers and litigious patients.
No big deal as no one is going to prescribe this anyway but my point was simply that docs do have an alternative or several already and won't use it so why wait for some future A/D that they will never develop due to it destroying their business. They can't make a perfect A/D as then depression would disappear wouldn't it?
I completly understand what your saying. In fact I am completly in agreement with you.
When a person has exhausted absolutly every form the therapy for their treatment resistant depression then doctors should offer alternative "off lable" drugs to them.
The only way I was able to get a trial with Suboxone for my cronic depression was thru an addiction doctor. I called him and told him my story and that I wanted to try Sub for my resistant depression and he agreed.
My Psychiatrist or GP never would have done this for me.
There are people like us that are using Opioids for their cronic depression and it is working. Thus there is proof that they can be used to treat depression.
I would not say it would be a good idea for people that get good or even fair results from traditional antidepressants, but for people like me that are almost completly medication resistant then I think it's only logical to do such things.
Unfortunatly the medical establishment does not see things this way. This is in part because all doctors are taught that Opiates are bad and should only be used for pain.
Things were not always that way, but about 100 years ago Opiates were branded as evil in this country by our government. This branding imposed severe restrictions on their avalibility.
I do suffer from generalized anxiety disorder, and yes, I am concerned that Naltrexone will make it worse. Especially in the 50mg dose that was prescribed for me. Anxiety is a common side effect in addicts treated with theh 50mg dose. However, I've decided not to even try and take the full 50mg dose. Instead I'm going to start out at 3mg in the pm before bed. MS patients use 3 - 4 .5mg LDN and while they report the positive effect of elevated mood, I haven't found a single complaint of anxiety as a side effect at low dose.
Naltrexone is different from Suboxone. Naltrexone is a full opiate antagonist and binds completely with receptor cells, this prevents any action in the receptors, so there is absolutely no euphoria and no dependence caused by it. Suboxone on the other hand, contains a partial agonist/antagonist (buprenorphine) and a competitive antagonist (Naloxone) . This compound alters the action of the receptor cells, but does not fully bind with them. The result is that the Suboxone produces euphoria and is highly addictive.
I've been reading about Oxytrex, an Oxycodone and Naltrexone compound. The hope is that combining these two will produce a drug that effectively treats pain with a much reduced rate of tolerance buildup. There are mixed reports about the outcome of the trials. I think that this kind of drug might show promise used off-label for treating depression. The point is probably moot though, because it's still going to be a class II drug and nobody will want to prescribe it that way.
I'm trying to muster the energy to go pick up my Naltrexone. I plan to keep a journal on my profile page, but if anyone wants me to post my results in a thread I will.
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