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Old 04-08-2007, 12:47 PM   #1
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Question Methadone and Depression AND DOSING OF METHADONE

Hi all;

Hope everyone is having as "happy an Easter" as we can all have?

Does anyone with "treatment resistant depression" have experience with taking Methadone (For pain management)? I'm taking 10mg, 4X day (it's not really covering my pain at all) I "hit the wall" w/Percocet's as far as tolerance (I was taking 10mg, 2 pills 4X day and 2, 4mg Dilaudid at night. . now i'm off of EVERYTHING and on the dosage mentioned above of Methadone.

Does anyone know it it's true that it's not a great med for pain for people with pretty severe depression?

Also, PLEASE tell me it's a "myth" that it ruins your teeth. . I would Die! I have beautiful teeth (as a matter of fact, it's "all I have" and I would freak if this med damaged them.

PLEASE, as many who know about EITHER the teeth issue OR the depression issue, let me know. **NEW QUESTION** DOES THE DOSAGE I'M ON OF METHADONE SEEM EVEN "CLOSE" TO THE DOSAGE I WAS ON OF PERC & DILAUDID? IT'S NOT NEARLY COVERING MY PAIN???

THanks so much

God Bless us all. . .

Barb

Last edited by bjeanne; 04-10-2007 at 07:22 PM. Reason: Add another question to my post

 
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Old 04-09-2007, 02:53 AM   #2
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Re: Methadone and Depression

Hi barb, I've never read a true cause and effect relationship betwen depression and methadone, However it did make me feel very Blah and unmotivated. My shrink has a bigger problem with fentanyl . We have discussed patients that were doing perfectly fine on a multi med cocktail that took years to find for depression and it all went to heck once fent was introduced.

I do believe there truly is unresponsive depresion out there, but when it comes to chronic pain, there isn't an anti depressant that makes being isolated, in pain and feeling useless any better. This type of depression is reactive, not organic and doesn't repond to anti depressant the same. However anti depressant are used in pain management for reassons other than depression, they reduce substance P, a potent neuro inflamatory agent patient with chronic pain produce, if they help deal with reactive dedepression, good for those it does, but there is no chemical reason a drug makes an intolerable life tolerable. It wouldbe like thinking an anti depressant would make an abused spouse happy in their relationship.

As far as the teeth thing. Long term use of any med that dries your mouth puts your teeth at risk. Gums receed from dry mouth, exposing the margins/edges of fillings that were once protected by the gum line and crowns and bridge work will also be underminded by the effects of dry mouth and receeding of the gums. You also don't have the protective enamal below the gum line so when gums receed you are at greater risk of gum line cavities.

Antidepressants and opiates are notorious for causing dry mouth, so does smoking and many other meds. It doesn't happpen over night but after years of these meds, you will read about people spending thousands trying to maintain their teeth to no avail. I've spent over 12K on bridge work and crowns since 93 and I'm only 42 and waiting for my lower denture to arrive. There are some newer rinses on the market that simulate and stimulate saliva production, but you have to use it preventitively and start before the damge is done if your taking a med known to cause dry mouth. It's not the med itsellf, it's the under reported side effect and significance of dry mouth and what it does to your teeth.

Good luck and you still haveother options simply because the short acting versions of oxycodone and dilaudid were not effective.Meth is a big leap when used as a first line long acting med. What about LA oxy, LA morphine, LA oxymorphne. Meth is rarely used as a first line long acting due to it's unpredictable and wide range of response from patient to patient. Every doc is different though and I have yet to meet one that didn't think he was right.

Good luck, Dave

 
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Old 04-09-2007, 08:39 AM   #3
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Re: Methadone and Depression

Oh god! Methadones best purpose is not for pain relief its given to herione addicts to ween of herione! Although, methadone does help a little for pain, but Oxy conton (mispelled) would be way more helpful for pain than methadone. Yes, methadone is very bad for a person with depression for god sakes it causes people who aren't depressed to develop depression. Not to mention it is very addictive and I bet it makes you a cranky misrable person too. I was addicted to methadone and OCs for about a year and it isn't a fun lifestyle. It caused me extreme anxiety and depression when I stopped taking them. They are also bad for liver as well as any other strain of pain meds.

 
Old 04-09-2007, 09:55 AM   #4
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Red face Re: Methadone and Depression

OH LORD! Thank you both for your replies; now I'm more scared than ever. . you both confirmed what I thought I new!

Shoreline: This is ABSOLUTELY the FIRST long acting med this Doc has put me on. . . you can see in my past postings I've always gotten a response from people saying "you should definitely find a new PM Doc" . .I just don't want to start this whole, horrible mess over again and this Doc is supposed to be "the best" in my area. Don't get me wrong, I really like him WHEN I see him; but trust me, I can NEVER speak to him on the phone between appointments if something is bothering me and I truly believe it's all how you PRESENT something that affects change and the nurses that "tell" him what's going on with me? Well, suffice it to say; I believe A LOT gets "lost" in the translation! I'm so desperate at this point (I honestly feel like my mind is just going to "hit a wall" and CRACK. . how much pain and suffering can a mind truly handle????? We must ALL ask ourselves that at some time, yes?

ANY other info. would be soooo greatly appreciated.

Thank you both, and God Bless,
Barb

 
Old 04-09-2007, 11:54 AM   #5
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Re: Methadone and Depression

Hi Barb: I wasn't going to respond to your post as I thought Dave (Shoreline) did such a great job of explaining everything to you. Then I read another post on this thread and it was obvious there is a lot of misinformation about Methadone out there.

First of all, it is not just prescribed for withdrawing from heroin, like is was years ago. It is one of the "heavy duty" opiates used in treating CP. What Dave told you about your teeth is true, but contrary to another post, it's a very potent pain med used in CP.

I've been taking it for about four and a half years and have "dry mouth" and constantly drink Pepsi (I'm trying to switch to all diet) during the day. My dental work has gone up, but I go in twice a year and I haven't lost all my teeth. I take 180 mg a day (60 mg TID) and it pretty much handles my CP with nothing for breakthrough pain. When I first started having pain difficulties, my doctor put me on an antidepressant (Lexapro), as depression is very common when people suffer from CP for long periods of time. Because of this, I can say I haven't had any problems with depression while taking Methadone.

It is quite a jump from Percoset to Meth, but your doctor must have a reason for doing it. There are other LA meds he could try first, so if you're unsure of the medication, try discussing it with him and see if he would be willing to try Oxycontin or one of the others before the Meth. If he wants you to stay on Methadone, I wouldn't panic over it. Like I said I've been on it for years and find it a good med for pain. You could see if you could switch to another PM doc, but like you said that's a hassle too. What ever you decide, good luck and I hope you're able to discuss you situation with your doctor.
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Old 04-09-2007, 06:56 PM   #6
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Angry Re: Methadone and Depression

Thanks, Director . I appreciate your input. I'm glad the methadone covers your pain; I just have to wonder, compared to what dosage your on, the dosages of perc/dilaudid I WAS on, now being on only 40 mgs/day of Methadone, I can't even tell you how much pain I'm in! EVEN WITh the Spinal Cord Stimulator (which, by the way, I HATE). I don't know HOW to convince this Doc that 40 mgs, with NO breakthrough besides Advil, is JUST NOT cutting it???

I would swith in a MINUTE if I could just find SOMEONE in the CT area that knows of a SMART, compassionate Doctor. I go for Facet Joint Injections on the 19th of this month, so I have to wait/suffer till then before I can SPEAK to him directly.

Honestly, I feel a lot of times like my very sanity is on the brink.

Thanks, though and if you could possibly give some feedback on my dosage, I would greatly appreciate it.

Thanks SO much for your input!

Barb

 
Old 04-10-2007, 09:25 PM   #7
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Re: Methadone and Depression

Quote:
Originally Posted by bjeanne View Post
Thanks, Director . I appreciate your input. I'm glad the methadone covers your pain; I just have to wonder, compared to what dosage your on, the dosages of perc/dilaudid I WAS on, now being on only 40 mgs/day of Methadone, I can't even tell you how much pain I'm in! EVEN WITh the Spinal Cord Stimulator (which, by the way, I HATE). I don't know HOW to convince this Doc that 40 mgs, with NO breakthrough besides Advil, is JUST NOT cutting it???

I would swith in a MINUTE if I could just find SOMEONE in the CT area that knows of a SMART, compassionate Doctor. I go for Facet Joint Injections on the 19th of this month, so I have to wait/suffer till then before I can SPEAK to him directly.

Honestly, I feel a lot of times like my very sanity is on the brink.

Thanks, though and if you could possibly give some feedback on my dosage, I would greatly appreciate it.

Thanks SO much for your input!

Barb

 
Old 04-10-2007, 09:29 PM   #8
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Re: Methadone and Depression

listen thereis nothing wrong with methadone and your doctor just needs to increase your dosage.not only is it given to addicts it is also used as a painreleiver and thank god.tell your doctor your situation that u need more and you will be just fine and better off than the percacet u were taking.methadone last longer than dilaudid also . hope this helps

 
Old 04-11-2007, 06:44 AM   #9
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Re: Methadone and Depression

Hi Barb! I'm on Methadone 120 mg. per day with 30mg of oxycodone (4 per day) for breakthrough pain. I don't like the idea that you can only speak to your doctor when you see him for a procedure!! That just doesn't sound like a very caring or sympathetic doctor to me! Is he just so over booked or over worked that he doesn't have an hour or so at the end of the day to return messages? To tell you the truth, if I were in your shoes I would be looking for a new pain management doctor. I know that you haven't identified another doc in your area of CT, but sometimes you just have to make an extraordinary effort or drive a couple of hours to see someone who is going to support you and work with you toward your goal of pain control. Are you living near a university with a medical school attached to it? Have you tried calling your local hospital for names of other pain management docs? Many hospitals have referal lists. If your doc is willing to use methadone in the first place, I can't imagine why he wouldn't want to work with you to adjust your dose to something that gets you at least 50% better with your pain level. As others have said, you really can't be expected to achieve a "no-pain" status or anything close to that. But, a good pain doc should be able to get your pain scale number down significantly. Anyway, those are my ideas. I sure hope you get a doc quickly! All the best - KathyMac

 
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