depression post opiate withdrawal

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2 weeks 4 days ago #3297 by Bourque
Bourque created the topic: depression post opiate withdrawal
You know… one of the most difficult thing for me that I have ever encountered was when I have been going through the opiate withdrawals and it has been the depression after I have been done with it. it was really really bad and absolutely very hard… I have had a very bad state of dysphoria and I have not been able during that time to do anything at all… this thing has lasted for approximately 2 months or so before I have taken the decision to get back on the suboxone. So well.. I have been on this suboxone for like 5 months and been on about 6 mg and right now I am doing a 21 day methadone detoxification and I am currently down to 20 mg of it… everything seem to be going fine and I have no other worries than the fact that I might get into a bad depression when I am going to be done with the 21 days. I have started to use Prozac and this is an SSRI, I’ve started to use it because I wanted to combat the depression, however I have been wondering if anybody else out there has ever had success with the opiate withdrawal that has induced depression using absolutely any other antidepressant. So well… I have been thinking that since my brain it is not getting those chemicals that it needs in order to feel fine (that’s why we’re feeling like that), due to the fact that the opiates are messing with the chemicals that are being released, maybe an antidepressant that would help to release the chemicals in our brain that are not there right now like for example norepinephrine – dopamine disinhibitions (NDDIs)?! I am thinking that they can greatly help with the depression but I am a bit worried as I am not sure… maybe they would even do more harm than benefits? I am not sure. Or maybe a serotonin antagonist and reuptake inhibitors would do more job (the SARIs)? Is there anybody who has any recommendations or opinions for me in regards to this? thank you!

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2 weeks 4 days ago #3298 by Kenneth
Kenneth replied the topic: depression post opiate withdrawal
Oh well… from as much as I can see by reading your post, what you are actually describing it is Post Acute Withdrawal Syndrome (PAWS) and this is a very typical stuff to appear after discontinuing the opioids in general and methadone in particular I would say… having PAWS that’s a normal thing, trust me and you can get through it either, as many other people did it. I just don’t know that any one SSRIs or maybe SNRIs would be better than another in dealing with the depression that you have in PAWS, however I can say that I surely have seen them to help a little bit with the symptoms if started well before you are going to finally and completely discontinue using the opioids.
Those chemicals that your body it is not getting are the opioids that you have discontinued to put in it anymore. That’s as simple as it sounds – you were putting opioids in it and then you stop. Your brain needs time to get used. As much as I can see, apparently you have already learned in the past that in case you are going to just start to use a narcotic again like for example Subuxone and everything then seem to come back to ‘normal’ again.
So to be honest, I wouldn’t actually screw around with the serotonin antagonists or the like since the addition of more psychoactive drugs out there into the equation has the potential (and I would say it is quite a big potential if you let me presume) of causing some other further neurotransmitter dysfunction during this difficult, fairly early recovery period I think.
And yeah, I am not talking about this out of nowhere, I do have experience as I have been through all of this ordeal myself in spades so I do know what it is like to live with this and to have it. just about everybody out there who is doing searches feverishly for a way in order to achieve a soft landing or somehow to mitigate the effects of stopping those drugs. Unfortunately, stopping those drugs won’t have a soft landing and we all need to be prepared for this. there are some drugs out there like for example Immodium – AD, clonidine as well as Phenergan that can help with the symptoms of the acute withdrawal, however, based on my personal experience, only very little can have much of a positive impact on PAWS to be honest so you shouldn’t expect getting miraculous effects from it… having all of this said… a firm resolve as well as the passage of time (of course) are pretty much the only tools out there that I know for sure that they are working effectively and 100%. I’m not trying to discourage you, I’m just trying to make you understand that unfortunately, there’s no easy way. hopefully you’re going to get help out of this.

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