[iamsufferingalotlmao]

My doctor and I have been trying to figure out what I have. It's a long spiel if you want to read my post history.

Anyways, from what I've gathered, we've focused on many of the neurological systems, and as of recently, we have focused on the dopaminergic system via the use of stimulants. Stimulants have had an affect, but it always feel like they are more of a masking agent, and don't really get at the real problem.

This leads to other systems, one of which is the opioid system. I have tried almost every possible drug, so I'm not sure what I've done that is directly involved with that system, but I do know that I have done Naltrexone. Naltrexone is the one drug I'm sure I've done that involves the opioid system. And it had no effect on me, at all. I don't want to neccesairly give up on the opioid hypothesis, but don't know where to turn to next, so I guess that is this here.

So my next question is, what is the difference between naltrexone and suboxone? From what I've deduced, suboxone is like a more acute version of naltrexone, as it combines buprenorphine with naloxone. Bup and naloxone combine to help relatively acute withdrawal periods. Suboxone is different, though, because of the buprenorphine, which has what could be considered more of a "feel good" traditional opioid type-feel (that could lead to addiction). This feel-goodness is what makes the withdrawal smoother, as it isn't like you are getting taken off opioids cold turkey.

Does this very oversimplified paragraph hold up?

Thus, is there any value in trying suboxone, as a shot in the dark? I guess just to see how the supposedly stronger aspects of it may interact with what I have? Or is that too dangerous. At this point I'm really at rock bottom, so I want to explore the most "out there" of options, and it seems that suboxone may be a rational extension from naltrexone.

Thoughts?

 

[Peter]

They are very different. Naltrexone is a pure opioid-antagonist, which blocks mu-opioid-receptors at low doses (50 mg) and additionally kappa-opioid-receptors at higher doses (250 mg). Buprenorphine strongly activates mu-opioid-receptors and blocks kappa-opioid-receptors. The naloxone that Suboxone contains doesn't have an affect unless you inject Suboxone.

Buprenorphine combined with lower doses of Naltrexone might be able to selectively block kappa-opioid-receptors, while preventing buprenorphine from binding to mu-opioid-receptors and exerting it's addictive effects. This could be worthwhile, since blocking kappa-opioid-receptors might theoretically improve depersonalization disorder. Naltrexone alone could do this at high doses, but this carries the risk of liver toxicity and an empty pocket.

 

[leminaseri]

improve depersonalization disorder.

 

[Peter]

View attachment 4974

I dislike Windows and some days ago I tried MacOS for the first time... and I hated every minute of it. Therefore I'm not going to take lessons from Steve Jobs and Bill Gates.

 

[iamsufferingalotlmao]

They are very different. Naltrexone is a pure opioid-antagonist, which blocks mu-opioid-receptors at low doses (50 mg) and additionally kappa-opioid-receptors at higher doses (250 mg). Buprenorphine strongly activates mu-opioid-receptors and blocks kappa-opioid-receptors. The naloxone that Suboxone contains doesn't have an affect unless you inject Suboxone.

Buprenorphine combined with lower doses of Naltrexone might be able to selectively block kappa-opioid-receptors, while preventing buprenorphine from binding to mu-opioid-receptors and exerting it's addictive effects. This could be worthwhile, since blocking kappa-opioid-receptors might theoretically improve depersonalization disorder. Naltrexone alone could do this at high doses, but this carries the risk of liver toxicity and an empty pocket.

Thanks for clarifying and taking the time to write all that out! I will run the idea by my doctor.

 

[Peter]

Thanks for clarifying and taking the time to write all that out! I will run the idea by my doctor.

It has been used to treat opioid dependence:

https://www.researchgate.net/profile/Gilberto-Gerra/publication/7369574_Naltrexone_and_buprenorphine_combination_in_the_treatment_of_opioid_dependence/links/5412ef1c0cf2fa878ad3caf0/Naltrexone-and-buprenorphine-combination-in-the-treatment-of-opioid-dependence.pdf

A combination of Buprenorphine and Samidorphan (quite similar to Naltrexone) termed ALKS-5461 has been trialed for treatment-resistant depression. While it did not turn out to be effective and FDA refused to give approval, it was regarded as safe, meaning apparently it wasn't addictive.

This guy TDX, who appears to be an enemey of many people on this forum, even tried the Buprenorphine-Naltrexone-combo for some months. Unfortunately it did not improve his symptoms and Naltrexone gave him unpleasant side-effects. Apparently he did not experience any of the typical withdrawal effects, when he discontinued Buprenorphine. But one day after taking the last tablet his neuropathic pain increased significantly and stayed this way for some months. So while Naltrexone appears to protect against most of Buprenorphine's addictiveness, there might be a temporary hyperalgesic effect upon discontinuation that Naltrexone doesn't prevent and could cause problems if you happen to suffer from neuropathic pain.