In my writings , I have often commented on the mood stabilizing effects of opiates administered to the painful bipolar. Early on, I believed that this effect was seen most frequently with the opiate methadone. And that is probably true but as my experience has grown I am seeing a comprable effect with opiates such as oxycodone and, rarely, a few others I ready to add another to the list. I recently encountered a gentleman of about fifty at a book signing. He was arthritic and painful and also many years bipolar, that disorder manifesting chiefly as high energy, mind busy,disinhibited mania. He had been on all the appropriate drugs for bipolarity but none had controlled his mood until he was given the opiate Dilaudid (hydromorphone) for his pain. He told me that the benefit was sudden and total, with good control of both mood and pain. The required dosage wae rather high, on the order of 60 mg. per day. His psychiatrist, God bless her, encouraged ongoing use of the drug even though there was litle precedent for the treatment of bipolarity with opiates ( my own opinions and those of a few others excluded) My guest was reluctant for he had been in the past addicted to cocaine, which, he acknowleged he was using to control his bipolar mood swings. So, after several months of emotional and physical wellness like none he had known before, he discontinued his Dilaudid out of fear of addoctiion. I saw him a month from that event. He was speeded up, talking rapidly, and clearly manic- and painful. We chatted quite a long time and I told him that, in my opinion, the risk of addiction to opiates k
in the person who is achieving control of bipolar mood swings is probably quite low. He bought several copiesof my books to share with his therapist, psychiatrist, and primary care physician. I am hopeful he will resume, under supervision,his dilaudid therapy for I now know that it can indeed control both bipolarity and pain
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Reply #1 on : Tue January 26, 2010, 10:02:06