T Nation

Been on Opiates, How to Raise Dopamine


#1

I will keep this as short as possabile. I have been on opiates for almost 8 years. Started out with Loratab and then switched to Methadone because I was taking to many Tabs. The reason I started was due to back pain body aches, couldn't perform my work which was very physical. Now I know it wasn't all due to pain etc, I know now the low T was causing issues. But at the time didn't know it and was doing what I could to function so I could make a living.

So now that I have been on the right track with HRT and have switched jobs that is not as near as physicaly demanding on my body I am having troubles weaning off the Methadone. I was at one point taking 5 10mg Methadone a day. I am down to 2.5 mg a day now and I am feeling like shit and don't want to start taking more again. Also my E2 is on the high side which I have a AI for it now and it should be getting under control. Other then that my labs are exellent.

Basicliy I feel tired all the time, really depressed, and the fact I am not numbing my self out with the Methaone I am now dealing with the emotions of my wifes affair a few years back. So I have a lot going against me right now and I don't want to go back to the way I was. I know the opiates are a big player on the effect of dopamine in the brain. When you take them away you feel worse then before you was on them and it takes the body a long time to start making it own dopamine again. (I hope I am saying or understanding this right)

I am wondering if there is anything I can take to boost Dopamine or make me feel better until I get past all of this and things return to normal. I can't keep feeling like this for to much longer. I really hope when the E2 gets down from 53 to lower 20's I will feel a little better. I have heard KSman mention something about raising Dopamine but can't seem to find it. Any help on this matter would be great.

By the way me and the wife have been through marriage counciling etc. and have worked through a lot of our relationship problems. It just feels like I am having to deal with it all over again because of my clear head now and the lack of feel good brain chemicals.


6 Months into TRT, Honeymoon Gone, Opiates to Blame?
#2

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#3

I use:

http://en.wikipedia.org/wiki/Cabergoline - avail as a research chem
http://en.wikipedia.org/wiki/Selegiline - Rx, selective MAO

Caber increases dopamine and selegiline increases dopamine by reducing its rate of destruction. The combo allows for good results from smaller amounts of both.

If I need a tune up, I will take some wellbutrin. Selegiline increases the effects of wellbutrin induced increases in neural transmitters. I do not take wellbutrin steady as it sort of wears me out. It is a bit stimulating for some and I do not seem to be able to tolerate steady use.

Yes, your dopamine system has become screwed up. That is one of the mechanisms of dependence/addiction.

Many docs are afraid of MAO’s, for good reason. Selegiline is a selective MAO-B inhibitor in doses of up to 10mg/day. That avoids most of the negative effects attributed to MAO’s. But it does extend the life of some meds and one has to be aware of that. If going in for elective surgery, get off for 14 days before to avoid possible anaesthesia issues. If an emergency, tell the doctors. I had one emergency surgery with these meds and told the anesthesiologist and he did not seem very concerned.

This works for me. I am looking for mild improvements. Others may need more.
Caber, 0.5 mg/week, can be dispensed EOD as well.
Selegiline 5mg EOD

Some docs freak about caber because it is a Parkinson’s drug. But it increases dopamine and that is what Parkinson’s needs. A doc that has a functional medicine mind set would not have a problem because he has learned to think for himself.

Caber also lowers prolactin and caber is the front line treatment for prolactin producing pituitary adinomas. It is amazing what 0.5mg/week can do.

I also take trazodone for steep. A very cheap Rx, $10 for 90 days at a few pharmacy chains.

When I fist took trazodone, I felt dopamine rich after the first good sleep in years. It does not have nasty effects like some other Rx sleep aids. This might also improve your state of mind. These come in 150mg tabs. They can spit to 50, 100, 75 portions. Start with 50 as its effects are greater when you start. I now need 75-100mg. Do not introduce multiple drugs at once, if something does not feel right, you will want to know what it was that did that.

While traz will give you a deep sleep, melatonin will convince your different brain centers to get sleepy. Use a time release product; otherwise the melatonin dose will be clearing in around 4 hours and dropping melatonin levels is the wake up signal for the brain. So must be time release. Most products are not time release.


#4

KSman
I have been on about every SSRI in the past. The only one that was just okay was Lexapro. Still didn’t work good enough to continue. I have taken Wellbutrin before and it seemed to jack me up. More anxiety etc.

My wife takes a drug for restless leg syndrome. If I recall she mentioned something about it being used for Parkinson disease. I will have to see what it is.
My cuurent meds are:
Methadone 10mg x 2.5 a day
Klonipin 1mg as needed, lately every night!
Cialias 20mg cut in 1/4 and taken daily = 5mg a day
Test Cyp 180mg very 2 weeks
HCG 250iu EOD
Arimidex .25mg EOD
Synthroid 75mg daily
D3 5000iu a day
DHEA 1000iu a day
I have tried Trazadone before and it did work well for me. What exactly are you taking along with the Trazadone? I would like to get a script for it again and proceed from there. Also would like to stop the Klonipin which shouldn’t be a problem. I have been on it for a long time but normally take very little of it. Only recently taking more because of anxiety.

If I started the Trazadone what would be the next step if I still feel down depressed etc?
Thanks cobra003


#5

I know this sounds like a broken record, but the E2 cannot be harped on enough in terms of
mood, anxiety, feelings of well being, for me even sleep quality. KSman can elaborate more I am sure.

I recently had a big E2 spike, and I can say wow…horrible, depressed, angry, bitchy, felt like crying
all day. Got it under control and its a world of difference.

Hope u feel better soon.


#6

[quote]PKNY wrote:
I know this sounds like a broken record, but the E2 cannot be harped on enough in terms of
mood, anxiety, feelings of well being, for me even sleep quality. KSman can elaborate more I am sure.

I recently had a big E2 spike, and I can say wow. horrible, depressed, angry, bitchy, felt like crying
all day. Got it under control and its a world of difference.

Hope u feel better soon.

[/quote]

My E2 was 53 in a range of 0-56. I have been on .25 EOD of Arimidex for about 10 days now and have noticed my mood is getting a little better. Not as depressed, or emotional, which was causing some obsessive compulive thinking, and yes feel like crying not like me at all. So hopefully lowering E2 is a bigger player then the need for more dopamine. My erections are really suffering though. No morning wood at all and when there is arousal erections are about 70% at most.

I know everyone is different but how long did it take you to get your E2 under control and feel better? I hope everything is going good for you! Thanks for the good words!


#7

I use Aromasin, Adex always bottomed me out, made my joints hurt and killed my sex drive / erection quality.
I never could get it to balance out, but aromasin doesn’t give me those sides.

I recently added some masteron into my trt (200mg T-cyp with 100mg Masteron-E split into 2 shots a week), and it gave me a big E2 spike.
I’ve read masteron can lower your SHBG which can free up more of your regular T dose, and it did.
I usually take 12.5mg every other day, but after I recognized the high E2 signs, I started taking it each day and I was back to feeling great within 2 days.

A bit of bro science for ya, drink Green Tea. I’ve read that compounds in green tea attach to E2, and
assist your body in eliminating it reducing the amount that is free in your system (your AI will prevent the conversion of T–>E2, but won’t get rid of what is already in your system). FWIW, it seems
to work for me, could be placebo, but at worst green tea is good for you on many other levels.

Good Luck.


#8

[quote]KSman wrote:
I use:

http://en.wikipedia.org/wiki/Cabergoline - avail as a research chem
http://en.wikipedia.org/wiki/Selegiline - Rx, selective MAO

Caber increases dopamine and selegiline increases dopamine by reducing its rate of destruction. The combo allows for good results from smaller amounts of both.

If I need a tune up, I will take some wellbutrin. Selegiline increases the effects of wellbutrin induced increases in neural transmitters. I do not take wellbutrin steady as it sort of wears me out. It is a bit stimulating for some and I do not seem to be able to tolerate steady use.

Yes, your dopamine system has become screwed up. That is one of the mechanisms of dependence/addiction.

Many docs are afraid of MAO’s, for good reason. Selegiline is a selective MAO-B inhibitor in doses of up to 10mg/day. That avoids most of the negative effects attributed to MAO’s. But it does extend the life of some meds and one has to be aware of that. If going in for elective surgery, get off for 14 days before to avoid possible anaesthesia issues. If an emergency, tell the doctors. I had one emergency surgery with these meds and told the anesthesiologist and he did not seem very concerned.

This works for me. I am looking for mild improvements. Others may need more.
Caber, 0.5 mg/week, can be dispensed EOD as well.
Selegiline 5mg EOD

Some docs freak about caber because it is a Parkinson’s drug. But it increases dopamine and that is what Parkinson’s needs. A doc that has a functional medicine mind set would not have a problem because he has learned to think for himself.

Caber also lowers prolactin and caber is the front line treatment for prolactin producing pituitary adinomas. It is amazing what 0.5mg/week can do.

I also take trazodone for steep. A very cheap Rx, $10 for 90 days at a few pharmacy chains.

When I fist took trazodone, I felt dopamine rich after the first good sleep in years. It does not have nasty effects like some other Rx sleep aids. This might also improve your state of mind. These come in 150mg tabs. They can spit to 50, 100, 75 portions. Start with 50 as its effects are greater when you start. I now need 75-100mg. Do not introduce multiple drugs at once, if something does not feel right, you will want to know what it was that did that.

While traz will give you a deep sleep, melatonin will convince your different brain centers to get sleepy. Use a time release product; otherwise the melatonin dose will be clearing in around 4 hours and dropping melatonin levels is the wake up signal for the brain. So must be time release. Most products are not time release.[/quote]

Trying to taper off this Methadone is kicking my arse. I know it is causing some problems with my HRT and the ability to know what or how I am feeling. Is there anything particular you would recommend to help me with the tapering and Dopamine issues? I don’t want to ad but one thing at a time so if there is a problem I know what it is. I thought about giving trazodone a try for a while.
If I had the time and money I would go inpatient rehab and detox from it. I am down to 20mg a day from 50mg at the highest.


#9

[quote]cobra003 wrote:

I have been on opiates for almost 8 years. Started out with Loratab and then switched to Methadone because I was taking to many Tabs. The reason I started was due to back pain body aches, couldn’t perform my work which was very physical. Now I know it wasn’t all due to pain etc, I know now the low T was causing issues.[/quote]

You may have that the wrong way around. It is well known that opioids cause hypogonadism, so your low T was probably a result of the pain medications, not the initial cause of the issues. In many cases the opioid-induced hypogonadism is reversible, so once you are off the methadone you might try a restart and see how it goes.

Methadone is hard to quit, but there are some medications that can help with the withdrawal. You should ask your doctor.


#10

One supplement that increases dopamine receptors is citicoline. It has a slight euphoria-producing effect on me, especially the first day. Start with small doses.

By the way, I am on an opioid too (Tramadol, for pain). The last time I quit I found using Xanax for a few days to be excellent for the withdrawal. I was in Mexico at the time and could buy it OTC.

Since then I have started using tramadol again for pain, then find myself again in the same position where I can’t quit it without going through withdrawal. This time, unfortunately, I don’t have access to Xanax. I could possibly get hold of some marijuana, and I’ve been wondering if marijuana might help me deal with the withdrawal.


#11

Knowing what SSRI’s feel like and been fortunate to have only needed on one episodic situation: Traz does not feel like an AD med!

Sleep for me:
100mg traz
5mg time release melatonin
recently added2000mg vit-C, something that I noticed was helpful by accident
And a cal-mag supplement would be helpful.


#12

[quote]KSman wrote:
Knowing what SSRI’s feel like and been fortunate to have only needed on one episodic situation: Traz does not feel like an AD med!

Sleep for me:
100mg traz
5mg time release melatonin
recently added2000mg vit-C, something that I noticed was helpful by accident
And a cal-mag supplement would be helpful.
[/quote]
Yeah Traz feels the same to me not like a AD or SSRI’s anyway. Are you not taking the Cabergoline or Selegiline any more? I don’t have much of a sleeping problem but thought the Traz might have other benefits.


#13

Yes, taking caber, but not for sleep. Selegiline once a week now.


#14

KSman,

I am currently on TRT (now pretty well dialed in after a year of adjustments and issues) and recently got a prescription for Caber from doctor for restless leg syndrome - I do have that but the other benefits of Caber had my attention before.

I was super hypersexual for about two weeks on .25 mg every third day of Caber - like it was amazing. Went from libido struggling to sex and or masterbation 2 times every day. Every woman looked hot to me, lol. Then the effect slowed down a little. Trying to determine why. Should I up the dose to .5 mg? Maybe dopamine receptor downregulation occured? If so, how can we upregulate dopamine receptors?

Also what did you mean when you said you took Wellbutrin if “you needed a tuneup” - will you please explain in detail?

You appear to be on of the most experienced and knowledgeable people I’ve seen on any of these forums and I would greatly appreciate hearing your thoughts.

C Hunter One


#15

There have been times when I have felt down, seemingly low dopamine, and Wellbutrin for a few days is helpful. I have seen where many TRT guys simply do not feel right when TT, FT and E2 should be solving problems. Looking back, I was not focused on thyroid so much then, not its my #1 hot button as low thyroid function can really make people feel down.

Manipulating dopamine? Everyone would like to know, but sustained high dopamine levels do not seem sustainable. More caber will not create sustained improvements, your body will accommodate. Many on TRT get hyper-sexual for a while, then things calm down, the honeymoon effect.


#16

Thank you for the info! I know this thread is really old but it is still relevant for those like me following in your footsteps.

What’s the best things we can do in your experience that will keep libido and EQ at top of game?

I will pretty much take any medication. I have Melanotan II and PT-141 on the way now. Do you think Selegine would be helpful in this way?

Finally, what meds will help prevent dopamine receptor downregulation? Or maybe taking Caber 1 time a week would give me a few days to reset to normal so I could reap the hypersexual benefits about half the time (like around the weekends) if it cant be sustained indefinately?

Thanks so much, C Hunter One :slight_smile:


#17

One last thing - how do you watch your thyroid? I should probably start doing that. Usually I just watch Total and free T, E2, prolactin, Progesterone, Cortisol, DHT - the hormones I know of thatp effect libido and EQ.

I want to dial in perfectly for sexual peak so am trying to cover anything that relates.