Mental Health Buprenorphine (Subutex/Suboxone/Temgesic) for Depression (TRD)?

[Drench]

Hi guys,

I have been looking into effective medical treatment of depression for a friend.

They have been on a selection of SSRI's and an SNRI and Mirtazipine trying to break through the depression and at the moment it really isn't working.

They have been looking at the other medication which may be considered to have a useful anti-depressant effect. They settled on two different drugs - Ritalin/Dexedrine and Buprenorphine. They have decided to put all of their research into Buprenorphine due to the anxiety promoting effects of any Amphetamine salts.

Buprenorphine is usually used to help opiate addicts quit, but it has a strong secondary effect as an anti-depressant. It basically (is meant) to stop users using as it blocks certain opiate receptors. The anti-depressant effect is currently being studied (see papers below).

I have an anecdotal report, a young male with depression took between 1-2mg per day for an extended period with extremely successful results. They reported a complete dissipation of depressed thoughts and feelings along with a strong anti-anxiety effect. Dosing worked out best at 1mg twice a day.

Does anyone here have any experiencing of the anti=depressant effects of Buprenorphine?

These papers are worth reading -

http://www.psychiatryadvisor.com/mo...resistant-depression-outcomes/article/368764/

http://www.treatment4addiction.com/treatment/drug/buprenorphine/antidepressant/

http://www.psychiatrictimes.com/maj...-buprenorphine-treatment-resistant-depression

https://www.naabt.org/documents/The_Buprenorphine_effect_on_Depression.pdf

http://mentalhealthdaily.com/2014/0...sistant-depression-partial-mu-opioid-agonist/

 

[m060mm]

There's no evidence (to my knowledge) of anxiolytic effects of buprenorphine. That said, why use (thoroughly) unproven amphetamines as an antidepressant, only to add another highly addictive medication (buprenorphine) to combat the side effects?

That said, I know (personally) of a seemingly reckless doctor from one of the nation's top universities prescribing up to 24mg/day of buprenorphine for depression. His decision to explore this is recent (months).

On a personal level, I would say buprenorphine helped with my depression but I don't know where my depression would be at if I never used heroin, so there are confounding factors.

 

[paranoid android]

amphetamines are used for treatment resistant depresssion but if you have a addictive personality at all your looking for trouble. In low doses Dexedrine helps but in high doses it makes depression much worse in my experience anyway.

Using Bupe or any opioid for depression is asking for it in my opinion. Sure they help at first but tolerance builds quickly so you end up increasing the dose and adding a opiate addiction to your depression.

Have you tried TCA's or even MAOI's? I would suggest them over these drugs which are just asking for trouble imo. If you think your depressed now wait until you get opiate withdrawal or worse yet Amphetamine psychosis. A 4 day Dexedrine binge once sent me into a state of suicidal psychotic like depression for weeks and had i not had good friends to talk to i may very well have killed myself.

 

[Kittycat5]

I think we should wait until longer term studies are out. The one you referenced was only 8 weeks. What happens when tolerance begins? As stated above, you are asking for trouble until we get a firmer understanding.

 

[paranoid android]

^ I don't think Bupe is that special from what i have read. I take Morphine for chronic pain and sure for the first few months it really helped my Bipolar depression. But now except for those brief moments of euphoria i don't get any real mood lift. Using Bupe or any opioid would be a drug of last resort in my opinion when SSRI's, SNRI's, TCA, Atypical anti-depressants like Mirtazapine and Bupropion have been tried and after MAOI's, anti-psychotics as a add on, mood stabilizers like Lamotrigine and Lithium have been tried and even low dose Amphetamines have been tried. Speaking from personal experience the temptation to increase the dose to help the depression is just too much and once you start using it for that you can certainly run into major problems as did i with Oxycodone, Morphine and Dilaudid.

I have never taken Buprenorphine though so i don't personally know how bad it is for raising your tolerance to the euphoric effects.

 

[Kittycat5]

Oh I agree fully PA. All other tried and tested options should be exhausted before even attempting it. I am not convinced of bupe as an antideppresant but one of those links in the original post talked of an investigational drug similar to bupe with a stronger mu antagonist than naloxone being tested for depression, so I reserve judgement until more info is out.

Edit: actually the investigational drug is bupe with samidorphan, not a new agent.

 

[paranoid android]

Hmm i remember them using Cyclazocine which is a mixed Mu antagonist/Kappa agonist similar to Talwin aka Pentazocine in treating bipolar depression with fairly good results. But the side effects of dysphoria and hallucinations made scientists loose interest in it.Here is what i could find on wiki about it.