Bup patch to treat depression is close to being approved

Author: TeeJay

Posted: Wed Dec 26, 2012 8:00 pm

It’s an interesting progression in psych treatment IMO, using buprenorphine to treat depression. I’m definitely one of the sceptics, given that I’m on a high dose of buprenorphine and still have to endure periods of bad depression. However I have no doubt that, for those with no tolerance, opioids of any kind (heroin / morphine / buprenorphine / methadone / oxycodone) will deliver good relief to their depressive symptoms. Where I have my doubts is whether the effect will be maintained once the tolerance rises. ie in my case, my tolerance matches my dose of Sub … so I don’t get any relief if I’m depressed when I take my dose.

It’d be interesting to see how long the studies into it have lasted. To really know if buprenorphine has longevity the study would need to be long enough in duration that the subjects become tolerant to the mu-agonist effect, because the only anti-depressant maintenance comes from the kappa antagonism. A study that goes for a month or two months could easily claim awesome results based on the mu receptor agonist effect ("stoning" effect) but they could say the same for heroin.

Is there any reason you’re trying buprenorphine before experimenting with tricyclics or supplementing anti-depressents with lithium? At least with those options you can stop them relatively easily if you find they don’t work. I’m no doctor, but I wouldn’t label myself treatment resistant before I’d tried all types of treatment.