Author: bunnyman

Posted: Tue May 29, 2012 9:00 pm

It is allowable for doctors to prescribe all sorts of controlled substances off-label. Darken’s experience of being prescribed stimulants for depression is a good example. As far as I know, amphetamine and the like are indicated for ADD and marketed otherwise only for appetite control and shift-work sleep disorders. Treatment-resistant depression is an off-label use, albeit perfectly acceptable and medically sound. Benzos like Valium and Xanax are another example. These are indicated for seizure control and panic disorder or general anxiety disorder, but in reality are given to just about everyone under the sun who asks for them (often specifically) from many psychiatrists. "Mommy’s Little Helpers" and all that business. I don’t see why opiates should be any different. Hell, tons of people have to take Percocet for the rest of their lives or live with unbearable pain!

Certainly buprenorphine should not and will not ever become a first-line depression drug, but it should be available to someone for whom regular antidepressant therapy has failed repeatedly. Given the nature of true diagnosed major depressive disorder with it’s attendant misery and very real risk of eventual death by suicide, buprenorphine has the potential to save and transform lives for such an indication. And if a medically-managed dependence on an opioid occurs, then I chalk that up to another unpleasant but acceptable side-effect.

Bunny