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Buprenorphine for depression?

by Chris Strosser
5/14/07

Until the mid-1950s, opiates were used to treat major depression; however, their high potential for abuse and addiction, and the introduction of new anti-depressants made opiates take a backseat for a while. In 1995, clinical trials were done with buprenorphine to reevaluate the possibility of using opioids for treatment-resistant, otherwise known as refractory depression. Buprenorphine is considered a partial opioid agonist; it acts as an agonist at mu-opioid receptors and an antagonist at kappa-opioid receptors.

Participants in the clinical trials were given 0.15 mg of buprenorphine either sublingually or intranasally every morning, some achieving the maximum dose of 1.8 mg. The size of the dose given was determined by clinical benefit, and side effects. Four of the ten participants in the trials achieved complete remission, and two had slight improvements, which indicate buprenorphine may be an effective treatment for refractory depression. The results, however limited, serve to remind us of the potential opioids have for treating depression. 10-15% of the depressed population do not respond to traditional anti-depressants, and buprenorphine may be the answer.

Sources

[1] Bodkin JA, Zornberg GL, Lukas SE, Cole JO. Buprenorphine treatment of refractory depression. McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical School, Belmont, MA 02178, USA. J Clin Psychopharmacol 1995 Feb; 15(1):49-5. [link] Accessed: May 14, 2007.

[2] Nemeroff C. Buprenorphine for Refractory Depression. Journal Watch Psychiatry. Aug. 1, 1995. [link] Accessed: May 14, 2007.