Seven out of 10 individuals with depression achieve some level of remission, either through medication, therapy or both. Of the remaining 30 percent, many have treatment-resistant depression (TRD). For some time, researchers have experimented with using buprenorphine to treat TRD where more traditional treatments had failed. Buprenorphine is not an antidepressant; it’s a narcotic that is mainly used these days for opioid addiction. This article examines two studies involving this unconventional method to treat TRD.
The University of Pittsburg study
Between 2010 and 2011, researchers at the University of Pittsburgh conducted an eight-week study of 15 older adults diagnosed with TRD. Participants were given low doses of buprenorphine. After three weeks, researchers found most participants reported a sharp decline in symptoms. The participants also reported feeling less sad and pessimistic. Eight weeks after the drug treatment was discontinued, researchers tested again to confirm the clinical effectiveness. The researchers used these results to conclude that buprenorphine treatment may be an effective treatment for TRD in older adults.
An earlier and less promising study
Earlier research on buprenorphine and TRD, published in 1995, seemed to show similarly positive results. This study involved 10 subjects with major depression. Each received low doses of buprenorphine. Three participants dropped out of the study after two doses due to nausea or dysphoria. Of the remaining seven, three dropped out after four weeks on the drug for nausea, sedation and personal crisis. Four participants completed six weeks on the drug. As in the later study, participants who completed at least four weeks reported feeling significantly better after one week on buprenorphine.
The study published histories of the five subjects who completed at least four weeks. While the first patient’s depression was still in remission two years later, the fates of the other four patients revealed that buprenorphine was not as effective in the long-term as it initially seemed.
Patient two showed marked improvement until he disappeared for almost two years. He resurfaced briefly after his HMO doctor increased his dosage. The study lost contact with him after that.
Patient three thrived for six months until his rehabilitation program suggested he return to work full-time. This brought renewed complaints of anxiety and physical pain. He was unable to fill his buprenorphine prescription, and his conditional rapidly deteriorated. He experienced intense withdrawal symptoms, resulting in a full relapse of his depression.
Patient four was a 70-year-old woman. Like the other participants, she fared well on the drug. Post-study, she resumed her social and leisure activities, but after eight weeks, things went south. She felt her depression returning despite adhering to the drug regimen. Her doctors increased her buprenorphine dosage with no effect. They then tapered her off the drug completely. Despite some nausea and pain, she reported her depression as holding steady without the drug.
Patient five was a 33-year-old male with a history of drug abuse. Like his cohorts, he reported remarkable results at the end of one week. His chronic back pain subsided and he was able to reduce his reliance on codeine to mitigate the pain. Things went south for this patient when his psychotherapist terminated their sessions. His back pain returned, as did nausea despite an increase in drug dose. He ended up in the hospital angry and uncooperative. He stopped taking buprenorphine.
Buprenorphine has a low risk for addiction. Like methadone, it is a proven maintenance drug for opioid addiction. It can be good for addicts, but individuals with TRD present with a host of issues unrelated to addiction. The results of the 1995 study prove that just temporarily relieving symptoms doesn’t solve TRD.
The Sovereign Health Group specializes in treating depression using evidence-based and holistic modalities along with therapy. For more information on our comprehensive treatment programs for mental health, contact our 24/7 helpline.
About the author
Darren Fraser is a content writer for Sovereign Health Group. He worked two and half years as reporter and researcher for The Yomiuri Shimbun until they realized he did not read, speak or write Japanese and fired him. Undeterred, he channels his love of research into unearthing stories that provide hope to those dealing with addiction and mental illness. Darren loves the Montreal Canadiens hockey club and horror films and would prefer to enjoy these from the comforts of his family’s farm in Quebec. For more information about this media, contact the author at firstname.lastname@example.org.
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