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Re: opiates and major depression » juanantoniod

Posted by BrittPark on January 27, 2003, at 18:51:47

In reply to Re: opiates and major depression, posted by juanantoniod on January 27, 2003, at 16:26:33

I just did a medline on "buprenorphine depression" and got 161 hits. Almost all are concerned with respiratory depression. There are three relevant references:

Biol Psychiatry 1996 Jun 15;39(12):989-90
Buprenorphine for depression: the un-adoptable orphan.

Callaway E.

Publication Types:
Editorial

J Clin Psychopharmacol 1995 Feb;15(1):49-57
Buprenorphine treatment of refractory depression.

Bodkin JA, Zornberg GL, Lukas SE, Cole JO.

McLean Hospital, Consolidated Department of Psychiatry, Harvard Medical School, Belmont, MA 02178, USA.

Opiates were used to treat major depression until the mid-1950s. The advent of opioids with mixed agonist-antagonist or partial agonist activity, with reduced dependence and abuse liabilities, has made possible the reevaluation of opioids for this indication. This is of potential importance for the population of depressed patients who are unresponsive to or intolerant of conventional antidepressant agents. Ten subjects with treatment-refractory, unipolar, nonpsychotic, major depression were treated with the opioid partial agonist buprenorphine in an open-label study. Three subjects were unable to tolerate more than two doses because of side effects including malaise, nausea, and dysphoria. The remaining seven completed 4 to 6 weeks of treatment and as a group showed clinically striking improvement in both subjective and objective measures of depression. Much of this improvement was observed by the end of 1 week of treatment and persisted throughout the trial. Four subjects achieved complete remission of symptoms by the end of the trial (Hamilton Rating Scale for Depression scores < or = 6), two were moderately improved, and one deteriorated. These findings suggest a possible role for buprenorphine in treating refractory depression.


Lancet 1982 Sep 25;2(8300):709
Antidepressant effects of buprenorphine.
Emrich HM, Vogt P, Herz A, Kissling W.
Publication Types:
Clinical Trial
Letter
Randomized Controlled Trial

As you can see there hasn't been much research into opioids as antidepressants. My guess is that the DEA discourages the NIH from funding such studies. Sad but true for the forseeable future.

Cheers,

Britt


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URL: http://www.dr-bob.org/babble/20030125/msgs/137826.html