Posted by jerrympls on March 20, 2006, at 1:47:31
In reply to opioids: dose/response relation?, posted by pseudoname on March 19, 2006, at 11:01:24
> Do those of you who take an opioid for depression notice that when your depression is worse it helps to take more of it?
>
> I've been taking 0.5 mg of buprenorphine (Subutex) twice a day for depression. The last several days, though, my depression has been stratospheric. So I've been upping the dose. Yesterday I took probably 3 mg altogether.
>
> It *seems* to take more bupe on really bad days, but when it kicks in, it works the same as ever. But maybe I would've felt better anyway.
>
> There are a handful of us here. Please tell me your experience. Thanks.Here are som abstracts I've gathered over the years. Hope they can be of some help- I believe one study shows a dosage range between 2-8mg of Buprenorphine:
----------1: Am J Psychiatry. 1999 Dec;156(12):2017.
Treatment augmentation with opiates in severe and refractory major depression.Stoll AL, Rueter S.
Publication Types:
• Case Reports
• LetterPMID: 10588427 [PubMed - indexed for MEDLINE]
----------
5: Biol Psychiatry. 1996 Jun 15;39(12):989-90.
Buprenorphine for depression: the un-adoptable orphan.
Callaway E.
Publication Types:
EditorialPMID: 8780832 [PubMed - indexed for MEDLINE]
----
9: 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.Publication Types:
Case Reports
Clinical TrialPMID: 7714228 [PubMed - indexed for MEDLINE]
10: J Subst Abuse Treat. 1990;7(1):51-4.
Depressive symptoms during buprenorphine treatment of opioid abusers.
Kosten TR, Morgan C, Kosten TA.
Department of Psychiatry, Yale University School of Medicine, New Haven,
CT.Among 40 opioid addicts treated as outpatients with sublingual
buprenorphine (2-8 mg daily) for a month, depressive symptoms significantly decreased in the 19 who were depressed at intake to treatment.PMID: 2313769 [PubMed - indexed for MEDLINE]
------
Jerry
poster:jerrympls
thread:622037
URL: http://www.dr-bob.org/babble/20060315/msgs/622376.html