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Re: Does anyone have the original buprenorphine study?

Posted by undopaminergic on May 29, 2008, at 22:43:56

In reply to Does anyone have the original buprenorphine study?, posted by Horned One on May 29, 2008, at 15:22:38

> Can anyone lay their hands on the studies that showed buprenorphine was an effective antidepressant?
>

See the following web addresses - the first one is most authoritative, but I'm including the others in case the first one goes off-line:

http://64.233.183.104/search?q=cache:oCHVpMr4kT0J:www.journaladdictionmedicine.com/pt/re/adm/selectreference.htm
http://opium.poppies.org/index.php?showtopic=9033
http://www.drugbuyers.com/freeboard/showflat.php?Cat=0&Number=196682
http://balder.prohosting.com/~adhpage/bupe.html

>
> * I'm addicted to OTC codeine products, and have been for a number of years. I could therefore be classed as 'opiate dependent' and thus a candidate for maintenence therapy. Although codeine is a weaker opiate than bupe, this is how we could write it on the official documentation.
>

Buprenorphine (BUP) is stronger than codeine per unit of weight, but at typical starting doses of both drugs - codeine at 30 mg or less and BUP at 0.6 mg or less, codeine may actually be stronger in some respects.

>
> * I have chronic fibromyalgia-like pain and what might be early onset arthritis, which is one of the motivating factors behind my codeine usage. A strong painkiller would therefore be most welcome, if not appropriate.
>

Ironically, it may be easier for you to acquire oxycodone or other opioids than bupernorhpine based on the above complaint by going to pain specialists or others who prescribe these drugs as a matter of routine.

Bob wrote:
> If they achieved such fantastic results, then why is it not mentioned these days?
>

There are a number of reasons that I think are significant.

One reason is that the use of buprenorphine (BUP) for opiate substitution therapy for addicts has diverted attention from the use of BUP for other purposes, including pain and depression. Furthermore, the abuse of BUP, mainly as a result of its high availability in some locales, as well as the prevalence of prescribing it to known addicts, who are more liklely to abuse it, has given the drug negative attention and contributed to make it a lot more controversial than it was at the time when its use in depression was investigated and publicised.

I have reasons to believe that psychiatrists - or more accurately a subset of them - use opioids in their practice for the treatment of refractory cases a lot more often than one might be led to believe by the scarcity of published studies. This is of course due to the controversial nature of the subjects. Their use of opioids for psychiatic conditions is simply not something that doctors like to speak openly about.

Furthermore, not everyone responds well to opioids and it is usually possible to find alternative satisfactory treatments, including MAOIs, MAOIs with stimulants, and off-label uses of a number of drugs. As a result, the use of opioids in psychiatric disorders remain a relatively limited practice.


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URL: http://www.dr-bob.org/babble/20080528/msgs/831995.html