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Re: opiates and major depression » europerep

Posted by Chairman_MAO on October 19, 2011, at 13:50:09

In reply to Re: opiates and major depression » Chairman_MAO, posted by europerep on October 19, 2011, at 8:32:45

>
> > You found success with it because it is a mu-opioid agonist. You'd have just as much success with morphine. The kappa antagonist effect is good, but let's keep it real here.
> >
>
> Actually, buprenorphine is a partial mu-opioid agonist. Furthermore, research on kappa-antagonism shows its potential for treating depression, so this component of buprenorphine may well play a role. Lastly, buprenorphine's metabolite norbuprenorphine is a delta-agonist, which may as well contribute to buprenorphine's antidepressant potential.
>

Yes, I know it is a partial mu-opioid agonist, but you can get equipotent analgesia comparable to any other mu agonist so long as you don't go over buprenorphine's "ceiling", beyond which efficacy drops (but you already know this, I'm sure, because you bothered to "call me out" on its being a partial agonist). There is ample literature using conventional mu agonists to treat depression effectively.

I think that buprenorphine makes an excellent candidate for use as an antidepressant for many reasons--the number one reason being its safety in overdose. It has more than antidepressant potential, it _is_ an antidepressant. It's wonderful to have all of these hypothetical discussions about which receptor subtypes do what, but it's not very useful clinically. What matters is what works.


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poster:Chairman_MAO thread:81414
URL: http://www.dr-bob.org/babble/20111016/msgs/1000218.html