Posted by CaptainAmerica1967 on November 2, 2011, at 11:28:30
In reply to Re: opiates and major depression » CaptainAmerica1967, posted by SLS on November 1, 2011, at 5:40:40
> Hi.
>
> > Best wishes in trying buprenorphine-Subutex if you plan to try it. 1995 Harvard Study by Bodkin and currently a clinicaltrials.org is studying the effects of bup in late life TRD (BUILD study?)
>
>
> Would you be able to post a link to the study?
>
> Thanks.
>
> I am hoping that I won't need buprenorphine, but I guess I should start working on my doctor now to try to get him to change his mind. He doesn't want to use it on me.
>
>
> - Scott
--------------------------------------------------There are actually two studies with buprenorphine going on; the current clinical trial on late life TRD (Build) and one that hasn't started yet (BUO-TRD) both in Pittsburg, PA
http://clinicaltrials.gov/ct2/show/NCT01071538
http://clinicaltrials.gov/ct2/show/NCT01407575I can no longer find the original Bodken 1995 Harvard Study using "liquid buprenorphine" which is 50% more bioavailable squirting under the tongue with the max dose in the study 2mg/d compared to sublingual tablet (Sutuex) with a max dose of eqivalent to 4mg/day.
I end up paying cash even with insurance for the Subutex or about $100 a month but if you're an addict, I think nearly 100% is covered which isn't right because many meds are used off label; Inderal (propanolol) for mirgraine, trazodone as a hypnotic or Tricyclic Antidepressant (Anti-Cholinergic effect) to prevent enuresis or bedwetting, but the last two are only classified as antidepressant.
I have osteoarthritis and the lowest dose of the new Buprenorphine patch (Butrans) is 5mcg/micrograms per hour or eqivalent to 5mg of Subutex-bupreneorphine, 1 more mg than I'd normally be taken but at least I wouldn't be forking out $100 of my own each month.
The Suboxone has the anti-addiction medication naloxone mixed with the buprenorphine at a 4:1 ratio (bup to nal) which may or may not help the addiction process (very doubleful as I worked as a clinical pharmaceutical consultant and I know the tricks pharmaceutical companies play once a medication goes generic and when Subutex went generic, they can out with Suboxone which isn't better than Subutex but several times more expensive, but I actually got my insurance to cover the Suboxone instead of the Subutex, but I know why; the cost of Suboxone was about 3-4x that of regular buprenorphine and Suboxone even more expensive with insurnace coverage so I opted to stay on Subutex but hope to get Burans patch which should be covered for me but my psychiatrist has been hesitant to go to it either thinking it's not as effective or the 1mg more of buprenorphine. I'm thinking more cash in my pocket and maybe even feeling better wtih 5mg of bup.
I got Buprenex (injectable liquid bup) covered as I have osteoarthritic pain and any physician can RX it without a triplicate, vial of buprenorphine for injection which mens you'd really become addicted, but like the Harvard study I would just squirt bup underneath my tongue or use intranasally (more bioavailable) but to get close to the dose of Harvard study of 2mg, I would have had to buy so many vials that it was 3-4x the cost of Subutex tablet equal 4mg of the tablet buprenorphine (Subutex) used sublingually with insurnace still and that's why I stay with the 2mg of Subutex twice a day which equals the max of the Harvard liquid bup. The only problems that all psychiatrist have is that the darn FDA will not recognize opioid as valid treatment for refractory depression, but believe just like herbal or integrative medicine that the view will change over the years.
poster:CaptainAmerica1967
thread:81414
URL: http://www.dr-bob.org/babble/20111027/msgs/1001513.html