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Cited by 352Treatment of Major DepressionOpioid Use Disorder TreatmentPain Management and Opioid Use

Buprenorphine Treatment of Refractory Depression

Bodkin, J. Alexander, Zornberg, Gwen L., Lukas, Scott E., Cole, Jonathan O.·1995·Journal of Clinical Psychopharmacology
DOI 10.1097/00004714-199502000-00008
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Abstract

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.

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Crossref · 10.1097/00004714-199502000-00008

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38 of 38 references verified0 citation errors · 0 not checkable

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  • Buprenorphine shows antidepressant effects in both opioid use disorder and treatment-resistant depression.

    “Buprenorphine has antidepressant effects when used for both opioid use disorder and treatment-resistant depression (279-284)”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [279]

  • Six clinical trials, one clinical case, and three additional studies investigating opiate-dependent patients were included, with 216 subjects with treatment-resistant depression treated with buprenorphine in monotherapy or with an opioid antagonist.

    “Overall, six clinical trials [41,42,43,44,45,46]—of which three were randomized, double-blind and placebo controlled studies [41,44,45]—and one clinical case [47], including a total of 216 subjects with TRD treated with BUP in mono-therapy or together with an opioid antagonist (naloxone or samidorphan) were included.”

    From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [42]

  • Bodkin et al. treated 10 treatment-resistant depression subjects with buprenorphine up to a maximum daily dosage of 1.8 mg; after four to six weeks, seven patients showed clinically striking improvements in subjective and objective measures of depression.

    “Bodkin [42] treated 10 TRD subjects with BUP, according to tolerance and clinical benefits, with a maximum daily dosage of 1.8 mg. After four to six weeks, seven patients showed clinically striking improvements in both subjective and objective measures of depression.”

    From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [42]

  • Buprenorphine has a rapid antidepressant and anti-suicidal action, acting in about a week after the first administration.

    “Taken together, according to the included studies, BUP has a rapid antidepressant and anti-suicidal action: in fact, this psychoactive compound seems to act in about a week after the first administration [41,42,43,44,46,47,48,52].”

    From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [42]

  • Bodkin et al. and Gerra et al. reported cases of irritability, anxiety, and dysphoria that led to drop-out from the study in implicated patients.

    “Bodkin and colleagues [42] and Gerra et al. [50] even reported some cases of irritability, anxiety, and dysphoria, which led to drop-out from the study of implicated patients.”

    From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [42]

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Authors
Bodkin, J. A., Zornberg, G. L., Lukas, S. E., & Cole, J. O.
Affiliations
Harvard University (US)
ORCID
Venue
Journal of Clinical Psychopharmacology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1995-02
Volume
15
Issue
1
Pages
49-57
ISSN
0271-0749 (ISSN-L)
DOI
10.1097/00004714-199502000-00008
OpenAlex
W2063621859
Cited by
346
References
39
Citations by year
2026: 1 · 2025: 7 · 2024: 5 · 2023: 7 · 2022: 10 · 2021: 9 · 2020: 19 · 2019: 22 · 2018: 25 · 2017: 18 · 2016: 20 · 2015: 20 · 2014: 21 · 2013: 18 · 2012: 13
FWCI
3.28
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Psychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (DA-00115)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
buprenorphine, treatment-resistant depression, major depressive disorder, antidepressant treatment, opioid side effects
MeSH terms
Adult, Aged, Buprenorphine, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales

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