Opiate Treatment in Depression Refractory to Antidepressants and Electroconvulsive Therapy
Abstract
*Departments of Psychiatry, and Psychotherapy, and †Addictive Behavior and, Addiction Medicine, Rhine State Hospital, University Duisburg-Essen, Essen, Germany [email protected]
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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 [280]
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 [46]
Nyhuis et al. observed improvement of depressive symptoms in six nonpsychotic treatment-resistant depression patients after seven days of buprenorphine monotherapy at a medium dose of 1.2 mg/day.
“Nyhuis and colleagues [46] observed in six nonpsychotic TRD patients an improvement of depressive symptoms after seven days of BUP treatment, as a monotherapy, at a medium dose of 1.2 mg/day.”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [46]
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 [46]
The short duration of some study designs (one week or a few days more) may be insufficient to observe long-term efficacy or emergence of adverse effects of buprenorphine.
“Unfortunately, a period of one week [41,44,46], or a few days more [52], may be not sufficient to observe the long-term efficacy or the emergence of some adverse effects related to this agent.”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [46]
In studies that considered side effects, specific side effects were described in the majority of patients.
“Not all the studies included in this review analyzed the occurrence of side effects related to BUP use but, in those who considered their possible emergence [42,43,44,45,46,50,51], specific side-effects were described in the majority of patients.”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [46]
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(2024) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9798894551289.cd03
Opioid agents for treatment-resistant depression
Serafini, G., Adavastro, G., Canepa, G., Amerio, A., Aguglia, A., & Amore, M. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-824067-0.00016-5
Nygaard-Odeh, K., Soloey-Nilsen, H., Kristiansen, M. G., Brekke, O., Mollnes, T. E., Berk, M., & Bramness, J. G. (2026) · Addiction Biology · doi:10.1111/adb.70147
Brixadi for Stimulant Use Disorder: Evolving Pharmacologic Considerations and Clinical Implications
Sawaya, M. F., McNulty, M. E., Germain, C. J. S., Hachem, I. A., Calix, M. S., Lormand, R. M., McComb, N., Shehab, A. A. A., Wrightson, J., Anwar, A. I., et al. (2026) · Advances in Therapy · doi:10.1007/s12325-026-03772-4
- Authors
- Nyhuis, P. W., Gastpar, M., & Scherbaum, N.
- Affiliations
- University of Duisburg-Essen (DE)
- Corresponding author
- Nyhuis, Peter W.
- Gastpar, Markus
- ORCID
- Scherbaum, Norbert
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2008-10
- Volume
- 28
- Issue
- 5
- Pages
- 593-595
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W1994125953
- Cited by
- 90
- References
- 11
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 5 · 2020: 11 · 2019: 7 · 2018: 14 · 2017: 7 · 2016: 9 · 2015: 7 · 2014: 5 · 2013: 1 · 2012: 2
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- 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 › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- opioid therapy, treatment-resistant depression, antidepressant-refractory depression, antidepressant resistance
- MeSH terms
- Adult, Aged, Analgesics, Opioid, Antidepressive Agents, Buprenorphine, Major Depressive Disorder, Electroconvulsive Therapy, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Treatment Outcome
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