Possible antidepressive effects of opioids: Action of buprenorphine
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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 [41]
Emrich et al. found a slight to strong reduction of depressive symptoms in treatment-resistant depression patients treated with buprenorphine in a pilot ABA study.
“Emrich et al. [41], through a pilot ABA study conducted in TRD patients treated with BUP, found a slight to strong reduction of depressive symptoms.”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [41]
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 [41]
About 50% of treatment-resistant depression patients in Emrich et al. and Fava et al. showed improvement in depressive symptoms, and 66.7% in Karp et al.
“Other studies including TRD patients, anyway, showed an improvement in depressive symptoms in different percentages: about 50% in Emrich et al. [41] and Fava et al. [45], and 66.7% in Karp and colleagues [43].”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [41]
In the studies by Emrich et al. and Karp et al., after discontinuation of short-term buprenorphine therapy (e.g., one week), total scores on depression scales such as HAM-D and MADRS rapidly increased.
“According to the studies conducted by Emrich et al. [41] and Karp et al. [43], once the drug is discontinued after a short-term therapy (e.g., one week), the total score scales assessing depressive symptoms such as HAM-D and MADRS rapidly increased”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [41]
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 [41]
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- Authors
- Emrich, H. M., Vogt, P., & Herz, A.
- Affiliations
- Max Planck Institute of Psychiatry (DE)
- Venue
- Annals of the New York Academy of Sciences
- Publisher
- Wiley
- Published
- 1982-12
- Volume
- 398
- Issue
- 1
- Pages
- 108-112
- ISSN
- 0077-8923 (ISSN-L)
- 1749-6632
- OpenAlex
- W2055208356
- Cited by
- 152
- References
- 26
- Citations by year
- 2025: 4 · 2024: 5 · 2023: 7 · 2022: 7 · 2021: 3 · 2020: 10 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 7 · 2014: 7 · 2013: 8 · 2012: 2
- FWCI
- 3.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of the New York Academy of Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- buprenorphine, opioids, antidepressant effects, depression, opioid analgesics
- MeSH terms
- Antidepressive Agents, Buprenorphine, Clinical Trials as Topic, Depressive Disorder, Double-Blind Method, Humans, Morphinans
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