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Cited by 22Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPain Management and Opioid Use

Association Between Receipt of Antidepressants and Retention in Buprenorphine Treatment for Opioid Use Disorder: A Population-Based Retrospective Cohort Study

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Zhang, Kun, Jones, Christopher M., Compton, Wilson M., Guy, Gery P., Evans, Mary E., Volkow, Nora D.·2022·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.21m14001PMC PMC9926945
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Abstract

Clinical interventions targeting co-occurring psychiatric disorders may represent a tangible target for improving retention in buprenorphine treatment for opioid use disorder. The aims of this study are to characterize receipt of antidepressants among patients receiving buprenorphine treatment and to examine the association between receiving antidepressants and retention in treatment. A retrospective cohort design was used. Using data from a large national commercially insured population, the cohort was selected as adults aged 18 to 64 years who initiated buprenorphine treatment in outpatient settings between January 1, 2016, and June 30, 2017. Receiving antidepressants was identified as prescription fills in the period between 6 months prior to buprenorphine initiation and during buprenorphine treatment. Buprenorphine discontinuation was defined as no buprenorphine prescription supply for at least 60 days following the end of the last buprenorphine prescription. The cohort consisted of 11,619 individuals who initiated buprenorphine treatment and met our inclusion criteria. The cohort had a mean age of 36.3 years, 63% were male, and 55.7% received at least 1 antidepressant prescription at any time between 6 months prior to buprenorphine initiation and during treatment. Compared with those receiving no antidepressants at all, individuals starting antidepressants during buprenorphine treatment had an adjusted hazard ratio (HR) for treatment discontinuation of 0.72 (95% CI = 0.67-0.77), while receiving antidepressants only prior to buprenorphine initiation was associated with an increased risk of treatment discontinuation (HR = 1.40, 95% CI = 1.28-1.53). Findings suggest that receiving antidepressants during buprenorphine treatment is associated with improved retention. This highlights the critical importance of screening for and treating mental disorders concomitantly with treatment of opioid use disorder.

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  • Use of antidepressants alongside buprenorphine in patients with opioid use disorder and depression reduced the risk of overdose.

    “whereas the use of antidepressants alongside buprenorphine in patients with opioid use disorder and depression reduced the risk of overdose 141”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [141]

    The Results report that starting antidepressants during buprenorphine treatment was associated with a lower risk of treatment discontinuation, not a measured reduction in overdose risk. The Methods identify discontinuation and treatment duration as the outcomes; the paper notes that discontinuation increases overdose risk, but its Limitations say the observed association cannot establish causation. No page numbers are available in our copy. (LLM, conf=0.88)

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Cited by

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Authors
Zhang, K., Jones, C. M., Compton, W. M., Guy, G. P., Evans, M. E., & Volkow, N. D.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • National Institutes of Health (US)
Corresponding author
Zhang, Kun
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2022-04-27
Volume
83
Issue
3
ISSN
  • 0160-6689 (ISSN-L)
  • 1555-2101
DOI
10.4088/jcp.21m14001
PMC
PMC9926945
OpenAlex
W4224301181
Cited by
22
References
2
Citations by year
2026: 3 · 2025: 8 · 2024: 7 · 2023: 3 · 2022: 1
FWCI
4.19
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
antidepressants, buprenorphine, opioid use disorder, treatment retention, treatment discontinuation, psychiatric comorbidity, co-occurring psychiatric disorders, medication adherence, commercially insured adults
MeSH terms
Adult, Antidepressive Agents, Buprenorphine, Child, Preschool, Female, Humans, Male, Opioid-Related Disorders, Retrospective Studies, Cohort Studies, Opiate Substitution Treatment

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