Eight-Milligram Single Dose of Buprenorphine as an Expeditious Treatment for Severe Suicidal Ideation: A Case Report
Abstract
Introduction: Buprenorphine is used to treat opioid use disorder and pain syndromes. This drug may be a suitable treatment choice for refractory depression, anxiety, self-injurious behaviors, and suicidal ideation. However, it has a significant abuse potential, which limits its use in suicidal patients with a history of substance abuse. Case Report: In this report, we present a case of chronic suicidal ideation due to substance-induced depressive disorder in a 25-year-old man from Noorabad, Fars, Iran. The patient was successfully treated with an 8-mg single dose of sublingual buprenorphine with minimal probability of diversion or misuse. We observed that 8 mg of buprenorphine exerted a rapid effect on the reduction and cessation of suicidal thoughts and depression. Conclusions: We demonstrated the antisuicidal effectiveness of a single dose of buprenorphine, which can be administered with minimum risk of diversion or misuse for suicidal patients with a history of substance abuse.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A few case reports show similar effects in opioid use disorder patients on higher doses.
“Few case reports demonstrate similar effect in individuals with opioid use disorder using higher dosages (139, 285, 286).”
From A brain-centric model of suicidal behavior (2020) · cites this paper as [285]
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 [52]
For buprenorphine and suicidal ideation, the review included one randomized, double-blind, placebo-controlled trial and one case report in addition to the Striebel report, totaling 90 patients with heterogeneous diagnoses but clinically significant suicidal ideation.
“Regarding the efficacy of BUP on suicidal ideation, in addition to the Striebel report, two other studies were added—one randomized, double-blind, and placebo-controlled clinical trial [51], and one case report [52]—for a total of 90 patients having heterogeneous diagnoses (i.e., Borderline Personality Disorder, Major Depressive Disorder, Adjustment Disorders, Eating Disorders, Post-Traumatic St”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [52]
Ahmadi et al. reported a 25-year-old man with suicidal ideation and substance-induced depression successfully treated with an 8 mg single dose of sublingual buprenorphine as adjunctive treatment to olanzapine and valproate.
“Ahmadi and colleagues [52] investigated a patient with suicidal ideation and substance-induced depression: the 25-year old man was successfully treated with a 8 mg single dose of sublingual BUP as an adjunctive treatment to olanzapine and valproate 20 and 400 mg daily doses, respectively.”
From The Efficacy of Buprenorphine in Major Depression, Treatment-Resistant Depression and Suicidal Behavior: A Systematic Review (2018) · cites this paper as [52]
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 [52]
Cites
1 retracted
Larkin, G. L., & Beautrais, A. L. (2011) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145711000629 · Cited by 254 · see citing works
RetractedLithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis
Cipriani, A., Hawton, K., Stockton, S., & Geddes, J. R. (2013) · BMJ · doi:10.1136/bmj.f3646 · Cited by 920 · cited 1× · see citing works
“Prefrontal repetitive transcranial magnetic stimulation (1), electroconvulsive therapy (3), and administration of ketamine (4), clozapine, and lithium (5) have been introduced as acute treatments for suicidal ideation or attempts.”
BackgroundBuprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review
Yokell, M. A., Zaller, N. D., Green, T. C., & Rich, J. D. (2011) · Current Drug Abuse Reviews · doi:10.2174/1874473711104010028 · Cited by 397 · see citing works
Buprenorphine Treatment of Refractory Depression
Bodkin, J. A., Zornberg, G. L., Lukas, S. E., & Cole, J. O. (1995) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199502000-00008 · Cited by 346 · see citing works
Yovell, Y., Bar, G., Mashiah, M., Baruch, Y., Briskman, I., Asherov, J., Lotan, A., Rigbi, A., & Panksepp, J. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15040535 · Cited by 311 · see citing works
Aalto, A., Elovainio, M. J., Mika Kivimaki, B., Uutela, A. K., & Pirkola, S. P. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.09.008 · Cited by 258 · see citing works
George, M. S., Raman, R., Benedek, D. M., Pelic, C. G., Grammer, G. G., Stokes, K. T., Schmidt, M., Spiegel, C., DeAlmeida, N., Beaver, K. L., et al. (2014) · Brain Stimulation · doi:10.1016/j.brs.2014.03.006 · Cited by 193 · see citing works
Karp, J. F., Butters, M. A., Begley, A. E., Miller, M. D., Lenze, E. J., Blumberger, D. M., Mulsant, B. H., & Reynolds, C. F. (2014) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.13m08725 · Cited by 191 · see citing works
The Role of ECT in Suicide Prevention
Fink, M., Kellner, C. H., & McCall, W. V. (2013) · Journal of Ect · doi:10.1097/yct.0b013e3182a6ad0d · Cited by 188 · see citing works
Emergency Treatment of Young People Following Deliberate Self-harm
Olfson, M., Gameroff, M. J., Marcus, S. C., Greenberg, T., & Shaffer, D. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.10.1122 · Cited by 166 · see citing works
Greenwald, M., Johanson, C.-E., Bueller, J., Chang, Y., Moody, D. E., Kilbourn, M., Koeppe, R., & Zubieta, J.-K. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.04.043 · Cited by 124 · see citing works
Psychometric assessment of beck scale for suicidal ideation (BSSI) in general population in Tehran.
Esfahani, M., Hashemi, Y., & Alavi, K. (2015) · PubMed Central · Cited by 99 · see citing works
Opioid partial agonist buprenorphine dampens responses to psychosocial stress in humans
Bershad, A. K., Jaffe, J. H., Childs, E., & de Wit, H. (2014) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2014.12.004 · Cited by 93 · see citing works
Major Depressive Disorder and Kappa Opioid Receptor Antagonists.
Li, W., Sun, H., Chen, H., Yang, X., Li, X., Liu, R., Shao, L., & Qiu, Z. (2016) · PubMed · Cited by 36 · see citing works
The Anti-Suicidal Potential of Buprenorphine: A Case Report
Striebel, J. M., & Kalapatapu, R. K. (2014) · The International Journal of Psychiatry in Medicine · doi:10.2190/pm.47.2.g · Cited by 31 · see citing works
Norelli, L. J., Smith, H. S., Sher, L., & Blackwood, T. A. (2013) · ijamh · doi:10.1515/ijamh-2013-0069 · Cited by 30 · see citing works
Hypersensitivity to hypercapnia: Definition/(s)
Vickers, K. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.11.004 · Cited by 8 · see citing works
Ahmadi, J. (2016) · Insights in Biomedicine · Cited by 7 · see citing works
Self-citationRemember the Good Times? Biased Autobiographical Memory in Depression
Etkin, A. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15101313 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A brain-centric model of suicidal behavior
Mann, J. J., & Rizk, M. M. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.20081224 · Cited by 214 · see citing works
Serafini, G., Adavastro, G., Canepa, G., De Berardis, D., Valchera, A., Pompili, M., Nasrallah, H., & Amore, M. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19082410 · Cited by 162 · see citing works
Suicide Risk and Addiction: The Impact of Alcohol and Opioid Use Disorders
Rizk, M., Herzog, S., Dugad, S., & Stanley, B. (2021) · Current Addiction Reports · doi:10.1007/s40429-021-00361-z · Cited by 175 · see citing works
Mehri, A., Ghorbani, S. S., Farhadi-Babadi, K., Rahimi, E., Barati, Z., Taherpour, N., Izadi, N., Shahbazi, F., Mokhayeri, Y., Seifi, A., et al. (2023) · Journal of Intensive Care Medicine · doi:10.1177/08850666231166344 · Cited by 25 · see citing works
Rizk, M., Stanley, B., Choo, T.-H. J., Pavlicová, M., Scodes, J. M., Rotrosen, J., & Nunes, E. V. (2025) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2025.2524110 · Cited by 3 · see citing works
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
- Authors
- Ahmadi, J., & Abtahi, S.
- Affiliations
- Shiraz University of Medical Sciences (IR)
- Venue
- Iranian Red Crescent Medical Journal
- Publisher
- DoNotEdit
- Published
- 2017-08-22
- Volume
- 19
- Issue
- 9
- ISSN
- 2074-1804 (ISSN-L)
- 2074-1812
- OpenAlex
- W2750349706
- Cited by
- 6
- References
- 19
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2018: 1
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Iranian Red Crescent Medical Journal (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- buprenorphine, suicidal ideation, sublingual buprenorphine, single-dose therapy, treatment-resistant depression, opioid use disorder, abuse liability, self-harm
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
