Buprenorphine Improved Resistant Depression Outcomes

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Buprenorphine, a medication used in the treatment of opioid addiction, may also benefit patients with treatment-resistant depression, who have not responded to antidepressants, researchers found.

Jordan F. Karp, MD, of the University of Pittsburgh School of Medicine in Pennsylvania, and colleagues assessed whether buprenorphine improved symptoms in 50 patients with treatment-resistant depression (TRD aged 50 years and older. Participants were prescribed titrated doses of buprenorphine (0.2–1.6 mg/d) during an eight-week period.

Changes in depression, anxiety, sleep, positive and negative effect, and quality of life were assessed. The Montgomery-Asberg Depression Rating Scale (MADRS) served as the main outcome measure.

Mean depression score (MADRS) at baseline was 27.0 versus 9.5 at week eight. A sharp decline in depression severity occurred during the first three weeks of buprenorphine exposure (mean change = −15.0), the researchers reported in the Journal of Clinical Psychiatry.  

In addition, depression-specific items measuring pessimism and sadness indicated improvement during exposure, supporting a true antidepressant effect. Also, executive function and learning improved during treatment.

“Low-dose buprenorphine may be a novel-mechanism medication that provides a rapid and sustained improvement for older adults with TRD,” the researchers concluded.

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Buprenorphine May Benefit Patients With Treatment-Resistant Depression

The objective of the study is to describe the clinical effect and safety of low-dose buprenorphine, a κ-opioid receptor antagonist, for treatment-resistant depression (TRD) in midlife and older adults.

Method: In an 8-week open-label study, buprenorphine was prescribed for 15 adults aged 50 years or older with TRD, diagnosed with the Structured Clinical Interview for DSM-IV, between June 2010 and June 2011. The titrated dose of buprenorphine ranged from 0.2–1.6 mg/d.

We assessed clinical change in depression, anxiety, sleep, positive and negative affect, and quality of life. The Montgomery-Asberg Depression Rating scale (MADRS) served as the main outcome measure. Tolerability was assessed by documenting side effects and change in vital signs, weight, and cognitive function. Clinical response durability was assessed 8 weeks after discontinuation of buprenorphine.

READ FULL ARTICLE From http://www.psychiatrist.com/JCP/article/Pages/2014/v75n08/v75n0802.aspx
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