Buprenorphine Prescription for Treatment Resistant Depression?

September 7, 2012 6:21 PM

Buprenorphine and Treatment Resistant Depression

I've heard that Suboxone/Subutex have been used successfully off-label by psychiatrists for Treatment-Resistant or Refractory depression.

I've been diagnosed with Treatment Resistant/Refractory Depression. I'm going to see my psychiatrist tomorrow and would like to try Suboxone/Subutex for my Depression.

Full disclosure: I am well aware that Suboxone and Subutex are prescribed to opiate/opioid addicts. I am a Heroin/Oxycodone addict. I want to get on a Suboxone Maintenance program, but the cheapest price quote I got was $375 dollars. I cannot afford such prices as well as the price for the medication, so I feel like this would kill 2 birds with one stone, treating my depression as well as opioid addiction.

As for my psychiatrist, I want to show her some Medical literature about the success of using Suboxone/Subutex for Treatment Resistant Depression. I found one good article Abstract but have come to a standstill when it comes to articles. I fear my Google-fu has failed me.

If the hive mind would be so gracious as to point me in the right direction with links to articles or their own experiences that would be wonderful and I thank you all in advance!

If you think I am being shady by trying to go through this route, please tell me why. Most recently, I tried to get legitimate help through a detox program at a hospital here in NYC, but I was not accepted into the program and had to detox at home.

I know there are methadone clinics, but Methadone frankly scares me as it is even stronger than heroin and has a long half life and is even harder to kick! I do not inject, I only insufflate heroin, but it is indeed ruining my life and I feel like Suboxone is one of my only options. If I had the spare $300-$500 dollars to see a Suboxone doctor, I wouldn't be going through so much trouble to acquire Suboxone in a legal albeit roundabout manner.

Thanks for reading; feel free to PM me if you have any personal experience with this you'd like to share.

posted by Pleadthefifth to health & fitness (7 answers total)

What you want to do to find medical literature is use Google Scholar. You may have to go to a university library to read the articles and print them off.

Your doctor needs to know all the drugs you've taken, and that you're dealing with a current addiction. This is not optional.
posted by SMPA at 6:39 PM on September 7, 2012 [5 favorites]

Kappa-opioid ligands in the study and treatment of mood
disorders is an NIH public access manuscript for a 2009 review article that touches on the issue. Please check the email listed in your profile for some more information.
posted by mean square error at 7:52 PM on September 7, 2012

Do you plan to tell your psychiatrist you are using heroin?
posted by space_cookie at 7:58 PM on September 7, 2012

Doctors need a special license to prescribe Suboxone, whether it's for addiction, pain or depression. I'm afraid you're stuck finding a 'Suboxone doctor.' Also, if you're attempting to use any justification for a Suboxone scrip other than opiate dependence your insurance likely won't pay for it.
If it were up to me Suboxone would be available over-the-counter and every doctor's office would have a big bowl of it, right next to the condoms and the clean needles. Good luck in your search.
posted by arrmatie at 8:40 PM on September 7, 2012 [2 favorites]

Agreed with arrmatie. Doctors who aren't specially licensed to prescribe suboxone cannot do so. You'll want to discuss why you think this is a good idea (i.e. treating the opiate addiction as well) because otherwise, suboxone will probably not be the first or second thought.

I think that Google Scholar is decent but still does not seem to give the same results as directly searching PubMed.

Abstract 1: Buprenorphine treatment of refractory depression by Bodkin et al.

Abstract 2: Opiate treatment in depression refractory to antidepressants and ECT by Nyhuis et al.

There doesn't seem to be much research on this topic, I'm afraid, but if you can get the actual articles, say through a university/medical library as SMPA suggests, you could look at the reference list to help you find more sources.
posted by treehorn+bunny at 9:45 PM on September 7, 2012 [1 favorite]

I MeMailed you.
posted by The Elusive Architeuthis at 5:26 PM on September 8, 2012

Oh yeah, as did I.
posted by item at 8:03 AM on September 9, 2012