Suboxone for Clinical Depression...

[tomhunter]

Well, long story short, I was diagnosed with clinical depression way back in 89, and I've suffered from it ever since. We've tried more than a dozen (well more than that, actually) different meds, SSRIs, SNRIs, all the natural supplements you can think of with NO improvement - at all, only the horrible side effects. In short, I'm "treatment resistant." So, my GP located one of the few qualified Suboxone psychiatrists (addiction specialist) and he put me on 1mg of Suboxone once a day for the next week, going down to 0.75 the week after, 0.5 the week after, .25... then off - just to see if it's any help. I was recently on Norco for almost a year (and other opiates - all prescribed) due to a major shoulder injury. The opiates were the first thing that actually boosted my mood and lifted my depression, if only temporarily. But, of course, that was not the "point" of the prescription. So, fast forward a year, and here I am. With all these dynamics, the docs agreed I qualify for an experimental try with off-label use of Sub in an attempt to alleviate my depression. So far, had some quality stomachaches and mild nausea , insomnia , headaches , and heart palps , but also a slight improvement in my depression. It's Day 3, and I have to say... I'm on the fence so far about it. I'll be very interested to read the myriad comments and other threads on this topic!

[Katipo]

Welcome Tom,
I really hope sub will prove effective in treating your depression. It's still early days for you so try to be patient as your body stabilises. While successfully treating my addiction, I have also benefited from its mood elevating properties.
Depression was my normal for many years before sub,
Hope this works for you!

[tomhunter]

Thanks! Hoping my body adjusts and this stuff works...

[Lillyval]

Hi Tom, welcome.
I, too, am on low dose Sub for depression, 0.5mg. I was on it for opiate dependence previously (stopped almost 3 years ago) and have the same doctor prescribing it.
I'm really surprised they started you on 1mg - that's a huge dose = to 30-50mg morphine. Many non-addicts vomit or get very high on a dose like that. I would have thought they'd started you on 0.25 and have you work your way UP to 1 mg. Anyway, if it does work (and I'm hoping it does), what is the plan after you are off in a month? Or are they hoping that 4 weeks on Sub will take you out of your current depressive episode and reset you to baseline?
I wish you the best, and please keep posting to let us know how you are doing.
Lilly

[tomhunter]

Yes, it certainly seemed a high dose when i took the first one on Friday! I have a high opiate tolerance (was on 70-80mg Norco a day until I quit a few weeks ago), so I can't imagine what 1mg of Sub would do to someone opiate naive. But, I guess the doc would have adjusted the dose accordingly.

I think the plan is to give the med a month at the gradually decreasing dose to see if it actually helps. I have to say, I didn't think to ask him: why not start out at a lower dose and work up? So, that's on me.

I guess I'll know in a week or so if it's working. Right now it makes me pretty drowsy, though not "high".

This really is the last drug I'm going to try for my depression - if this doesn't help, I'm just going to accept the depression and try to live with it. Im so tired of meds... and messing with my brain chemistry. You get to a point where you don't even know what your baseline is, and that makes assessing things a challenge.

[TeeJay]

I wouldn't give up on treatment just yet, if Suboxone doesn't work out. There's some promising studies on the effects of ketamine for depression. And (if your depression is particularly crippling) there's always ECT, which despite its stigma, is actually quite an effective tool for treating treatment resistant depression. I know some people who swear by it, and are quite high functioning. Others say they wouldn't do it again if they were paid.

[tomhunter]

Met with the doc today. We're going down to 0.75 for a week, then .5 for a week, to see if I get the same benefits, without having to take such a relatively high dose for depression...

[Michelle F.]

Hi Tom, I agree with TeeJay...don't give up! I too know folks who swear by ect with the only side effect being some memory loss. Good luck! I hope the suboxone works for you! Please stick around and keep us informed of your progress!

[tomhunter]

thank you - so far, it seems to actually work, where SSRI, SNRIs and other "antidepressants" have failed...badly my only sid effects are libido, heart palps, and headaches. I can live with those if it lifts this depression, for once! we did go down to .75mg and it doesnt seem to work as well, but we'll see - doc wants me to see how low i can go while still getting the benefits, and i think that's smart. plus, the lower i go, the lesser the three side effects.

[gossamerwings]

I too have severe, treatment-resistant clinical depression. I currently take Abilify and citalopram (Celexa) for my depression. It helps some. I have tried so many medications for my depression, combinations of meds, even ECT. Give the buprenorphine time, I truly believe that it helps.

I am also under treatment for opiate dependence, and have been working with a sub doc for four years. I started out taking Suboxone tabs, then switched to the films. Due to allergic reactions to the films, I switched to Subutex in July. I take 1/2 of an 8 mg tab twice a day.

All I can say, is that a couple of months after beginning my treatment four years ago, I definitely noticed some lifting of my depression. It's never gone, however I believe that the bup does help.

I encourage you, Tom (or anyone with treatment-resistant depression) to hang in with the buprenorphine. It helps. I feel for you--TRD is no fun, and makes life extremely difficult.

[katie calloway]

I know this is a really old thread but I'm new here and am kind of reading through everything.

I always felt that opiates were the only thing that made me feel "normal", "happy", "content" - in a word, NOT depressed. And I had severe depression, lifelong depression that manifested as severe irritability, anxiety, and general impatience/intolerance for most people. I am in recovery now, but I remember I used to ask my husband, "why don't they prescribe opiates for depression?"

I think we all know the answer to that, but if Bup can prove to be a safe(r) treatment for depression, I would find that completely understandable. I'm on Bup now for chronic pain (in the context of OUD), and I know one benefit is that my mood is stabilized and generally upbeat.

[rule62]

Sorry for the late reply Katie but I just saw this one. Yes, opiates trigger the endorphines in our brains that make us feel better so of course it helps with depression. Suboxone being an opiate too, albeit a very mild one, I'm glad it helps. About an hour after I take my dose I do feel like my mood is better so yes, a nice side benefit.

I think some anti-depressants do the same thing. One time I was prescribed Effexor and it did put me in a better mood although to me it felt fake. Do what you need to do. At least it's legal.

[docm2]

there are studies being done for Buprenorphine for depression. It will be combined with another molecule to limit dependence. I have several people that are doing well and no longer take any mood stabilizers or antidepressants.

Several generations ago, laudanum was used for depression, downside of course is tolerance and dependence.

So, yes, Suboxone can be affective for people with co-occurring depression with OUD.