When do you consider low-dose buprenorphine for the management of treatment resistant depression?

How have you prescribed it and if so what dosing strategy? Where does it fall on your pharmacologic approach to treatment resistant depression?

Answer from: at Community Practice

At doses of 0.25-2 mg, buprenorphine has potent kappa opioid receptor antagonism, and this conveys anxiolytic and antidepressant activities. It can be used in an augmentation mode with other antidepressants. See (Karp et al., PMID 25191915; Fava et al., PMID 26869247; Thase et al., PMID 31254971; Fa...

Comments

at Stamford Hospital
I had no idea this was an option.

at Psych Care Consultants
A disadvantage of this treatment is that the patie...

at University of Texas at Austin Dell Medical School
I need more information. Anyone with experience?

Answer from: at Community Practice

Because of the potential for nausea/vomiting, it is important to give a test dose of 0.25 mg daily orally. If that is tolerated over a week, increase to 0.5 mg daily for a week, then 1 mg daily, depending on response.

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When do you consider low-dose buprenorphine for the management of treatment resistant depression?

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