Posted by SLS on February 26, 2014, at 14:45:05 [reposted on February 28, 2014, at 2:20:06 | original URL]
In reply to Re: Buprenorphine - Freedom of speech - Why not? » SLS, posted by LostBoyinNC45 on February 26, 2014, at 13:52:22
You are certainly entitled to your opinion as I am mine. If you don't feel that buprenorphine should be used to treat depression, just say so. Why do you feel the need to set in place a posting rule that squelches other opinions?
Perhaps you have no need of creative and heroic treatments. Many people here do. When you decide to write your book, I won't feel bad if you should choose to deride me and my opinions. In the end, that's all this stuff really is. I am very much undecided as to whether or not I will want to try buprenorphine in the future. However, the buprenorphine is likely to taste better than horse piss, which I would gladly imbibe were it to remedy my medical condition. The stakes for me are too high to allow someone like you to remove my alternatives. I have a personal stake in having buprenorphine remain available to me to use to treat my affective illness. I have a personal stake in having buprenorphine remain available to a good friend of mine who had been addicted to heroin.
What is your personal stake in forbidding me from discussing the use of buprenorphine to treat TRD?
Well, for now, I will repost the link to the NIH-sponsored clinical trial of buprenorphine for depression with a smile. - just because I can.
http://clinicaltrials.gov/show/NCT01407575
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Detailed Description:
Rates of treatment resistant depression (TRD) in randomized controlled trials range from 50-80% using SSRIs and SNRIs. Innovative treatments are sorely needed. Modulation of the opiate system may be a novel treatment approach for TRD. Buprenorphine (BUP) is a partial agonist at mu-receptors, and also displays affinity for kappa and delta receptors. BUP has a favorable safety profile with low risk of respiratory depression, and the pharmacokinetics are not affected by advanced age or renal dysfunction. This combination of mu-agonism and kappa-antagonism produces less dysphoria than methadone, and animal studies suggest that kappa-antagonism may exert antidepressant effects. In this small proof of concept RCT (n=20), the investigators hypothesize that there will be differences between the group receiving buprenorphine and the group receiving placebo for the following: 1) depression, anxiety, and sleep, and 2)activation of the limbic system and brain structures rich in opiate receptors and critical to reward circuits. In addition, the investigators hypothesize that there will not be differences for measures of safety (vital signs, measures of memory and reaction time, and falls) between the two groups. This pilot project will provide compelling preliminary data to support a R01 application to test the efficacy of buprenorphine for these therapeutically challenging patients.
Specific Aims:
Describe the relative safety of BUP in adults with TRD. The investigators hypothesize that there will be no differences in vital signs, measures of memory and reaction time, or falls between the two groups.
Describe the clinical effect of BUP in adults with TRD. The investigators hypothesize that depression, anxiety, sleep, and health-related quality of life, will improve to a greater extent among those receiving BUP.
Characterize the change in the phMRI responses to buprenorphine compared to placebo. The investigators will compare activation of the limbic system (rACC, insula, and amygdala) and brain structures rich in opiate receptors (periaqueductal grey) and critical to reward circuits (nucleus accumbens) before and immediately after administration of BUP or placebo.The investigators are recruiting 20 community-dwelling adults, age 21 and older, who have tried at least two FDA-approved antidepressant medications at therapeutic doses each for at least 6 weeks during this episode of depression, and are still depressed
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- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1061277
URL: http://www.dr-bob.org/babble/admin/20131217/msgs/1061501.html