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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by jessbessbobess on January 18, 2012, at 12:50:50
Hi everyone,
I am wondering whether anyone knows any physicians who are potentially willing to prescribe buprenorphine for treatment resistant depression. I live in Canada but I am willing to travel to the US to find such a physician. Canada and US physicians are fine.
I have tried 30+ medications and ECT and nothing has given me remission so far. I have read the studies and anecdotal evidence of those who say buprenorphine has helped them.
Many thanks,
jessbessbobess
Posted by rjlockhart04-08 on January 18, 2012, at 14:36:18
In reply to Buprenorphine for Treatment Resistant Depression, posted by jessbessbobess on January 18, 2012, at 12:50:50
It's kinda hard to bring that up in a doctor session because they would tend to think your seeking the drug even thought its only buprenorphine.
The points you have to have is that you have tried all options and explain to them about your distress. I have treatment resistant depression and many resistant other things that all the things that I have tried have failed. Yes, it does help because some doctors will prescibe anything you want, there's ALOT in LA that prescibe celebrities their drug needs. You could also call this "legal drug dealers". But in your case, your not seeking heavy abuse potential medication. You just have to find the correct one which can take years of finding diffrent alternatives. I don't have a direct awnser for you. I don't know many doctors that will be willing to try opiates for depression, but there are some out there. There are some people here on babble that could explain this a bit better than I can, and give you advice better.
To opiates or lower potential abuse opiates like Suboxne you have to have history of using opiates and that your having withdraws from them be prescibed any alternative opiate medication.
Posted by Phillipa on January 18, 2012, at 15:43:36
In reply to Re: Buprenorphine for Treatment Resistant Depression, posted by rjlockhart04-08 on January 18, 2012, at 14:36:18
I know of known but wouldn't it be lovely if someone does? Phillipa
Posted by europerep on January 18, 2012, at 15:53:42
In reply to Buprenorphine for Treatment Resistant Depression, posted by jessbessbobess on January 18, 2012, at 12:50:50
Hello...
I would suggest you contact the authors of the available studies on buprenorphine for TRD. At least some of them are actually practicing clinicians, who might be willing to give you an appointment or give you further advice. For an actual treatment you need of course to provide documents about your medical history and all that, but you don't have to have all that if you just want to send them an email or something.
Alternatively, there is also at least one study going on in the US on buprenorphine in "regular" TRD (by that I mean "non-late-life depression"). Here's a link: http://www.clinicaltrials.gov/ct2/show/NCT01407575 It says they are not recruiting yet, but their last update is from the middle of last year. Can't hurt to drop them an email as well.
This is really something I'd generally recommend to patients with TRD. Be proactive. Send emails to people who have published in the field and who might be willing to help you. If you're lucky, and if you are a case where an "unconventional" treatment may really be indicated, they might help you out.
Let us know if you succeed in your search for a doctor. (Although it would probably be better not to name specific doctors in here, unless they're fine with it.) good luck in any case!
ER
Posted by jono_in_adelaide on January 18, 2012, at 16:53:24
In reply to Re: Buprenorphine for Treatment Resistant Depression » jessbessbobess, posted by europerep on January 18, 2012, at 15:53:42
The Meninger Clinic in Topeka, Kansas?
Posted by jono_in_adelaide on January 18, 2012, at 17:13:11
In reply to Re: Buprenorphine for Treatment Resistant Depression, posted by jono_in_adelaide on January 18, 2012, at 16:53:24
Posted by emmanuel98 on January 18, 2012, at 19:02:59
In reply to Buprenorphine for Treatment Resistant Depression, posted by jessbessbobess on January 18, 2012, at 12:50:50
REcently, someone wrote here about studies at McLean hospital, but you probably need to travel to McLean and be hospitalized to talk to a doc about it. At one point, I asked for buprenophine (actually I asked for suboxone and my doc at McLeans said she would consult about it, but parnate turned out to work for me. Remember that buprenopine is an opiate -- longer lasting in your brain than heroin/morphine/ oxycodone -- but still an opiate and like all opiates, tolerance and the need to increase dosage are issues. I was addicted for several years to oxycodone and it kept, for several years, my depression at bay. But eventually, I developed tolerance and it stopped working. I imagine the same thing would happen on buprenorphine.
Posted by europerep on January 19, 2012, at 7:22:57
In reply to Re: Buprenorphine for Treatment Resistant Depression, posted by emmanuel98 on January 18, 2012, at 19:02:59
Hey there... I guess you were referring to me as the member who wrote about McLean hospital? I don't know whether they have any studies going on over there, but some of the people who were responsible for the publications on this subject are still working there.
It's true, as Scott said in another thread, that the body of evidence for buprenorphine in TRD isn't fairly huge. It's worth noting though that the little evidence that exists is overwhelmingly positive. It's not a "one study says yes and the other one says no" type of situation. There is also more evidence for the benefits of kappa antagonism in depression treatment (publications by Carlezon et al., also from Harvard).
Lastly, successful treatment of TRD with buprenorphine doesn't obey the same rules as recreational use of opiates in order to "have fun". There are people who have been on the same low dose of buprenorphine for years and are still doing well. Of course, the tricky thing is to find out whether a patient who benefits from buprenorphine is experiencing an antidepressant effect or a mild opiate high. I am probably one of those whose improvement during the first days of taking buprenorphine was more due to a high than due to an antidepressant effect. However, while I can only speak for myself here, tapering off of buprenorphine slowly (!) was not all that problematic for me. And, more than a year later, I still have some of it lying around, and I have no temptation whatsoever to take it. Buprenorphine really isn't a good drug to get high.
In short: for some patients I think it's worth trying, and the people at McLean have extensive experience with it. They know how to go about that type of treatment. They are the people I would try to talk to first when considering using buprenorphine for TRD.
ER
This is the end of the thread.
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