Buprenorphine and depression

[keiralee]

Hi everyone I have been on on 0.4mcg of Buprenorphine for a couple of months. I almost immediately started to feel depressed. Have never suffered from depression in my life before. My consultant prescribed Trazadone 50mg and has recently increased the dose to 100mg. I feel so very down. Opioids give me insomnia, the Trazadone gives me 3 or 4 hours sleep which is good but is it helping with the depression.

My consultant says Buprenorphine does not cause depression, it helps with depression!!

I cannot take Gaba or Pregab as these drugs made me very ill years ago and I'm panicked to even think about trying them again.

Your thoughts on this would be appreciated.

[SueJohnson]

Your consultant is wrong. Opioids definitely can cause depression. The normal dose of trazodone for depression is 150 mg so you might try increasing it.

[LotteM in reply to SueJohnson]

No Sue, the consultant is right. There have been research papers about the antidepressant working of buprenorphine.

Buprenorphine is different from most opioids, as they bind fully to the mu-opioid receptor. Buprenorphine binds only partially to the mu-opioid receptor and antagonises the kappa-and delta-opioids receptors.

Still, this does not mean that it is impossible that the buprenorphine made keiralee feel low. We all react differently. Keiralee, only stopping the buprenorphine (temporarily) will ‘prove’ whether it is indeed the buprenorphine that makes you feel depressed. The thing is that you need something else to address the RLS. Would it be an option to get methadone or Targinact (oxycontin with naloxone) during that time? My doctor (neurologist) and I are always hesitant to address negative aide effects with another strong medicine. They all have their side effects. It is a difficult situation, though, as I understand the buprenorphine is effective for your RLS. Hopefully the higher dose of Trazodone works sufficiently. If not, do discuss your options, the consultant seems willing and knowledgeable enough.

[SueJohnson in reply to LotteM]

You are right. In general opioids can cause depression which is what I had in my notes but in checking buprenorphine can have the opposite effect.

[SueJohnson]

Another possibility is to switch to Suboxone which contains Naloxone which may help to counteract the depression. Discuss this with your doctor.

[SueJohnson]

There are also 2 other antidepressants you could try. Nortriptyline and moclobemide.

[Eryl]

RLS is most commonly caused by neuroinflammation caused by foods in the diet and Buprenorphine does not address this, it merely attemps to dampen down the signals. Neuroinflammation can occur in every nerve in the body including the brain which manifests itself as mental health problems like depression.

The answer is not medication but a change to your diet. youtu.be/79ysr0JEUyY?si=owq...(Not working as expected?)

[DicCarlson in reply to Eryl]

This dovetails with Dr. Chris Palmer's book Brain Energy - fascinating investigations for mental health. Mostly improving mitochondria effectiveness with a Keto diet.

[keiralee]

Thank you everyone

[Biscuitface]

I had depression with Buprenorphine initially. Dr Buchfuhrer advised Pregabalin 25 to 50mg daily. This did help.

[Shumbah]

Dr Glen Brooks who started this ball rolling for us with Buprenorphine owns a Ketamin clinic he treats people with PTSD , major depression and people who Ketamin does not work for he uses Buprenorphine in high doses and 3 times a day and gets good results with depression.

I do believe that when we get out RLS under control with Bup that our body sometimes demands a bit of pay back for what it’s been through

Some people will sleep for 6 months and yes perhaps you may feel down and perhaps for 6 months .it may be an adjustment period.

But then again we are all so unique and you are the second person I have ever heard of who has said they feel this way on Bup.

I’m so very sorry if this is the case for you😟

[keiralee in reply to Shumbah]

Thank you

[Typicallygaslit]

I tend to react the opposite to ‘most people’ and so I also get depression from Buprenorphine. This was worse while I was on HRT (estradiol). I also try and find ways of cutting it down as much as possible as it also tends to keep me awake at night. It makes me feel quite energised and jolly to begin with but then I get depressed in the day time. I think it’s ridiculous to say that something ‘can’t’ cause a certain side effect as we all have our metabolic issues. I wouldn’t take a serotonin agonist on top as I have noticed that I’m prone to serotonin syndrome. You might like to look it up and check the meds that are black listed for this problem because you just might be like me and get more issues the more of these drugs you take. It’s most common drugs in fact.

[keiralee in reply to Typicallygaslit]

Thank you

[Trish8433]

I have had rls for 40 years and interestingly have had depression for most of that time. I finally came off pramipexole earlier this year and have now settled on 0.6mg of buprenorphine daily. I take nothing else. I ,for the first time in many years feel normal. So amazing to not feel depressed. I was prescribed anti depressants earlier this year, they helped for a short while then seemed to have no effect.I can't believe how normal I feel. Sometimes get slight breakthrough rls but nothing that a bit of walking won't fix.

I guess we are all different.

Like others, I would not have survived without the support and guidance on this forum. THANKS ALL.

[keiralee in reply to Trish8433]

Thank you