My depression is being treated with Suboxone...

[somanysymptoms121]

I have severe depression and anxiety...both of which are treatment resistant. The physical and mental symptoms of my anxiety and depression are horrible. I have taken almost every single anti-depressant and anti-anxiety medication out there...SSRIs, SNRIs, atypicals, etc. My internist actually has noted that I am allergic to a number of SSRIs because of the extreme aggression and disorientation it they have caused me.

So I have mostly just gotten by with benzodiazapines (typically clonazepam, sometimes xanax), however I have been very careful with these drugs. I only use them for severe panic attacks...like when I feel like I need to go to the ER etc. I have read many horror stories about withdrawling from these medications which keeps my use to a minimum. (I take 1mg when I have an extreme attack, which is maybe 2-3 times a week...I don't think I am at risk for addiction...however I think I probably do have some mental dependence. It is the only medicine that has worked for me, so I am sure I would be pretty scared and uncomfortable if I didn't have it on hand.)

For a long time, overall I have grinned and bared it when it comes to the depression. I have taken a pretty holistic approach, using occassional counseling (sometimes I feel like it makes me worse), excersize, diet, massage, friends, and family to try to feel as good as I can. I am in my mid 20s and I honestly the majority of my waking moments have been disguised misery. And basically after college my ability to disguise my illnesses became impossible and my depression became incredibily severe. The physical symptoms got incredibily intense...stomach issues, back pain, severe weight loss, etc. Basically, I could not function anymore and it scared the hell out of me. It was the most hopeless feeling I have ever felt in my life.

So I began seeing a psychiatrist in the new city I live in and again we tried a couple of the usual medications. I tried Wellbutrin again(caused disorientation, shaking, increased anxiety) and then Zoloft again(caused extreme aggression, confusion, muscle tension/clenching).

Eventually, he suggested using a very low dose of Suboxone. That although it is primarily a medication used to treat drug addiction, it is also shown to be a useful anti-depressant. At this point I had lost 20 lbs, was not eating, working out, not talking to anyone, incredibily physically ill everyday..specifically in the morning....I was willing to try anything.

He prescribed me 1mg per day. It is a 2mg pill that I break in half and dissolve under my tounge. Needless to say, the medication gave me relief. I was pretty snowed for the first two days...not sure if it was the medicine or me just being exhausted. I have been on it for about 2 weeks now with pretty much no side effects. It has done wonders for my anxiety and a lot for my depression.

I have done my research and really grilled my doctor about the drug. I realize there is addiction potential because it is a synthetic opiate, which makes me a bit nervous since I am supposed to take it daily.

I know this is more of a mental health related post, but the substance abuse community seems to know everything about Suboxone. There are so many mixed reviews...I guess at being 2 weeks in I am looking for any knowledge. I don't want to have to increase my dose(doc said I wouldnt have to if I took it as prescribed) and I don't want to become dependent to a point where I feel sick if I don't have this medicine.

I know I gave a pretty long explanation of my story here...I figure the more people know...the better able they will be to give advice. Any comments are welcome...positive or negative. Suggestions, ideas, advice, anything. Thanks.


BTW...I am really impressed with this board...you all are very supportive of one another.

[Sithtiger]

It's sad and really is horrible that Opiates don't work for depression because they make us feel SOOO good, or so it seems.  Opiates really are like the Matrix (if you will).  They're not real!  If you could go back, would really want to?  I think most of us including myself would say yes, but there's a catch.  Even if it didn't hurt us mentally and physically, we would be slaves to the drug.

I do believe that someday there will be a 'magic pill' of sorts that will almost instantaneously heal us or rather covert our brain chemistry back to where it should be without any side effects.  Unfortunately for us, that may not be in our lifetime, so we're gonna have to bare the burden ourselves.

Scientists are changing their minds about the brain.....that is that once they thought an adult brain couldn't be changed....it couldn't be reprogrammed, but now they're seeing that it can.  With the help of drugs I think we can reprogram ourselves.  No, it won't be easy, but it can be done.  We just have to believe that it can!

[Mercedes175]

I also want to add that anti-depressents come with severe withdrawals and side effects that can last months..usually don't even kick in till atleast 3months post stopping.  You described yourself more depressed and agitated..typical withdrawal and side effect of an anti-dep that is stopped or isnt jiving with you.  Happened to me.

And, the fact your depression may be from the withdrawals from all these other meds you were taking..not your origingal depression is accurate.  

My point is, have you ever gone a good 6months with nothing?  Otherwise your symptoms could be just anit-dep withdrawals ..these drugs are not given enough credit for withdrawals on their own...head meds do have withdrawals..and anti-dep have long half lives so I could see you thinking it was was just "you" months later feeling depressed and anxious.

I think giving you sub is a mistake too. It is an opiate.  I suffer from depression too...but that is why I am here.  Loved the Tramadol when it was prescribed for me for sore throat.  My doctor actually allowed me to take it later when I asked about the "anti-dep" useage...I too hated all the anti-depressents..made me anxious, irriatable, insomniac...panic attacks..same as you.  BUT, the trams...wow..felt "complete"...slept better, had more energy...

Fast forward now a few months ahead...I have headaches now (didnt used to have)..feel fog heady 90% of the day..wake up with absolutel horrible flu like pains...just last night I left the house only once to take my daughter to soccer practice..got really sick in the car and came home and upchucked..had nothing in my stomache.  I feel like everyone warned me this has hit its own plateau.  Also when I run long between doseages..especially in mornings...I go through withdrawals.  My reality..I now know my depression will be worse when I stop..never had all these aches and pains before...

I have not stopped yet but plan on after the holidays..but just wanted to be real with you.  Sub is not a good route.

You are young..in your 20's...you need to go deep with yourself and God and get to the heart of "you"...no drug is going to turn you around..  We do this step in AA called the 4th step...it is amazing.  You should look into a 12step group...I know I got over alcohol abuse through this and realize that all my issues were deep ingrained in my way of thinking.  My prayers are with you.

This drug I am on I am dependent because it is making me sick..but do have a head start on recovery already due to my involvement with AA (my 12step group.)...I thought it was ok being my dr gave it to me...thought it was non-addictive..big mistake.  All opiates are temporary.

[mtgoat911]

so i have actually had this post on my mind for days
i asked several professionals if they would consider using sub. as a tx for depression, all work with this drug or in the mental health profession, all said no
i wanted to make sure before i posted again
sub. is not approved as a tx for depression
i told them of the journals i have read on the internet, but i already know that you can find anything on the internet, if your looking to justify using sub for depression, it will be hard to convince a reputable doctor, but not difficult to find a case study on the internet
if someone reads this post and is suffering for depression, please do not consider sub as an option,
not all people are born with the disease of addiction, some people are born with depression and get hooked, others may live drug free for decades and then get in a car wreck and become chemically dependant on the pain meds
the patient who started this thread is on 1mg of sub now, but in a few months she/he will need more, eventually the patient will become dependent and we all know how diffucult an addiction to sub can be
please re-read sithtigers post, the drugs work for a little while, then they turn on us
now we are stuck not only with the depression we have developed an addiction
this is a recovery forum, we must maintain and atmosphere of recovery, i would never suggest that anyone take sub. for depression, because the risk will never out way the benifits
there are so many of us who have actually done this
we have taken opiates for depression
it just doesnt work,  in the end it caused us great harm
i hope that somanysymptoms comes back so we can tell her where to turn for help with this depression so many of us have delt with

[Sithtiger]

If I would have read this a year ago or even up to only 6 months ago, I would have agreed 100% with you.  It's odd the way talk about your depression because you're the only person that I've seen that describes depression the way that I do.

Ironically, I was treating my Bi-Polar/PTSD with Vicodin.  I started out taking only 2 a day then 4 then I was up to 60+ a day a few months ago.  I'm detoxing right now and I'm entering day 7 without Vicodin.  I've been on the stuff for over 14 years!  I took the 5/500's.  

For some reason, the Vicodin seemed to stop working.  I was so sure it was helping me and perhaps it was for a while but just a month or so ago, I started getting nausea everytime I took some Vics.  Also as I look back, there are periods of time in which the Vics didn't do a darn thing.  

I can't say I know exactly how you feel, but I can say that it's sounds very similar to the psychological pain that I have.  Like you, I've tried about all the new and old anti-depressants and nothing has worked.  I think you'll find in the long run that all opiates seem to work at first, but they're just really covering it up.  I know you're thinking....so what.....anything to relieve my pain.  That's what I was thinking this year after I started seeing a psychiatrist again and she kept saying that it's not really helping you.

I don't think mine will be cured either by any meds, but little by little.....and I do mean little....I'm slowly getting stronger.  You need to get off the Sub and try to deal with your emotions without opiates.  I can't believe I'm actually saying it, but I believe the Vicodin that I've been taking up until 7 days ago was hurting my mentally and physically.  

I imagine though that you won't stop until you see that it's actually hurting you.....that's the way it was with me.  Anyway I'm just trying to save you from future pain.  There's nothing worse than running out of your drug of choice.  I hope you find something that helps you.  If you do, by all means message me!

[Tuck24]

Also here is a study they did a few years ago..........Vance.

Methadone And Morphine in Depression
Irl Extein, M.D.,1 David Pickar, M.D.,2 Mark S. Gold, M.D.,3 Philip W. Gold, M.D.,4 A. L. C. Pottash, M.D.,1 Donald R. Sweeney M.D., Ph.D., 1 Richard J. Ross, M.D., Ph.D.,4 Robert Rebard, M.D.,5 David Martin, B.A.,3 and Frederick K. Goodwin, M.D.4


Fair Oaks Hospital, Summit, New Jersey.
Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, Maryland.
Psychiatric Diagnostic Laboratories of America, Summit, New Jersey.
Clinical Psychobiology Branch, National Institute of Mental Health, Bethesda, Maryland.
Department of Reproductive Medicine, University of California


There has been much interest in recent years in the possible role of endogenous opioid peptides (endorphins) in depression (1). The high concentrates of opioid receptors and endorphins in limbic and hypothalamic regions, and their interaction with noradrenergic and dopaminergic systems, suggests involvement of endorphin systems in depression, as do certain clinical observations. These include anecdotal reports from the prepsychotropic era of the efficacy of opiates in depression, the appearance in some detoxified opiate addicts of depression responsive to opiates and antidepressants (2), and reports of improvement in some depressed patients following beta-endorphin (3). These observations, as well as the euphoric, analgesic, and calming effect of opiates, suggest that decreased functional activity in endorphin systems may be involved in the pathophysiology of depression.

In order to test this endorphin hypothesis of depression and to explore the possible efficacy of opiates in depression, the investigators administered single doses of methadone and morphine to depressed patients. Clinical and neuroendocrine responses were measured.

All subjects gave written informed consent to participate. The first experiment was an open investigation in 10 patients with major depressive disorder by Research Diagnostic Criteria (4) (9 unipolar, 1 bipolar; 5 male, 5 female; mean age = 44 ± 5). The control group was comprised of two normal volunteers and four inpatients with personality disorders (2 male, 4 female; mean age = 33 ± 8). Patients with recent neuroleptic use were excluded, and patients received no medication except flurazepam for at least 1 wk prior to the study. After an overnight fast, subjects were at bedrest for placement of an indwelling venous catheter through which 5 mg of morphine were infused at 9:00 a.m. Samples of blood were obtained via the catheter before, and 30, 60, 90, 120, and 180 min after, morphine infusion for assay of serum prolactin (PRL) in duplicate by radioimmunoassay (5). Each subject filled out an adjective checklist self-rating scale before the infusion and at the time of each blood drawing.

The second experiment was a double-blind, placebo-controlled investigation in six inpatients with major depressive disorder by Research Diagnostic Criteria (4) (2 unipolar, 4 bipolar; 2 male, 4 female; mean age =48 ± 4). None of the patients received any active medication for at least 2 wk prior to the study. Patients were at bedrest after an overnight fast for placement of an indwelling venous catheter through which 5 mg of methadone or saline placebo were infused at 9:30 a.m. Samples of blood were obtained in four of the patients via the catheter 60, 30, and 0 min before, and 15, 30, 60, 120, and 180 min after, the infusion for assay of plasma PRL and cortisol by radioimmunoassay and competitive protein binding, respectively. Clinical assessment was performed by Brief Psychiatric Rating Scale (BPRS) and NIMH self-rating scales before, and 15, 30, 60, 120, and 180 min after, infusion.

FIGURE 1. Effects of 5 mg intravenous morphine on self-rated mood in patients with major depressive disorder and controls.

FIGURE 2. Effects of 5 mg intravenous morphine of serum prolactin in patients with major depressive disorder and controls.

In the first experiment, morphine infusion produced only small nonsignificant antidepressant and antianxiety effects in both the depressed and control groups (see Figure 1). Baseline PRL (mean in ng/ml ± SEM) of 10.5 ± 1.9 for depressed patients and 9.0 ± 1.4 for controls did not differ. D PRL (peak minus baseline) of 7.2 ± 2.7 in the depressed patients was lower than that of 31.9 ± 9.5 in controls (p<0.01 by two-tailed t-test; see Figure 2).

In the second experiment, all six patients correctly distinguished the active methadone from the inactive saline infusion. Three of the six reported themselves "better" two the "same," and one "worse" 30 min after methadone infusion, whereas all six patients reported themselves the "same" 30 min after saline infusion. The methadone infusion produced little change according to BPRS and self-rating scales (see (Figure ). Methadone, but not placebo, produced large increases in plasma PRL (see Figure 4). Serum cortisol 180 min after saline infusion was significantly lower than cortisol 180 min after saline infusion (p<0.01; see Figure 5).

The well-documented increase in serum PRL produced in normals by opiates and endorphins is thought to be mediated in part by inhibitory opiate receptors on dopaminergic neurons (5-9). The blunted PRL response to morphine in depressed patients may be related to subtle changes in baseline PRL secretion or diurnal pattern and may reflect changes in endorphin, dopamine, serotonin, or other neuronal systems. This blunted response is consistent with an opiate receptor deficit, or presence of excess of an endogenous opioid antagonist, in major depressive disorder. The elevation of PRL in depressed patients after 5 mg of methadone, which is about twice as potent as morphine, suggests that depressed patients are not refractory to the neurodendocrine effects of opiates but may require a higher dose to achieve the same effect as in normals. The decrease in plasma cortisol following methadone is interesting in view of the known hypercortisol secretion in depression. Since ACTH and beta- endorphin have a common precursor (1), methadone may exert a feedback inhibition on ACTH and cortisol secretion.

FIGURE 3. Behavioural effects of 5 mg intravenous methadone and placebo in patients with major depressive disorder.

FIGURE 4. Effects of 5 mg intravenous methadone and placebo on plasma prolactin in patients with major depressive disorder.

FIGURE 5. Effects of 5 mg intravenous methadone and placebo on plasma cortisol I patients with major depressive disorder

[Tuck24]

Also remember this, and don't get frustrated but sometimes the depression comes back with more severity after you stop suboxone/methadone.......just talk to your physician about it......Good Luck.

[Tuck24]

Goat.....Methadone is given for Depression. Go to the New England Journal of Medicine and you will see. Also Hydrocodone minus tylenol is given. just because we disagree with it does'nt make it wrong. Am I wrong? Are any of us Physicians here or know more than a Physician. My Dr. years ago, after round of anti-depressants told me to take my lortab instead, but I never took it as prescribed knowing I would get more from him. If you don't have the addictive gene you can't be an addict, those are Dr. Drew's words not mine.

[morganave]

Remember,even though you are worried  about becoming addicted to the sub, it maybe the releif you need right now so you can feel normal, and then you can talked to your DR and get you depression under control.  Worry about one thing at a time.  I am thinking about getting the sub from my doctor.  I took one/half of a sub and never felt more normal in my life.  I might have to weigh which is worse, the constant pain and hunt for meds, or finally getting the monkey off and out of my life for good.

[mtgoat911]

your doctor could loose his/her medical license for perscribing sub for depression
you are doing a ton of self medicating, i suggest you start working on the root problems
i can really relate to you saying that you have felt like you have being going through wd's all your life
i started have anxiety attacts very young, i remmeber not being able to sleep, being depressed and in pain, physically and emotionally
did your doctor or therapist suggest a 12step program, if you can try na,
atleast check out EA
your need help with your emotions
using narcotics for your problems is a feeding your problems

there are safer meds you can take, not sub or xanax

you know that the sub is helping, but are afraid of getting addicted
i have read several studies and taken several poles
people who enjoy opiates, such as suboxone, do not do well with zoloft/welbutrin/sris
people who were addicted to speed do well with welbutrin, its a speedy anti-depressant
i can suggest several non-narcotic medications that could help you, but i feel that your shrink needs to do that

were you ever an opiate addict? so now are they going to be giving mental illness patients sub?
thats no different than giving methadone to depressed patients,
this is way outside the legal standard of care for suboxone
if there anything you are leaving out?

wish you the best, i am very blunt so dont take anything i say or ask in the wrong way

[somanysymptoms121]

I think Im gonna take a break and see if I have any issues. It has been 16 days at 1 mg...should I expect any issues?

[somanysymptoms121]

Positive or negative...I appreciate any feedback.

[cattalina]

Wow wow wow... I'm shocked that a doctor put you on sub for depression/anxiety. Honestly I can't believe your doc can legally prescribe that for you... I suppose that's just how the system works tho. I've been on sub for quite some time and have found that it does not help with depression one iota. As a matter of fact - the longer I'm on it the worse the depression gets. I agree with ochooked --- arm yourself with knowledge that'll be your best defense against the sub. Alot of us were bamboozled into thinking there were little to no negative side effects and there is MANY negative side effects. My personal opinion is that you shouldn't be taking it for the symptoms you described. Although what you suffer from may mirror drug wds, it's not drug wds and you're not an addict, according to your story. It's inevitable that your body will grow a dependency to the sub and the mental addiction will occur much quicker. So essentially you're starting this NOT an addict and at some point you will become an addict. Even at .5 or 1mg/day physical/mental addiction/dependence will happen. I'm sorry to be the only one with negative feedback but this just doesn't seem right. I don't know exactly what your situation is but from what you described it's horrible and I feel for you. But IMHO suboxone/subutex is a bad idea. I'm not a doctor, so this is just my opinion, but if I were you I'd go see different doctors/therapists etc and find another way to get relief. There has to be other options for you than sub. Even tho you're not starting off as a drug addict you will suffer from the same side effects as addicts do while taking it and trying to come off of it. Please gather the knowledge that this site has to offer and consider continuing to search for a better option. Also - there is no generic for suboxone/subutex and the price is basically the same for both.

[snowflake620]

yes especially with the b-12 and b-6 and 5htp,they have all but alleviated all of my symptons and I have only been taking them for about 10 days,for me they are a lifesaver.
snowflake

[somanysymptoms121]

Even at the dose I am taking? .5-1mg? I did more research and am realizing that I was mistaken before. There are people that start at up to 30+mgs due to opiate tolerance. Do you think me taking .5mg (1mg/day at most) for a year would create the same WD problems as someone who started at 32mgs and tapered down over a year?

The stories I am reading are pretty scary. However, the physical and mental symptoms of my depression and anxiety are pretty much the same as drug withdrawls. Until I started the 1mg of Suboxone a day...I have been severely depressed, exhausted, anxious, had diarhea and vomiting daily, constant aches and pains for years and years.

So its kind of a catch 22.

I don't know. It helps so much and its been such a long painful road. Reading all this just makes me uneasy about it. I can't find very much information about it being used as an anti-depressant anywhere...which worried me even more now.

[ochooked]

Wow!!!  I can say I am amazed at your doctor giving you Suboxone for you problems.  I do hope it works for you but just to be armed with knowledge I would suggest you go to the Health Pages - (upper right had side of this page) and look for a post titled "Members Experiences Coming off Suboxone" --- it may help you decide on how much and how long you will stay on Sub.  I guess the best way to tell how it is affecting you is to stop taking it and see what happens after 3 or 4 days --- if nothing happens then you may be safe ---  I would sure recommend caution though.  Many doctors do not fully understand just how powerful Sub is or how to correctly dose it ---  I would say that most people on this site do not think of Sub as a good way to come off Opiates except in the case of Heroin --- It just has such a long half life and stays in the body for so many days after you quit.  Wish you all the best.

[somanysymptoms121]

I have not really tried any supplements aside from typical vitamins. Have you noticed a big difference with the products you use? Specifically for physical issues, mainly stomach and exhaustion? Thanks.

[somanysymptoms121]

Thanks...I appreciated the quick response.

I am fearful of dependence, however, my doctor doesn't think I have too much to worry about being at 1 mg. I have read the descriptions of opiate withdrawl...ironically enough, the symptoms are pretty much a description of how I have felt my entire life. Which is kind of sad, but true.

Ultimately, I feel like it is alleviating my stomach problems(which are horrible), my aches, and my exhaustion. It really is an incredible relief. And with the success I have had thus far, I do think I will probably continue to take it indefinitely.

My doctor did warn about the potential of feeling a "high" from taking the medicine. I don't think it gave me a high, although it did kind of knock me out when I took the 1mg the first few days. I may just try taking .5mgs and see if that is enough. I am really sensitive to medications...I thought I read that someone was taking 20mgs...but it must have been 2.0mgs. Must have misread it.

One last question... I read that Suboxone and Subutex is the same except Suboxone has an extra ingredient that blocks the ability to inject it, which is supposed to prevent abuse. I am wondering if there is a price difference between Suboxone and Subutex. I would rather have Subutex if it is cheaper because I am not being treated for addiction. I could not find any concrete prices for Subutex. Also, does anyone know if there are generics available? It is an absurdly expensive drug...I was blown away when I saw the price. Overall...its worth it, I would probably pay more for the amount of relief it gives me...but I am still curious. Gotta try to save money where ya can these days right?

Thanks again.

[snowflake620]

have you ever tried amino acids to help with your anxiety and depression? i a;so suffer from depression and have been on many antidepressants with no good results but since taking the aminos 5htp and L-theanine i am like a different person?they are all natural so no side effects or withdrawal.
snowflake

[wannabefree330]

Sub has several benefits that are not listed as indications for usage.  It also helps many people with chronic pain....although it is notindicated for chronic pain.  Many usages are found out by people taking a drug for one reason, and they find it either helps in other areas, or hinders in others.  I am glad it is working for your anxiety and depression.  I am assuming you will be on long term management since you have tried so many other drugs and they have not helped, or you are allergic. Not sure if you will reach a level of tolerance when using it for your issue.  If you do take it for a long period of time and decide you want to stop, you will have to wean off of it very slowly.  It will cause w/d even at low doses.  Doesn't mean you cannot stop taking it, just means it will take a long time to taper.