Is Suboxone an Effective Treatment for Depression?
In the United States, clinical depression, or major depressive disorder, is among the leading causes of adult disabilities. For an average of 12 percent of those suffering with major depressive disorder, the condition is lifelong. Over 21 million people had at least one major depressive episode in 2021.
Depression is difficult to face each day, and even more difficult to overcome. Fortunately, certain medications are making it easier to manage the symptoms of depression. Most surprisingly, researchers are even exploring the use of Suboxone for depression.
For those unfamiliar, Suboxone was developed by medical scientists as an alternative to methadone. Suboxone is revolutionary because it combines a low-power opioid with naloxone, an opioid blocker.
Suboxone has saved countless lives and prevented many recovering users from relapsing. The power of Suboxone is that it helps people avoid uncomfortable withdrawal symptoms. Suboxone now has the potential to help people suffering from depression. For those with depression, Suboxone can help manage the difficult daily symptoms.
So, is Suboxone a good choice if you have clinical depression? How does Suboxone work? What is its potential for depression management?
What Is Suboxone?
Suboxone was created as an alternative to methadone, which is a highly regulated drug used in the treatment of opioid addiction. Methadone is effective when monitored by a doctor, but it is so restricted that people must go into a methadone clinic each day to get their dose. This is inconvenient and can be costly, which led to many people dropping out of their recovery program and relapsing on opioids.
When Suboxone was developed, scientists set out to make a safer drug. The goal was to create something people could pick up from the pharmacy and regulate themselves. Those scientists were successful. While you need a prescription to get Suboxone, treating an opioid addiction with Suboxone is a matter of picking up a prescription and self-administering.
The oversight of an addiction specialist is still important, even with a take-home medication like Suboxone. But Suboxone is far safer than methadone and other stronger alternatives. The way in which Suboxone works also shows promise for people with depression. That is why it is important to understand Suboxone’s primary components. Suboxone is a combination of two drugs: buprenorphine and naloxone.
Buprenorphine is a semisynthetic opioid. Buprenorphine results in very small amounts of opioids interacting with the brain. Like stronger opioids, buprenorphine leads to mood-lifting effects and relaxation. But buprenorphine has a low ceiling. This means the effects stop getting stronger even as a person increases their dosage, which helps discourage misuse.
Buprenorphine is known as a partial agonist, while heroin, fentanyl, and other opioids are full agonists. Both work by activating opioid receptors in the brain, which reduces pain and creates a peaceful, relaxed feeling.
While full agonists activate the receptors completely, buprenorphine only partially activates the receptors. So, buprenorphine creates a much milder stimulation. This makes it substantially less habit-forming and addictive.
The presence of buprenorphine in Suboxone allows individuals to gradually recover from an opioid habit while decreasing the severity of withdrawal symptoms. But the buprenorphine can still create an addictive high. Suboxone is particularly addictive for non-opioid users without an opioid tolerance. The addition of naloxone helps prevent misuse of Suboxone.
Buprenorphine only partially activates opioid receptors and has a “ceiling” to discourage misuse. The presence of naloxone in Suboxone further discourages misuse. If taken as prescribed, the naloxone remains inactive. This means the person experiences the mild mood-lifting effects of buprenorphine. But if Suboxone is injected (as drugs often are when being misused), the naloxone activates, blocking opioid receptors.
When naloxone blocks opioid receptors, the buprenorphine in Suboxone has no impact on the brain. The naloxone can also create uncomfortable withdrawal symptoms, like nausea and vomiting. These symptoms, in combination with the absence of opioid effects, make it impossible to misuse Suboxone via injection.
Understanding Depression in the Body
Depression is a complex condition that comes in many forms. One of the most severe types of depression is major depressive disorder. This condition leads to feelings of hopelessness, anger, and sadness that can persist for weeks at a time. Chronic depression (CD) can also affect day-to-day life. CD is characterized by persistent sadness with milder symptoms. But CD symptoms last longer than the symptoms of major depressive disorder.
Any number of things can cause depression. Causes include genetic predisposition, personal trauma, and stress. Ending a relationship, losing a job, or even having conflicts with friends and family can all bring on depression.
Certain medications, including those for high blood pressure, can also lead to depression. People experiencing depression describe their experiences as:
Constant sadness that is strong enough to get in the way of everyday activities. It can also block the enjoyment of hobbies to the point where a person stops taking part in those hobbies at all.
Occasional short bursts of energy. General periods of fatigue where a person feels hopeless, discouraged, or even frustrated.
Mood swings that range from overwhelming sadness to anger, which may or may not have a clear trigger. The anger may manifest itself in self-sabotaging behavior, verbal outbursts, or physical violence.
Suicidal thoughts. Can include both thoughts and actions, including self-harm.
The symptoms of depression can come and go with time, but one thing is certain: depression will not treat itself. At the very least, treating depression requires reflection. Talking about what contributed to the depression and what would help a person get through it is essential.
In most cases, medical intervention is necessary to keep the individual safe from self-harm. Intervention also helps them manage the symptoms that can get in the way of daily life.
For those suffering from depression, seeking help is a brave and wise thing to do. Common therapies for depression include one-on-one talk sessions and antidepressant medication. Unfortunately, for some people, depression therapies do not prove effective. So, the severe symptoms of depression continue. That is when alternative treatment methods, like Suboxone, may be considered.
Depression leads to feelings of sadness and hopelessness because of a lack of serotonin and/or dopamine in the body. These chemicals regulate everything from mood to appetite. So, a person can experience a range of emotional and physical changes when these chemicals are out of balance.
Suboxone shows promise because it directly interacts with the receptors responsible for releasing dopamine and serotonin.
Is Suboxone Being Used to Treat Depression?
For its original purpose as an opioid treatment, Suboxone is incredibly effective, and it has saved many lives. Of course, it’s important to realize that Suboxone can be dangerous. Suboxone produces very mild effects in someone recovering from opioid use. But Suboxone can become addictive for someone with no opioid tolerance in their system. That is why it is a Schedule III drug in the United States.
As a Schedule III drug, Suboxone is closely regulated and can only be legally acquired with a prescription. With that said, there are legitimate applications for Suboxone use, particularly in the treatment of opioid addiction. Still, it does have a low to moderate risk of creating physical dependence. Suboxone also has a high risk of creating psychological dependence. Dependence is more likely for those using Suboxone without a prescription. Dependence is also likely in those using Suboxone who have not misused opioids.
Because Suboxone has such a high risk for psychological dependence, the FDA has not yet approved it for depression treatment.
But if a person presents with both clinical depression and opioid addiction, they may be prescribed Suboxone. Suboxone is accepted as a treatment for addiction, and it might help depression. Meanwhile, if a psychiatrist can prove that no other depression therapy has been effective for a patient, they can recommend Suboxone for depression treatment.
Suboxone is an unconventional depression treatment option. The use of Suboxone for depression treatment has long been debated, and many professionals continue to advocate for its use. In fact, Harvard Medical School even conducted a clinical trial.
In Harvard’s clinical trial, they gave Suboxone to patients with nonpsychotic major depressive disorder. For these people, antidepressants, electroconvulsive therapy, and other standard treatments had not worked. The study ruled that these patients were treated “successfully” using Suboxone. So, they concluded a “possible role for buprenorphine in treating refractory depression” in the Journal of Clinical Psychopharmacology.
But that Harvard Medical School study was conducted in the mid-1990s, and Suboxone is still not approved by the FDA for depression treatment. The short answer is simple: Suboxone is not being used to treat depression — at least, not yet.
Can Suboxone Help Those with Depression?
Research has shown that both physical and mental pain is controlled by a single chemical system. This is further supported by the fact that general pain is a common symptom of severe depression. In response to these findings, medical scientists are working to develop a new medication. One that addresses both physical and mental pain, like Suboxone already does.
Suboxone impacts opioid receptors that release dopamine and serotonin. Dopamine and serotonin both occur naturally in the body. Dopamine helps regulate everything from rewards and mood to pain, pleasure, memory, and movement. Serotonin helps regulate mood, sleep, appetite, social behavior, and sex drive. It is helpful that Suboxone interacts with these neurotransmitters. So, many doctors support its use as an antidepressant.
Suboxone holds many potential benefits for those who have depression. The active ingredient (buprenorphine) is only a partial opioid agonist, so it quickly leads to an elevated mood. But a low ceiling prevents a strong or addictive “high” feeling. Still, Suboxone users have noted that activities and hobbies become more enjoyable.
Depression patients also tend to struggle with a sense of “normal,” due to deficiencies in dopamine and/or serotonin in their central nervous system. Suboxone can boost these two neurotransmitters, helping a person regain that inner balance. These effects alone would mark a major point of relief for those struggling with depression.
Suboxone impacts the receptors that help regulate relaxation and control anxiety. The active ingredient in Suboxone can help people with major depression and anxiety disorders cope with symptoms. We continue to learn more about anxiety disorder and its seriousness, like the fact that you cannot simply calm yourself down. So, partial opioid agonists like buprenorphine show great promise.
Thanks to all of Suboxone’s effects, the result is that patients begin to experience improved well-being. For opioid users, buprenorphine shows promise on a path away from stronger opioids. Plus, it minimizes withdrawal symptoms and helps a person enjoy their day-to-day lives again.
Theoretically, these same positive side effects can help someone with clinical depression. Suboxone can help a person overcome their symptoms and restore normality, pleasure, and balance in their lives.
Pursuing Suboxone for Depression Treatment
The FDA has not yet approved Suboxone for depression treatment. But more researchers are acknowledging its potential use case for depression symptoms. The primary area of research for Suboxone is as a therapy for people who have had no positive effects from traditional depression treatments.
For some medical professionals, the risk of Suboxone dependence far outweighs the strong depression symptoms that these “untreatable” patients experience daily.
To use Suboxone in this manner, patients would first have to meet a few requirements. The first step is proving that no other class of drug has been effective in managing symptoms. Also, it must be shown that other options, like talk therapy or electroconvulsive therapy, were not effective for their depression.
The patient would also have to be experiencing a severe depressive disorder. Additionally, symptoms have to be strong enough to justify a “last resort” treatment like Suboxone.
Severe depression symptoms may be enough on their own for those who have pursued all other treatment paths. Those people may be willing to try an unorthodox solution like Suboxone. But an even stronger case for Suboxone treatment is raised when a patient is showing serious red flags.
Flags include suicidal thoughts, substance use, psychosis, or hallucinations. Even in those severe cases, patients may not be prescribed Suboxone without a coexisting opioid addiction.
Ultimately, Suboxone has proved highly effective at fulfilling its original purpose — to manage opioid dependence and withdrawal symptoms. Now, it is being explored for yet another life-saving purpose and may one day be approved as a depression treatment.
For the time being, Suboxone is off-limits as a depression drug. Getting a prescription for Suboxone can be difficult even if a person is seeking treatment for an opioid problem.
The Risks of Suboxone for Depression Treatment
The sole reason why there is so much “red tape” surrounding the use of Suboxone in depression treatment is that it is a type of opioid. Although it is a partial agonist, there is a risk for dependence and habit formation. When looking specifically at using Suboxone for depression patients, some things must be recognized. For instance, while there are plenty of benefits, Suboxone is still very powerful and moderately addictive.
The moderately addictive qualities of Suboxone are minor. When compared to the severe side effects and extremely addictive qualities of the drugs that Suboxone is used as a treatment for. But people suffering from depression who’ve never had an opioid problem won’t have the same opioid tolerance. Someone with depression may find the peace and tranquility that Suboxone induces to be very addictive.
Also, Suboxone is not free from side effects, even when being used for its original purpose. Side effects vary from one individual to the next. So, there is no way to know just how powerful or effective Suboxone might be until a person begins taking it. Doctors must also consider the effects of ceasing Suboxone use. After all, withdrawal symptoms can occur when a person begins tapering off any opioid.
With all these considerations in mind, it’s easy to see why Suboxone for depression is still being researched. It is a potential treatment option, but not yet being pursued. The question of whether it could, should, or will be used in the treatment of depression remains unanswered. Researchers are still looking into the use of Suboxone for depression. Scientists are also exploring the development of similar medications for this specific purpose.
Suboxone Treatment Options
Suboxone for depression is not yet approved as an official treatment. But it is highly effective for those suffering from a substance use disorder. Suboxone may prove especially beneficial for those facing both a substance use disorder and clinical depression. If you find yourself in that situation, pursuing specialized help is the right way forward.
Treating a substance use disorder requires a personalized approach. This is even more true when a person is facing both substance use and depression at the same time. Depression and other mental health conditions can make withdrawal symptoms even tougher to face. They can also put a person at greater risk of using substances again.
Common treatment paths include inpatient and outpatient therapy. Both help manage symptoms and avoid relapse. Inpatient therapy is very intense and hands-on. Inpatient treatment is ideal for someone who does not have a strong support group at home. It is also fitting for anyone who needs the extra accountability. Being in a treatment center surrounded by caring professionals is very reassuring.
Meanwhile, outpatient treatment provides some added freedom and flexibility. It is great for an individual who has a support system to lean on, like family and friends. It is also good for someone who wants to continue taking part in work or other activities. Outpatient treatment makes it possible to continue attending work, school, and personal outings without interruption. At the same time, you are armed with the tools you need to overcome challenges.
There are countless other treatment paths a person may take, too. The answer depends on the situation and the severity of depression and/or substance use disorder. A partial hospitalization program (PHP) is one of those alternative solutions. PHP is more intensive than outpatient care, yet more flexible than inpatient care. No matter which recovery path you choose, treatment will always be personalized to your needs.
Are You Seeking Help?
If you are experiencing symptoms of depression or an opioid use disorder, reach out for professional help. With specialists by your side, you will be matched with the medication or therapy that is best for you. Personalized care ensures your health and safety as you take this brave step. Treatment will help you get through this difficult time and on the path to a brighter future.
Traditional depression therapies may or may not prove effective for everyone. The right team will help you pursue alternatives that are personalized to meet your unique needs. Those alternatives could include a combination of talk therapy, new medications, and general wellness and guidance to help restore the sense of joy and peace that you seek.