Does Suboxone cause depression?
Using opioids can be depressing. In the beginning, they solve a problem. If you were prescribed opioids for pain, you may have been happy to find a solution to make your pain more tolerable.
For many people who take opioids for pain, the medications work without any serious long term consequences. Yet, a certain percentage of patients who are prescribed opioids will develop a psychological dependence on their opioid medication.
Being addicted to opioids is very different from being physically dependent on them. Most patients will develop a physical dependence if they take opioids long enough.
Physical dependence on opioids is different from being addicted.
Physical dependence means that if you stop taking opioids, you will get physically sick. However, if you have a physical dependence on prescribed opioids for pain and you are not addicted, you will function normally when you take your medication as prescribed.
If you are addicted to opioids, even if you are taking them every day, you will experience an ongoing, never ending obsession with the drug. You will feel a compulsion to take opioids, even knowing that they are causing you harm. Opiate and opioid addiction is a severe form of psychological dependence that can be life threatening.
Suboxone’s main ingredient is buprenorphine, which is technically an opioid. Yet, it has unique properties that make addiction to buprenorphine very unlikely.
Addiction hijacks the reward center of your brain.
Being addicted to opioids is depressing because addiction hijacks your brain and traps you in your own mind. You know that you are hurting yourself and your loved ones, but you cannot stop. In the beginning, before addiction, opioids may have been emotionally uplifting for you. Now, being caught in the endless cycle of active addiction, you are likely depressed about your situation.
Suboxone treats opioid addiction. When you start taking Suboxone, you are able to start functioning normally again. The constant obsessions and compulsions fade away.
Suboxone and depression. Overcoming opioid addiction with treatment can lift your mood.
For many people, Suboxone makes depression better. Your depression may not go away completely with Suboxone treatment, but it will likely improve.
Is the reason for Suboxone treatment helping with depression because it treats addiction and blocks addictive feelings and cravings? It makes sense that making a positive move forward in your life would help to make you feel less depressed.
If you are in a Suboxone program to help treat your opioid addiction, you are most likely going to feel good about yourself. You can, for the first time in a long time, have hope for the future.
Interestingly, if Suboxone helps with your depression, it may be due to more than just improving your life. Suboxone may have a direct effect on your brain to reduce depression.
Opioid receptors and depression. What is the buprenorphine kappa connection?
We often imagine that opioid receptors are all the same in the human body. Opioids travel to the brain and bind to these receptors, causing various effects. This is an oversimplification. There are actually several different kinds of opioid receptor.
Buprenophrine works on three different kinds of opioid receptor. It is a partial agonist at the mu receptor and an antagonist at the kappa and delta receptor. When it comes to depression, the kappa opioid receptor is where things get interesting.
It turns out that blocking the kappa receptor has a positive effect on depression. Drugs that are kappa opioid receptor antagonists tend to have an antidepressant effect. Suboxone contains buprenorphine, which is such a drug, blocking the kappa receptor.
Buprenorphine, a mixed partial agonist/antagonist, is a very unique medication.
Opioids that stimulate the kappa receptor, or kappa opioid receptor agonists, may make depression worse. So, if you are addicted to opioids and depressed, it could be partly due to a direct effect of the opioid on the kappa receptor. For example, this could explain, in part, why people addicted to oxycodone often feel depressed.
Buprenoprhine, on the other hand, blocks kappa receptors. Therefore, Suboxone treatment can be an effective treatment for depression for some people. At this time, however, it is unlikely that any doctors are prescribing Suboxone for depression.
Since many patients who take Suboxone for opioid addiction are depressed before starting Suboxone therapy, we are able to see how well the medication helps with depression. Studies have shown that it works. Suboxone can function as an antidepressant in addition to being an effective opioid addiction treatment.
Does this mean that patients who are prescribed Suboxone do not need antidepressants?
While Suboxone does help many patients with depression, it is not a perfect solution. It may only relieve depression symptoms slightly, or for some patients, it may not help at all.
Because of this, it is not uncommon for patients who take Suboxone to also have a prescription for an antidepressant. Still, the Suboxone may give an additional boost, providing more relief from depression than the patient would have had with only the antidepressant.
Does Suboxone cause depression for any patients?
While Suboxone works great for treating addiction and it also helps some patients with depression, there is one situation where Suboxone can lead to depression. This happens, in some cases, when you have completed your Suboxone treatment and you are ready to stop taking it.
Suboxone causing depression as part of the suboxone withdrawal that occurs after treatment is not uncommon. An important thing to keep in mind is that, if you feel depressed after stopping Suboxone, it does not mean that you are addicted to Suboxone.
The withdrawal symptoms that occur in the days, weeks, and sometimes months after the Suboxone drop off, when the final dose is taken, are considered to be physical withdrawal symptoms. These symptoms may include mild to moderate depression.
What is the best way to prevent or reduce the severity of depression after stopping Suboxone?
Post-Acute-Withdrawal Syndrome (PAWS) is a set of symptoms that can persist after you stop taking an opioid. Suboxone contains the opioid, buprenorphine, so it can also cause PAWS. How long does withdrawal last when PAWS is a factor? In some cases, these detox symptoms can persist for months.
One way to reduce the severity of symptoms, including chills, aches, anxiety, and depression, is to eat healthy and balanced meals. Taking brain-healthy supplements that provide precursors to important brain chemicals is a good idea as well. The withdrawal supplements that help the most are ones that help the brain to replenish important neurotransmitters.
How to restore dopamine receptors with dopamine brain food and other brain supplementation.
Neurotransmitters in the central nervous system can be relatively depleted. Taking supplements that include neurotransmitter precursors and cofactors can help to reduce the depression that may occur after completing a course of Suboxone.
Serotonin, dopamine, norepinephrine, glutamate, and GABA are examples of important neurotransmitters involved in mood and are important for healthy brain functioning. GABA and glutamate are even available as supplements in health food stores. Some people take GABA for sleep, because of it’s calming effect.
Avoiding sweets and sugars can help with the recovery process.
In addition to supplements to support brain health and brain chemistry, a healthy diet, low in sugar is also important. Scientists have demonstrated in studies that refined carbohydrates and sugars are inflammatory and harmful to the body when taken in excess.
In addition to eating a diet low in refined carbs, you should also eat fruits, vegetables, and lean meats. Healthy eating can make all the difference when it comes to Suboxone and depression.
Exercise is also critical to success in reducing the severity of withdrawal symptoms from PAWS. You do not have to spend hours in the gym to feel better. A moderately paced daily walk outdoors for 30 to 60 minutes will help you to feel much better.
You may also find that meditation and deep breathing exercises help as well. Mindfulness-related activities are an excellent way to improve your mental, emotional, and spiritual health. This will help you to feel better and handle the limited period of Suboxone physical withdrawal after completing therapy.
If I am depressed after I stop Suboxone, should I take Suboxone again to feel better?
At first, you may think the answer to this question is a clear “no.” How could it make sense to go back on Suboxone because of Suboxone withdrawal symptoms?
You might think that it is similar to drinking hard liquor in the morning to get rid of a hangover. Is it always the right decision to fight through the withdrawal symptoms and avoid going back to Suboxone at all costs?
In most cases, if you have completed over one year of treatment and you feel ready to complete therapy, you should be able to get through any physical withdrawal syndrome that may occur after you stop treatment. By eating healthy foods and taking supplements, exercising, and practicing mindfulness, you will feel much better as you work through the withdrawal period.
However, there are situations where going back on Suboxone may be the best decision. Not everyone will do well stopping Suboxone treatment after a specific time period. While at least one year of treatment is recommended, some patients will do better to continue treatment for longer, even indefinitely in some cases.
Weighing the pros and cons is always important when it comes to making important treatment decisions.
If, after stopping Suboxone, you begin to experience addictive thoughts and feelings, such as cravings for opioids, it may mean that you will do best to resume treatment for a longer period of time.
Going back on Suboxone does not mean failure. Avoiding a dangerous relapse on opioids by resuming treatment is a huge success. Often, when a patient does resume Suboxone treatment, they are able to take a lower dosage than what they were taking previously.
Naltrexone is an alternative to Suboxone for continuing medication-assisted treatment long-term.
Another option for dealing with ongoing symptoms of depression and persistent withdrawal symptoms from stopping Suboxone is to start taking naltrexone. Naltrexone is a potent opioid blocker that is also used to treat opioid addiction.
Interestingly, naltrexone also blocks the kappa receptor, so it may have a similar effect in reducing symptoms of depression. Another useful effect of naltrexone is that it reduces opioid cravings.
If you are interested in naltrexone as an alternative to Suboxone, it is important to remember that you cannot start taking naltrexone right away after quitting Suboxone. You will have to wait about two weeks to avoid the risk of precipitated withdrawal symptoms. Precipitated withdrawal means that you will experience opioid withdrawal symptoms right away if you start naltrexone too soon.
LDN is a novel therapy that may be helpful in treating depression, anxiety, and other conditions.
Naltrexone can also be used in another way for treating depression and other related mental health disorders. Low dose naltrexone, or LDN, is a therapy using a very low dose of the drug. Instead of 50 mg, it is prescribed in the range of 3-5 mg. For patients to get naltrexone at such a low dosage, they will often have to go to a compounding pharmacist to have it specially made.
LDN for depression may be effective for some patients where other treatments were not effective. LDN is proving to be effective for a variety of conditions. There is low dose naltrexone for fibromyalgia, and even low dose naltrexone for weight loss. It may also help with anxiety and OCD.
Suboxone and depression should not be a concern when considering starting Suboxone.
As I have discussed here, there is little to no concern about depression caused directly by Suboxone. The main drug in Suboxone, buprenorphine, has properties to improve symptoms of depression. Additionally, Suboxone contains naloxone, an opioid blocking drug.
While very little of the naloxone is absorbed into the patient’s system, we should consider the possibility that the small amounts of this powerful opioid blocker that do enter the patient’s central nervous system might have an effect similar to LDN.
More research will be necessary to assess if Suboxone helps more with depression and other conditions compared to buprenorphine alone, due to the addition of naloxone. The reason naloxone is included in the Suboxone formulation is as an abuse deterrent, to deter patients from shooting up their Suboxone with a syringe and needle. It would be interesting to discover that there are also therapeutic benefits to having naloxone in the mix.
Speak to your doctor if you are interested in learning more about life-saving MAT for opioid addiction.
If you are avoiding starting Suboxone treatment because you are worried about depression and other opioid withdrawal symptoms after you stop taking Suboxone, you should not be too concerned about this. Medication-assisted treatment (MAT) is life saving and is a much safer way to quit street opioids, compared to abstinence-based treatment alone.
Withdrawal symptoms after completing therapy can be managed with help from your doctor. In weighing the risks versus benefits of Suboxone therapy, the benefits often outweigh the risks by a significant margin. Depression should not be a concern to prevent you from starting Suboxone treatment.