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Buprenorphine vs Naltrexone in Association with Depression-an Open Label Comparative Study

Insha MK, Neelofar J

Background: Buprenorphine is a partial mu-opioid agonist and kappa antagonist, whereas Naltrexone is a competitive μ receptor antagonist. Buprenorphine’s partial agonist activity can induce withdrawal in opioid dependent patients by displacing opioids from the receptors. It is administered sublingually, sublingual, whereas Naltrexone has a greater affinity for μ receptors than heroin and other opioid agonists. The therapeutic goal of using buprenorphine and naltrexone is to eliminate illicit opioid use and improve treatment retention. Our study was aimed to find any association between Naltrexone and buprenorphine treatment and depression in opiate-dependent individuals, who have been started on naltrexone and buprenorphine maintenance treatment.

Results: Our study shows that at 2, 4 and 6 weeks depressed mood was significantly higher in the Naltrexone group than in Buprenorphine. Insomnia, Psychic and somatic anxiety and Hypochondriasis, Gastrointestinal symptoms was found to be significantly higher in Naltrexone group than in Buprenorphine group. Buprenorphine was found to have a antidepressant action.

Conclusions: From our study, we concluded that Naltrexone was associated with Depression with higher HAM-D scores whereas Buprenorphine was associated with improved HAM-D scores.