Case Report: Buprenorphine-A Treatment for Psychological Pain and Suicidal Ideation?

BACKGROUND AND OBJECTIVES Buprenorphine is commonly used to manage opioid use disorder; however, the literature describes its potential role in treating treatment-resistant depression. METHODS We present a patient with bipolar disorder and opioid use disorder, who presented status post-suicide attempt. RESULTS After initiating buprenorphine-naloxone, the patient reported rapid improvement in depressive symptoms, pain, and suicidal ideation. DISCUSSION AND CONCLUSIONS This case demonstrates buprenorphine's antisuicidal and mood-stabilizing capabilities, potentially via antagonizing κ-opioid receptors as well as reinstating the balance between reward and antireward circuitry. SCIENTIFIC SIGNIFICANCE This case highlights buprenorphine-naloxone as a treatment for both treatment-resistant depression and opioid use disorder, as well as buprenorphine's rapid antidepressant, analgesic, and antisuicidal effects. (Am J Addict 2020;00:00-00).