# buprenorphine (suboxone) for anxiety/terror/depression



## bben (Oct 24, 2009)

Buprenorphine is a partial opiate agonist, because of this it has opiate effects while not dramatically creating an opiate tolerance. Its also a kappa opiate antagonist giving it less sedation as well as super potent antidepressant effects. As an opiate is disinhibits dopamine in the ventral tegmental area creating pleasure as well as binding to gaba neurons in the raphe nuclei decreasing the firing of serotonin neurons and therefore lowering anxiety. Lastly, it dramatically lowers glutamate in several areas helping with analgesia and ocd in some. Most tests have showed opiates to have minimal to no effects on cognition, thats certainly more than almost any other anti-anxiety class of meds.

Its easier to get than benzos and ten times less addicting and probably 20 times safer. No one has ever OD'd on buprenorphine alone.

it should instantly cure in the majority:

treatment resistant panic disorder
very severe generalized anxiety
moderate-severe depression
some forms of OCD
chronic pain/ neuropathies
opiate addiction

Just know this is an option thats not talked about all that much. Several studies (google if you want them its a harvard study, or take my word for it )have shown it working in treatment resistant depression when even electroconvulsive therapy wasn't working.

I will answer any questions on buprenorphine.


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## T-Bone (Oct 1, 2010)

Ive always found opiates to be much more effective than other medications at curing anxiety temporarily, even more effective than benzos, probably because they cause you to release massive amounts of dopamine. I totally disagree however that opiates are less addicting than benzos. But i dunno, maybe theres a study somewhere out there...
I'm sure scientists have studied the effects of opiates on anxiety and came to the conclusion that it was just not worth the risk to perscribe them for that reason.
Suboxone was a miracle drug for me. If i hadn't known somebody who was getting it to overcome their heroin addiction, ID probably still be using heroin myself. It's still addicting, and you can get somewhat of a buzz from it. However you cant overdose on it, because with every dose you take, youre also getting the narcon that is ALSO in the tablet, which counteracts with the opiate itself. They really should just do away with methadone and start building Suboxone clinics imo.


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## broflovski (Feb 1, 2011)

Ok, I'm highly interested in this one (though only theoretically, cause it's not available there i am). The pharmacological profile (with delta-agonism and kappe-antagonism in one, plus partial mu-activation) seems very consistent. I'd like to know what sensations/feelings it induces. Is it much alike other opioids? Do you think it is better then, to say, tramadol?


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## T-Bone (Oct 1, 2010)

broflovski said:


> Ok, I'm highly interested in this one (though only theoretically, cause it's not available there i am). The pharmacological profile (with delta-agonism and kappe-antagonism in one, plus partial mu-activation) seems very consistent. I'd like to know what sensations/feelings it induces. Is it much alike other opioids? Do you think it is better then, to say, tramadol?


suboxone does produce euphoria, like all opiates. only difference is that suboxone also contains a drug called naloxone, which counteracts with the opiate effect. its probably not possible to overdose on it. buprenorphine itself it a very strong opiate. its the naloxone( or narcon, which they give to patients suffering from opiate overdose) that limits amount of euphoria and resperatory depression from the opiate. in fact, taking more than two tablets would probably have the same effect as taking just one.


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## broflovski (Feb 1, 2011)

SomebodyWakeME said:


> suboxone does produce euphoria, like all opiates. only difference is that suboxone also contains a drug called naloxone, which counteracts with the opiate effect. its probably not possible to overdose on it. buprenorphine itself it a very strong opiate. its the naloxone( or narcon, which they give to patients suffering from opiate overdose) that limits amount of euphoria and resperatory depression from the opiate. in fact, taking more than two tablets would probably have the same effect as taking just one.


Thanks for info. Is buprenorphine indeed less sedating than usual opioids? The most important thing is to be able to do intellectual work while on it. 
As for suboxone - there was a rather sophisticated discussion on it in Bluelight, and they state that naloxone only prevents IV abuse (that is crucial in replacement therapy) and not active orally (and buprenorphine has stronger affinity for mu than naloxone).


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## Noca (Jun 24, 2005)

Theres no generic pill form of this in the US and is extremely expensive brand name IV or pill form. I cannot find any information as to cross tolerant opioid doses in chronic dosing schedules for pain management. Anyone want to supply me with some?


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## bben (Oct 24, 2009)

Buprenorphine is 30-40 times stronger than morphine i have read. Its got a bell curve shaped effectiveness range, with lower doses (0.2-2 mg) acting as a full agonist and higher doses not showing a dose dependent increase in effect. 

A full dose of buprenoprhine aka like 24 mgs is still less potent than 30mg methadone.

They really don't have charts for conversions available...


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## T-Bone (Oct 1, 2010)

broflovski said:


> Thanks for info. Is buprenorphine indeed less sedating than usual opioids? The most important thing is to be able to do intellectual work while on it.
> As for suboxone - there was a rather sophisticated discussion on it in Bluelight, and they state that naloxone only prevents IV abuse (that is crucial in replacement therapy) and not active orally (and buprenorphine has stronger affinity for mu than naloxone).


Naloxone CAN prevent IV injection, for one reason....while taking naloxone, its nearly impossible to get any kind of high or rush from injecting/snorting/ or ingesting any opiate, in turn making it seem pointless to try. thats really it. it counteracts the opiod no matter wether taken before, or after opioid ingestion. so naloxone prevents much sedated effect of the buprenorphine (the opiate in subaxone), and also prevents any further opiate intoxication from more buprenorphine, or any other opiate after the naloxone is injested. this is why its given to withdrawling heroin addicts, so after they take the suboxone, they can do heroin, but it will have no effect on them.

being a former opiate addict myself, i often used opiates as a way of motivation during work and was able to function fine. but i was an addict for several years, the sedating effects normally subside and youre just finding a fix to feel normal, and a reason to go to work. but yes suboxone overall is less sedating than say, heroin, dilaudid, or oxycontin. i surely dont recommend opiates for depression or a pick me up, no matter how much they may help. just not worth it.


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## broflovski (Feb 1, 2011)

As I know, buprenorphine itself is enough to make useless taking of any opioid because of its extremely high affinity to mu-opioid receptor (it prevents any other ligand - including antagonist naloxone in some degree - from binding to receptor). Naloxone in suboxone is putatively aimed to prevent IV abuse of buprenorphine itself (and is not active orally). 
So you don't recommend even that kosher suboxone for depression? My opioid experience is limited to codeine and kratom, and I'm scared to go further.


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## Noca (Jun 24, 2005)

Oh and for folks thinking about using opioids for depression, chronic opioid use depletes testosterone levels which can in turn cause fatigue and depression in men.


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## T-Bone (Oct 1, 2010)

broflovski said:


> As I know, buprenorphine itself is enough to make useless taking of any opioid because of its extremely high affinity to mu-opioid receptor (it prevents any other ligand - including antagonist naloxone in some degree - from binding to receptor). Naloxone in suboxone is putatively aimed to prevent IV abuse of buprenorphine itself (and is not active orally).
> So you don't recommend even that kosher suboxone for depression? My opioid experience is limited to codeine and kratom, and I'm scared to go further.


buprenorphine itself has no effect on IV drug use directly, and naloxone doesnt either. as i said before, naloxone's effects on IV drug use is by counteracting the effects of all opiods, making it pointless to ingest any further opiates. it doesnt matter if the naloxone was was ingested by IV, or orally, any further opiate igestion will have little to no effect. methadone was once considered a drug you could not overdose on either, untill many people did, and died. naloxone is why this drug has many many benfits over methadone. i suggest you research it some more.
and no i dont recommend opiates for your depression or anxiety.


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## UltraShy (Nov 8, 2003)

The Milwaukee Journal last year did an excellent job stigmatizing suboxone, after some idiot teen died from it (and presumably a whole collection of other drugs).

It got huge (read: hysterical) media coverage as she was very attractive and blond. If someone who looks like me died in the same manner it wouldn't cover most of the front page and go on for multiple pages.


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## broflovski (Feb 1, 2011)

UltraShy said:


> The Milwaukee Journal last year did an excellent job stigmatizing suboxone, after some idiot teen died from it (and presumably a whole collection of other drugs).
> 
> It got huge (read: hysterical) media coverage as she was very attractive and blond. If someone who looks like me died in the same manner it wouldn't cover most of the front page and go on for multiple pages.


Sounds like something similar to our anti-tianeptine campaign in Russia with all that TV films like "Tragedy called Coaxil". Though I know there always have been a great public concern on pain-killers in USA, and controversy on replacement therapy in Europe.


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## UltraShy (Nov 8, 2003)

broflovski said:


> Sounds like something similar to our anti-tianeptine campaign in Russia with all that TV films like "Tragedy called Coaxil". Though I know *there always have been a great public concern on pain-killers in USA,* and controversy on replacement therapy in Europe.


The media seems to love a hysterical style of journalism.

1. First the media reports about OxyContin, which they label "Hillbilly Heroin" as being the ultimate way to get high.

2. Next day a pharmacy gets robbed at gun point by a junkie demanding OxyContin by name. Gee, where ever did he get such an idea? Might he have caught the evening news the day before? One can reasonably assume such pharmacy robberies were largely inspired by the media when they ask for only one specific drug -- one endlessly mentioned in the media -- all while totally ignoring all the other C-II drugs locked up right next to the Oxy.

3. The media then reports on pharmacy robberies the media helped inspire and continues the cycle, making sure ever junkie knows exactly what to demand when robbing a pharmacy. The junkies never ask for the MS-IR nor MSContin, as the media failed to tell them it's morphine.

4. Many chronic pain patients are switched to methadone, since it does pretty much the same job, but lacks the stigma of OxyContin.

5. Then the media goes on to tell us about a new "epidemic" of methadone abuse, even though it's the opioid junkies least desire as it's not going to get them high! All it's going to do is prevent withdrawal symptoms as they search for stuff they really want like heroin.


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## bben (Oct 24, 2009)

UltraShy said:


> The Milwaukee Journal last year did an excellent job stigmatizing suboxone, after some idiot teen died from it (and presumably a whole collection of other drugs).
> 
> It got huge (read: hysterical) media coverage as she was very attractive and blond. * If someone who looks like me died in the same manner it wouldn't cover most of the front page and go on for multiple pages.*


Im sure everyone is already aware of how messed up society is, but your right. Opiates have been demonized forever, but often by people who have never taken one at above therapeutic doses.


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## Briisthebest (Apr 1, 2011)

I took suboxone to get off my addiction of heroin and it worked quite well. It does have anti-depressive effects and can make you feel much better. FYI Suboxone has naloxone in it which prevent addicts from getting high on opiates while on the suboxone, but Subutex is the same as suboxone without the naloxone in it.


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## Arisa1536 (Dec 8, 2009)

Dr House said:


> Oh and for folks thinking about using opioids for depression, chronic opioid use depletes testosterone levels which can in turn cause fatigue and depression in men.


interesting

I despise the term "opioid addict" because i have been called one by the community alcohol and drugs (CADS) place 
taking over the recommended dose of a pain killer makes one an opioid addict?
im just curious because i thought the term opioid was used for opium alkaloids like Codeine Morphine Thebaine and you know heroin and the good old fashioned opium poppy itself yet this silly cow i saw at CADs saw my benzodiazepine and painkiller abuse with paracetamol as "opioid addiction

Yes i take two to four codeine based pills daily for chronic daily headache which contain 9.75 mg of codeine in them, i laughed actually when she called me an "opioid addict" because i may take a grand total of 39 mg of codeine a day  call the police, its not even nearly a dangerous amount

Anyway since the term was given and i find medications for anxiety and SA generally do one thing but not the other, this suboxone sounds worth a try
hmm but getting a doctor in New Zealand or Australia to prescribe it? even for a mighty sum of cash, its not gonna happen :no


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## marcg (Dec 29, 2011)

*Suboxone*

Just started taking for severe anxiety and depression. MY firt dose was 2mg. I was barely able to walk and had 2 episodes of vomiting. Today I took 1 mg and was barely able to get up off my chair. Do you have any idea why I am so sensitive to SUBOXONE. Your advice i greatly appreciated.


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## Under17 (May 4, 2010)

marcg said:


> Just started taking for severe anxiety and depression. MY firt dose was 2mg. I was barely able to walk and had 2 episodes of vomiting. Today I took 1 mg and was barely able to get up off my chair. Do you have any idea why I am so sensitive to SUBOXONE. Your advice i greatly appreciated.


You're not especially sensitive to it, you have a normal reaction for someone without an opioid tolerance. Doctors seem to have no idea how powerful it is for someone who's not been addicted to heroin or oxycodone. My pdoc told me to try 2 mg but .5 mg is plenty. Cut it into quarters, or even smaller if you can. You might still have some initial sedation, nausea, and constipation but it should go away and it won't be nearly as bad.


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## Helpme88 (Jul 18, 2012)

*Where to get Suboxone*

I realize this thread is a few years old, but I am interested in trying Suboxone for severe ocd/anxiety/depression but I don't know how to obtain it. Can anyone help? No other meds are helping me, and I've about tried them all. If I take an opiate, sometimes it really helps me but sometimes it doesn't. I don't take it too often, but have taken it enough to wonder if I've gotten tolerant and maybe that's why it doesn't always help me? Really would appreciate a response. Thank you so much.


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## watertouch (Nov 4, 2013)

Well Subutex for anxiety... Ehh dont mention any other drugs or they will class you as a mix/substans abuser.


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## UltraShy (Nov 8, 2003)

Noca said:


> Oh and for folks thinking about using opioids for depression, chronic opioid use depletes testosterone levels which can in turn cause fatigue and depression in men.


Those using TRT, such as AndroGel, don't have to worry as our own testosterone production is already reduced to zero. Subutex can't lower my testosterone at all as I get mine out of a bottle daily.

At the end of next week I have an appointment with a Suboxone doc. They're limited by the DEA to a max of 100 junkie patients, so to fill their schedule, they have to see non-junkies like me. I think he's in for quite a treat, as I'm a most interesting & memorable patient.


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## JulianB (Aug 26, 2021)

bben said:


> Buprenorphine is a partial opiate agonist, because of this it has opiate effects while not dramatically creating an opiate tolerance. Its also a kappa opiate antagonist giving it less sedation as well as super potent antidepressant effects. As an opiate is disinhibits dopamine in the ventral tegmental area creating pleasure as well as binding to gaba neurons in the raphe nuclei decreasing the firing of serotonin neurons and therefore lowering anxiety. Lastly, it dramatically lowers glutamate in several areas helping with analgesia and ocd in some. Most tests have showed opiates to have minimal to no effects on cognition, thats certainly more than almost any other anti-anxiety class of meds.
> 
> Its easier to get than benzos and ten times less addicting and probably 20 times safer. No one has ever OD'd on buprenorphine alone.
> 
> ...


Please be patient this is going to be long.
I have been suffering from PTSD almost all my life and been on medication on one form or another since the age of 25 for depression.
I became addicted to street opiates (opium) for a short while and then I was put on methadone but every time I tried to cut down my methadone below 12.5mg the depression became unbearable despite being on a cocktail of antidepressants. 
So, they changed me to Buprenorphine which was a revelation. My psychic pain suddenly became a distant memory.
I had by then also had a VNS implant for about a year but I was also on Olanzapine which had turned me into a zombie. So, once I came off Olanzapine my depression improved too. I don't know which once was responsible but I was stable for 6 years on 2mg on Buprenorphine. I moved out of UK to Malta and even reduced my buprenorphine to 1.5mg every other day. 
But suddenly I started developing all sorts of strange symptoms that were initially diagnosed as fibromyalgia. But they also included low basal temperature, high blood pressure and others. The worst was severe insomnia like 72 hours with no sleep at all followed by 3hrs and the 72hours of no sleep again. 
I finally realised that it all coincided with battery of my implant running out after eight years which was their anticipated life time. I had totally forgotten about it and non of the doctors pointed it out. So, I tried to have it replaced but that was when I got drawn into a crazy web of buacracy that took years to understand. 
In Malta VNS device is allowed to be purchased for epilepsy cases only. So regardless of doctors' recommendations appropriation departments of hospitals refuse to purchase it. I was to be finally referred back to UK but then COVID struck and elective surgeries have stopped.
Despite it all my depression didn't come back for the 1st three years but my insomnia although kept changing its form, it still remains the worst aspect. The only thing that helps is upping the dosage of Buprenorphine which actually worsens the insomnia but at least improves the depression and energy levels.
My PTSD goes back to something that happened when I was 4 years old and is related to my sleep and now it seems to have returned with a vengeance causing me to walk in my sleep and wake up in risky situations at times. Other times I hallucinate or just don't sleep.
It is now almost 9 years that I am on Buprenorphine and if I want to have day without depression I have to take 12mg which I don't often out of fear of getting used to it.
My question is: Is my depression part of the withdrawal or part of my sickness?


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