Therapeutic Potential of Buprenorphine in Depression: A Meta-Analysis of Current Evidence

Siddhi Bhivandkar, Zouina Sarfraz, Lakshit Jain, Anil Bachu, Palash Kumar Malo, Michael Hsu, Shahana Ayub, Laxmi Poudel, Harendra Kumar, Hanyou Loh, Faria Tazin, Saeed Ahmed, Joji Suzuki

Abstract


Background: Emerging research indicates buprenorphine, used in management of opioid use disorder, has attracted interest for its potential in treating a variety of psychiatric conditions. This meta-analysis aimed to determine the efficacy of buprenorphine in treating symptoms of depression.

Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a search was conducted of several databases until April 25, 2022, for English language articles related to buprenorphine and its use in treating various mental health conditions. Standardized mean differences (SMDs) and its 95% confidence intervals (CIs) were reported for the Hamilton Rating Scale for Depression (HAM-D) and the Montgomery-Asberg Depression Rating Scale (MADRS) scores. Statistical analyses were performed using Cochrane RevMan 5.

Results: Of the 1,347 identified studies, six clinical trials were included. MADRS-10 least square mean difference (LSMD) inter-group assessment favored buprenorphine over placebo, but it lacked statistical significance. Similarly, MADRS scores as well as HAM-D inter-group assessment were in favor of buprenorphine, however, were not statistically significant. These findings suggest a potential therapeutic role for buprenorphine in treating depression, albeit with caution due to the observed lack of statistical significance and the potential for confounding factors.

Conclusions: Preliminary evidence suggests potential efficacy of buprenorphine at lower doses in improving improving outcomes specifically related to depression. However, due to limitations in statistical significance and possible confounding factors, entail cautious interpretation. Further rigorous research is needed to investigate the long-term effects, optimal dosing, and determine the role of adjuvant drug therapy.




J Clin Med Res. 2024;16(2-3):46-55
doi: https://doi.org/10.14740/jocmr5050

Keywords


Buprenorphine; Depression; Major depressive disorder; Treatment-resistant depression; Antidepressant; Buprenorphine/naloxone; Buprenorphine-based treatment

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