Veterans Affairs Medical Center, Mental Health Service, 215 North Main Street, White River Junction, VT, 05009, USA; Geisel School of Medicine at Dartmouth, Department of Psychiatry and Dartmouth Institute, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
Veterans Affairs Medical Center, Mental Health Service, 215 North Main Street, White River Junction, VT, 05009, USA; Geisel School of Medicine at Dartmouth, Department of Psychiatry, 1 Rope Ferry Road, Hanover, NH, 03755, USA.
J Psychiatr Res. 2023 May;161:393-401. doi: 10.1016/j.jpsychires.2023.03.037. Epub 2023 Mar 30.
Depressive disorders are common. Many patients with major depression do not achieve remission with available treatments. Buprenorphine has been raised as a potential treatment for depression as well as suicidal behavior but may pose certain risks.
A meta-analysis comparing the efficacy, tolerability, and safety of buprenorphine (or combinations such as buprenorphine/samidorphan) versus control in improving symptoms in patients with depression. Medline, Cochrane Database, PsycINFO, Excerpta Medica Database and The Cumulative Index to Nursing and Allied Health Literature were searched from inception through January 2, 2022. Depressive symptoms were pooled using Hedge's g with 95% Confidence Intervals (CI). Tolerability, safety, suicide outcomes were summarized qualitatively.
11 studies (N = 1699) met inclusion criteria. Buprenorphine had a small effect on depressive symptoms (Hedges' g 0.17, 95%CI: 0.05-0.29). Results were driven by six trials of buprenorphine/samidorphan (N = 1,343, Hedges's g 0.17, 95%CI: 0.04-0.29). One study reported significant improvement in suicidal thoughts (Least Squares Mean Change: -7.1, 95%CI: -12.0 - 2.3). Most studies found buprenorphine was well-tolerated with no evidence of abuse behavior or dependency.
Buprenorphine may have a small benefit for depressive symptoms. Future research should clarify the dose response relationship between buprenorphine and depression.
抑郁障碍很常见。许多患有重度抑郁症的患者并未通过现有治疗达到缓解。丁丙诺啡已被提出作为治疗抑郁症和自杀行为的潜在药物，但可能存在某些风险。
对丁丙诺啡（或丁丙诺啡/纳布啡等组合）与对照相比改善抑郁症患者症状的疗效、耐受性和安全性进行了比较的荟萃分析。从建库起至 2022 年 1 月 2 日，检索了 Medline、Cochrane 数据库、PsycINFO、Excerpta Medica 数据库和 Cumulative Index to Nursing and Allied Health Literature。使用 Hedge's g 及其 95%置信区间（CI）汇总抑郁症状。耐受性、安全性和自杀结局进行定性总结。
符合纳入标准的 11 项研究（N=1699）。丁丙诺啡对抑郁症状有轻微影响（Hedges' g 0.17，95%CI：0.05-0.29）。结果主要由六项丁丙诺啡/纳布啡试验驱动（N=1343，Hedges's g 0.17，95%CI：0.04-0.29）。一项研究报告自杀意念显著改善（最小二乘均数变化：-7.1，95%CI：-12.0 - 2.3）。大多数研究发现丁丙诺啡耐受性良好，无滥用行为或依赖性的证据。
丁丙诺啡可能对抑郁症状有轻微益处。未来的研究应明确丁丙诺啡与抑郁症之间的剂量反应关系。
