Kappa opioid receptor antagonism: Are opioids the answer for treatment resistant depression?

The Mental Health Clinician
Alyssa M PeckhamRobert L Dufresne

Abstract

Past trials of buprenorphine (BUP) in the treatment of major depressive disorder (MDD) have displayed favorable results, although its clinical utility was limited by the risk of abuse or physical dependence. By combining BUP with samidorphan (SAM), the euphoric high is negated by an opposing mechanism, which theoretically reduces addictive-like properties while allowing the antidepressant properties to remain. As such, the objective of this article is to analyze the results of BUP/SAM premarketing clinical trials as adjunctive treatment for treatment-resistant MDD. A comprehensive PubMed/MEDLINE search was conducted through November 9, 2017, using the following search terms: depression, samidorphan, buprenorphine, ALKS-5461. Additional data were obtained from Clinicaltrials.gov and resources included in the present study. All English-language clinical trials evaluating the combination of BUP/SAM in the treatment of MDD were included. A few premarketing studies have evaluated the efficacy and safety of BUP/SAM combination as adjunctive treatment in patients with treatment-resistant MDD. The FORWARD-1 through FORWARD-5 trials concluded (1) the most effective dosing ratio of BUP/SAM to reduce abuse potential was 1:1; (2) statistic...Continue Reading

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Citations

Nov 22, 2019·The Journal of Pharmacology and Experimental Therapeutics·David R MaguirePeter Flynn
Jan 10, 2020·Annual Review of Pharmacology and Toxicology·Moriah L JacobsonIrwin Lucki
May 8, 2019·CNS Drugs·Matisyahu ShulmanEdward V Nunes
Mar 25, 2020·Psychological Medicine·Caitlin A Madison, Shoshana Eitan
Dec 11, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Tahani K Alshammari
Nov 16, 2018·Journal of Affective Disorders·Gustavo KinrysMaurizio Fava
Apr 4, 2021·Journal of Clinical Medicine·Shane KaskiWanhong Zheng

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Methods Mentioned

BETA
sedation
pharmacotherapy

Software Mentioned

BUP

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