I recently received the following note from a reader:

I am aware of historical and recent studies where Subutex (a ‘partial agonist’ opioid called buprenorphine) was used very successfully in the treatment of depression. I am wondering if you have experience prescribing it for that, and what the success rate is? Can it be taken long-term? I am battling a very bad depression; what are my options on Subutex? Are you aware of any doctors in Michigan who work with Subutex for depression?

The gentleman raises a number of interesting questions. He also provides a glimpse into the desperation experienced by people with treatment-refractory depression. Patients with that condition describe one painful day after another, waiting endlessly for a ray of light to brighten the darkness.
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