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Just got my waiver, just started my first patient. She was transitioned from Meth to Bup by an addicton clinic with this planned hand off to me. She had a prior failed attemt because the Suboxone induced nausea and a significant depression. She is currently Tx for her depression but is finding The subutex worsens her mood. she currently has no other typical withdrawal sx. She is at 60 days on Bup. We are trying a 30- 60 day switch to Subutex. Have others had experience with depressive side effects or tried this strategy? (plan to opiate test in 30 days.)
We treat large numbers of opiate dependent people in an ambulatory detox in Baltimore. We were forced to use Suboxone initially since the Subutex was release later. We found very little nausea and vomiting with an initial dose of 4 mg sublingually and did not see any difference when we did use Subutex for a while on theoretical grounds. We have since returned to using just Suboxone particularly since it is less expensive. We have more problems with N&V when people have been taking methadone prior to taking Suboxone with the sx correlating with higher dose and recency of use.
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