Suboxone causes a variety of side effects, but depression isn’t usually one of them.
If you’re feeling low and sad during opioid use disorder (OUD) recovery, you can get help. But know that your medication is probably not to blame.
We do know that people with an OUD often have co-occurring mental health issues, including depression. In fact, people are often depressed because of their opioid use disorder, and using evidence based treatments like MAT can treat the OUD and subsequently cause improvements in depression.
Opioid Use Disorder & Co-Occurring Mood Disorders
Life with OUD can be challenging. Many Suboxone patients experience anxiety, depression, and other mental health concerns. But often, those problems pre-date the Suboxone therapy itself and are more a result of concurrent opioid use disorder.
Research shows that opioids can trigger depressive episodes in people with no prior history of depression.
The medications prompt your brain cells to release feel-good chemicals. In time, they won’t put those chemicals into your blood without drugs. In the absence of chemicals, you may feel depressed.
Researchers also say that people with mood and anxiety disorders are at higher risk of OUD. You may use these drugs as a form of self-medication for your mental health. Or you may be genetically inclined to misuse drugs if you have genes that spark mental health problems. For this reason, OUD and mental health concerns like depression often occur together.
What to Do if You Experience Depression During Suboxone Treatment
If you experience depression in the course of your treatment, you should always talk to your doctor. But know that treating your opioid use disorder is one of the best ways to combat depression. The Suboxone itself is rarely to blame. Instead, the etiologies of depression are usually multifactorial.
The medications your doctor uses to address addiction (including methadone and buprenorphine) are often linked to improvements in depression. These medications can correct chemical imbalances within your brain cells, helping you to feel more like yourself.
Your doctor can also use antidepressant medications to help you feel less depressed. These medications are safe to use while you’re taking Suboxone.
Therapy can also help to ease depression. There are multiple forms and types of therapy for depression, including cognitive behavioral therapy, interpersonal therapy, group therapy, etc. 
Your doctor might add these therapies to your treatment plan.
Depression is a relapse risk factor, so it’s critical for your doctor to understand how you’re feeling as you recover. Speak up and talk about your depression to get the help you need. With assistance, you’ll learn how to manage your depression and your opioid use disorder at the same time. Treating one often treats the other.
Can Suboxone Treat Depression?
The FDA approved Suboxone to treat just one condition: opioid use disorder. But some experts wonder if this medication can be used to treat depression too.
Depression is a complicated and multifactorial condition. Suboxone itself does not treat depression. However, some people find that their depressive symptoms are worsened by their opioid use. Therefore, treating the opioid use disorder may simultaneously have the benefit of improving the depression.
Buprenorphine inside Suboxone works on kappa, mu, and delta receptors, all of which modulate mood and emotions. Suboxone also prompts dopamine release, which can help people feel better despite their current challenges.
In one study of Suboxone in people with treatment-resistant depression, many did note improvements in their depressive symptoms as well as their OUD with the use of Suboxone. 
Depression and OUD are often comorbid, meaning they are frequently seen in the same individual and people who have one condition may also have the other. Studies of Suboxone misuse suggest that many people misuse Suboxone (or other opioids) in an attempt to treat depression and “self medicate”.  While this is understandable, it is not backed by research and may actually worsen depression. If you are using Suboxone or other substances to treat symptoms of depression, reach out to your doctor.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
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