Evidence map›Paper›PMID 26684923›Full record

Trial reportThe American journal of psychiatry2016

Ultra-Low-Dose Buprenorphine as a Time-Limited Treatment for Severe Suicidal Ideation: A Randomized Controlled Trial.

Yoram Yovell, Gali Bar, Moti Mashiah, Yehuda Baruch, Irina Briskman, Jack Asherov, Amit Lotan, Amihai Rigbi, Jaak Panksepp

Erratum issuedOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The American journal of psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 101 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 6 pooled it
36.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 6 syntheses or guidelines pooled it, 293 citations in OpenAlex.

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  4. Pharmacological interventions for self-harm in adults.The Cochrane database of systematic reviews · 2021
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  11. Results from a long-term open-label extension study of adjunctive buprenorphine/samidorphan combination in patients with major depressive disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2019
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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Yoram YovellFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Gali BarFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Moti MashiahFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Yehuda BaruchFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Irina BriskmanFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Jack AsherovFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Amit LotanFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Amihai RigbiFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Jaak PankseppFrom the Institute for the Study of Affective Neuroscience, University of Haifa, Haifa, Israel; the Abarbanel Mental Health Center, Bat Yam, Israel; the Wolfson Medical Center, Holon, Israel; the Department of Psychiatry, Hadassah Medical Organization, Jerusalem, Israel; Kinneret Academic College on the Sea of Galilee, Israel; Beit Berl Academic College, Kfar-Sava, Israel; and the Department of Integrative Physiology and Neuroscience, College of Veterinary Medicine, Washington State University, Pullman.
Beit Berl College · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSuicidal ideation and behavior currently have no quick-acting pharmacological treatments that are suitable for independent outpatient use. Suicidality is linked to mental pain, which is modulated by the separation distress system through endogenous opioids. The authors tested the efficacy and safety of very low dosages of sublingual buprenorphine as a time-limited treatment for severe suicidal ideation.

methodThis was a multisite randomized double-blind placebo-controlled trial of ultra-low-dose sublingual buprenorphine as an adjunctive treatment. Severely suicidal patients without substance abuse were randomly assigned to receive either buprenorphine or placebo (in a 2:1 ratio), in addition to their ongoing individual treatments. The primary outcome measure was change in suicidal ideation, as assessed by the Beck Suicide Ideation Scale at the end of each of 4 weeks of treatment.

resultsPatients who received ultra-low-dose buprenorphine (initial dosage, 0.1 mg once or twice daily; mean final dosage=0.44 mg/day; N=40) had a greater reduction in Beck Suicide Ideation Scale scores than patients who received placebo (N=22), both after 2 weeks (mean difference -4.3, 95% CI=-8.5, -0.2) and after 4 weeks (mean difference=-7.1, 95% CI=-12.0, -2.3). Concurrent use of antidepressants and a diagnosis of borderline personality disorder did not affect the response to buprenorphine. No withdrawal symptoms were reported after treatment discontinuation at the end of the trial.

conclusionsThe time-limited, short-term use of very low dosages of sublingual buprenorphine was associated with decreased suicidal ideation in severely suicidal patients without substance abuse. Further research is needed to establish the efficacy, safety, dosing, and appropriate patient populations for this experimental treatment.

Indexed as

Suicidal IdeationAdministration, SublingualAdultBuprenorphineDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMaleMental DisordersNarcotic AntagonistsPsychotropic DrugsTime FactorsTreatment OutcomeYoung AdultBuprenorphineNarcotic AntagonistsPsychotropic Drugs

Identifiers

PMID26684923
OpenAlexW2202695658

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.