Possible Psychosis Associated With Buprenorphine Withdrawal

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To the Editors
Buprenorphine is widely used in managing opioid dependence and is primarily a partial mu agonist and kappa antagonist at the opioid receptors.1 Buprenorphine also has possible effects on mood.2,3 In addition, buprenorphine has been reported to both cause psychosis4,5 and have possible antipsychotic6 properties. Only 2 earlier instances of acute psychosis caused after buprenorphine withdrawal7,8 have been reported, which, however, also had a history of psychosis and comorbid polysubstance use. We are reporting the third case of possible buprenorphine withdrawal–associated acute psychosis in a patient with no history and no other substance misuse.
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