Low-dose Buprenorphine as a Modulator of Social Motivation in Schizophrenia
Status:
Not yet recruiting
Trial end date:
2025-04-01
Target enrollment:
Participant gender:
Summary
Low social motivation is a significant symptom of schizophrenia and is a major cause of
disability and suffering for many patients struggling with the illness. Social motivation
refers to the drive to participate in or abstain from social activities. Many patients with
schizophrenia evidence both decreased drive to seek positive social input (approach
motivation) and heightened drive to avoid negative social input (avoidance motivation)
compared to individuals without the illness. Despite the enormous burden of these deficits on
patients, there are no medications that effectively treat impaired social motivation.
Buprenorphine is an unusual drug that is used to treat opioid use disorder at higher doses
and more recently, to treat depression and suicidality at lower doses. It is a unique opioid
medication that has a compound action that gives it the potential to improve social
motivation both by boosting approach motivation and by reducing avoidance motivation. The
effects of low doses of buprenorphine have previously. been studied in healthy volunteers,
showing that the drug enhances social motivation. These results in nonclinical volunteers
suggest that buprenorphine may be a promising treatment for deficits in social motivation
seen in some patients with schizophrenia. However, no previous studies have investigated the
effects of buprenorphine on social motivation in this population. Here the effects of a low
dose of buprenorphine (0.15mg) on social motivation in patients with schizophrenia (N=40)
will be assessed. In this double-blind, cross-over, placebo-controlled study, participants
will attend a 2-hour preparatory session and two 6-hour laboratory sessions, at which they
will receive either placebo or buprenorphine. During expected peak drug effect they will
complete validated tasks assessing social motivation. It is expected that buprenorphine will
increase approach motivation and decrease avoidance motivation as measured by an attention
bias task. The results of this study will lay the foundation for the clinical use of
buprenorphine as the first medication to treat social deficits in schizophrenia.