Opioids Heroin/opioids as antidepressants - why not?

[thurston]

I would rather try opiods before getting a brain implant or electroconvulsive 'therapy'. Better yet ketamine therapy, it's proven to work and non-addictive if done right. Also lacks the side effects of other pharmaceutical options because it's only done once or twice a week. But that's just me. And prolonged use of opiates indeed caused depression in me.

I do think that ECT is a leftover of a dark era of psychiatry. I know some swear on it, patient as well as docs, for to control otherwise resistant stuff but so does ketamine and I wonder whether in some case it might be the general anesthesia which helps instead of the electric shocks. I know of people who lost a good deal of their memory after getting ECT, permanently. Think of forgetting your marriage or similar stuff. Can be devastating. And with brain implants I imagine it will be sheer luck which protects you from the surgery damaging important brain structures.

My understanding is erasing memories is what ECT is supposed to do.

 

[plumbus-nine]

SSRIS are addictive too. SSRI withdrawal was the worst withdrawal I ever went through.

And they can induce or worsen depression.

I might be wrong, but I think nobody really knows how ECT is supposed to work other than by disrupting neural networks.

 

[skipjames]

maybe opioids and pharmaceutical coke why not ? I m in but seriously back home in south Italy people have used poppy tea for centuries to cure anxiety and depression , up until my parents generation it was even given to little kids , it was called "papagna" you might have heard the term in the Godfather...so methinks that at least natural opioids could be a better alternative to all the crazy shit they prescribe to people nowadays....

 

[mcflurry]

SSRIS are addictive too. SSRI withdrawal was the worst withdrawal I ever went through.

they dont cause „psychological“ addiction. many substances lead to tolerance (meaning: the body adapts to the effects of a drug/substance/medication). doesnt mean they‘re addictive in the same way as opioids are

 

[plumbus-nine]

they dont cause „psychological“ addiction. many substances lead to tolerance (meaning: the body adapts to the effects of a drug/substance/medication). doesnt mean they‘re addictive in the same way as opioids are

While I do agree that SSRIs aren't like opioids, so can their withdrawal come with similar symptoms. I think the whole distinguishing between physical and psychological addiction isn't the complete truth. Opioids just happen to cause a bunch of physical withdrawal symptoms but they aren't the worst, like restless legs and anxiety/depression.

 

[mcflurry]

While I do agree that SSRIs aren't like opioids, so can their withdrawal come with similar symptoms. I think the whole distinguishing between physical and psychological addiction isn't the complete truth. Opioids just happen to cause a bunch of physical withdrawal symptoms but they aren't the worst, like restless legs and anxiety/depression.

im sorry, but there is no such thing as an ssri addiction. there is no craving (=„psychological“ addiction).

 

[Fertile]

I know that back in the 1960s a few UK psychiatrists tried Diconal on people with severe refractive unipolar depression. Then a patient used the drug to commit suicide, the psychiatrists was charged, convicted and imprisoned.

THAT is why they aren't used for depression. You are handing someone almost the perfect means to kill themselves. The associated study (completed by other psychiatrists who were also trialling opioids) was, obviously, a failure.

 

[Hexenstahl]

Heroin/opioids as antidepressants - why not?​

Because it'll eventually stop working as an antidepressant and instead make you feel like an empty husk. I'm not kidding. It'll make you feel like a Nazgul. Long-term use of opioids gives you avolition, kills off your sex drive, deteriorates your affect regulation and ability to concentrate, heightens your stress vulnerability, decreases what in psychology is known as "resilience" and actually worsens your underlying depression. In fact it can create depression in a person who didn't have the condition in the first place due to its inhibition of testosterone production (both males and females need healthy levels of testosterone) so that even if you keep doing it 24/7 it won't get rid of the I-feel-empty feeling.
You're simply in the honeymoon phase of opioids and naively believe that it will remain like that...it won't.

 

[GetMeOutOfThisCRAP]

Look its not like opiates don't help depression... that is a bit too simple for what really is going on. Opiates are not to be relied on for eliminating depression, and anyone who achieves full-blown dependency for this purpose will in time find out that the depression you dodged with drugs will return just as badly in different ways.

On opioids full time the depression between doses is just as bad as the depression as when you were sober. Its simply timing the depression to hit different times throughout you day-to-day life. Everyone who has gone down this route would probably agree that the depression they cured temporarily with opiates/opioids simply was displaced in the future as opposed to "getting rid of it."

I know how much it sucks.. struggled with depression myself before meeting the drugs. My depression is different than most--its quick and only lasts a day or two. However, it was enough to rely on things that really didn't cure my depression. I simply postponed my depression lol.

 

[paranoid android]

i think opiates should definetely be used for treatment resistant depression. I don't see why not. Hell i wouldnt be againmst scripting coke along with something like dilaudid if depression was bad enough. i have yet to see anyone depressed after a speedball

 

[GetMeOutOfThisCRAP]

Tincture of opium, and later morphine, were at one time quite commonly (and successfully) given to treat depressive and panic states in patients; however with certain caveats.

Here's a couple extracts from historical literature :

"Several hundred patients suffering from the depressed stage of manic depressive insanity were given large doses of opium orally in many instances for periods of from six months to one year. Not one of these patients ever knew what drug he was taking or ever showed any untoward results when it was withdrawn, or in any other way gave evidence of a desire to continue its use."
- Journal of the American Medical Association, 1920

"Opium is indispensable in dealing with the fear states of the melancholic individual. But here we make the surprising discovery that the continued administration of opium, in the form of opium tincture, during the melancholic mental disturbances, even when continued over a long period of time does not produce drug addiction. That is, it does not, provided that the dosage is adapted to the diseased mental state of the patient and provided that the doctor is careful to withdraw the drug at the correct time. " - Dr. Paul Wolff, Weekly Journal of German Medicine, 1931

" Opium is indispensable in many cases of endogenous depressions. The prescription of opiates for states of depression is unobjectionable also because we know from experience that the depressed persons feel no need for narcotics when the depression has passed away, and practically never become addicts. " - Dr. Karl Bonhoeffer, Weekly Journal of German Medicine, 1931

... in response to this particular discussion (published under the line 'When is the prescription of opiates medically justified?'), another physician, director of the Berlin Sanitarium where morphine was used for some psychiatric patients, pointed out :

"... but also ONLY in endogenous, that is in periodic melancholy arising from a constitutional basis. Warning must be issued against the administration of opiate preparations in cases of reactive depression - that is, depression in reaction to the vicissitudes of life. In these cases, it leads with especial ease to the development of addiction. "

... Makes perfect sense to me.

Its so crazy how pharma has hyper extracted specific materials into pill formating. It created more addicts than ever before while actually ending up less effective for things like chronic pain in long term use. Opium doesn't have the best reputation historically because it still mass created opium den residents who would nod out their entire lives away. If someone had accurate knowledge of how to use the opium/extract it and safely dose it, even if they turned into a horrible drug addict the positive effects of euphoria/pain relief I'd theorize would go a much longer way still than oxy/percs. The doses from long term oxycodone use always become insane for chronic pain patients unless they moderate their own doses by cutting back significantly or taking breaks from the drugs for periods of time.

The problem is that opium is not brainlessly easy to acquire naturally and dose yourself. Even if someones resource is already prepared for them prior to getting their hands on the opium, its never going to be as simple as swallowing or inhaling a pill in 5 seconds. I don't see the public as wanting to deal with opium anymore over the pills since the ordeal does require some knowledge. There's no milligram count for opium iirc--but maybe its measurable in different ways I'm unaware of. Regardless of whatever pain relief tool people use, its always going to be opiates. No matter what format it comes in the plant always controls more people than there are people who exist that can control opiates lol. Its just too enticing as time goes on to not make regular use a potentially life-long routine within your life. It really sucks how manipulative the plant is and how mankind cultivates fields of the damn thing. I view the poppy plant as intelligent design since the prehistoric days. It knows how to manipulate its consumers but kill the abusers or make them suffer. The poppy plant thus ensures its survival by making mankind its slave that mass reproduces its plant population while making us guarantee its extinction never to occur. I suppose marijuana somewhat does this as well and probably cocaine. Kind of theorizing that these plants somehow know exactly how pleasurable they are and then ensuring that another species like humanity will perpetually demand its cultivation. The last thing humanity would be okay with is the poppy plant becoming 100% extinct. There's too many addicts/pain patients in desperate need of the plant to stop the plantations we create and maintain. Its all hypothetical crazy talk here, but there's evidence that other plants unrelated to drugs are incredibly self-aware of its surroundings to lvls that we still do not fully understand. Even with oxycodone probably being a major reason we cultivate the plant at all, it still requires our constant need to maintain fields of them.

 

[TheUltimateFixx]

Remarkable that opium didn't cause dependency in these cases of depression treatment. Do you think this is true? That it depends on your state of mind whether you become (quickly) addicted to opioids or not? Or did they possibly just give the opium for a few weeks until remission or switch to mania in manic-depressive cases etc?

I would presume that patients would be gradually weaned off the drug. But there have indeed been some documented instances in which individuals failed to manifest withdrawal symptoms. There might be some genetic or physiological quirk involved that makes some people literally unable to develop chemical dependence.

 

[trogere]

why don’t they use opioids for extreme cases of depression that can’t be treated by other methods?

Give an extremely depressed person some high quality heroin and I am sure they will start feeling better. I honestly don’t see what the problem would be if it was done under a docs supervision and was pharma grade opioids. I don’t see what would be wrong with this if you explained the risks to the person doing it and made sure they understood that they would become dependent on it. I think it would greatly increase a lot of peoples quality of life.

Ketamine is a good option for serious depression resisting to medication.
The risks and the consequences of opiate addiction are very serious.

 

[plumbus-nine]

If you abuse ketamine you can get major depressive disorder not to mention what horrific things can happen to your bladder but that’s if you abuse it
edited to add yeah ssri’s aren’t addictive like you crave them but they are physically dependent like it’s a nightmare to withdraw from them a hell of a lot longer withdrawals then opioids

I indeed got depression from abuse of dissociatives (mostly deschloroketamine, a longer-acting and more potent analog of ketamine, multiple doses per day). Initially it was stimulating and euphoric, a potent antidepressant, but the effects began to grow shorter and shorter, I had to redose more and more often, just to soon come down again to a depressed (more bed-locked true depression than what's often called depression, as in having zero energy and zero motivation, avoiding all sorts of stuff like just making a phone call etc) state. But quitting dissociatives is easy in comparison to other drugs. The withdrawal lasted a few weeks I think, but was complicated because I was also on opioid maintennace which can also cause depression and had much stuff I avoided to deal with. Dissociatives are, given their powerful mermory inhibition, good tools for escapism but can also turn against one if used that way.