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Are opiates really a long term solution to psychiatric maladies?

A

AlphaMethylPhenyl

Moderator: TDS
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Anecdotal evidence is fine, but I was hoping there was some professional opinion out there as to whether or not opiates/opiods offer prolonged protection against (principly) depression/bi-polar without having to raise the dose. If so, which?

I've done some internet research, but want to know what y'all think.
 
Not going to elaborate on it, but for full agonists the long and short answer is no, you can't continue opioid therapy indefinitely.
 
I've been curious about this too. Nothing as ever helped my depression/anxiety the way opiates have. While I quit oxy because I knew I had become addicted, the year that I was on it consistantly I felt normal and happy for the first time in my life. My body didn't hurt constantly, I wasn't exhausted all the time, I was actually in a good mood.. And I could function properly. I could actually work full time and still see friends, clean my house, and take care of myself. Normally I become overwhelmed very easily.

But obviously they're addictive and long term there's some serious consequences. But I think about going back on them all the time because to me it's worth it, what's the point in living a life where you don't leave your house because nothing makes you feel "good" and everyday thing seem pointless.

I'm really of two minds on this matter. Because I've also seen how addiction destroys lives and families.
 
I'd say no, it may alleviate depression for a couple years in controlled dosages, but after that your tolerance would build up rapidly. Depression is also a symptom of opiate withdrawal, and long term chronic opiate use usually results in memory loss, severe constipation, and or liver damage.
 
Partial agonists have been used to treat depression in some small studies, not sure how long term they were. But, doing a pubmed search of a few partial agonist names + depression might turn up what you're looking for.

But, in the future please have a more specific question or post some primary research when posting a thread, otherwise try posting to the big and banging thread.

-EA
 
All I know is that by nature I do not/have never been depressed ever in my whole life except when withdrawing from opiates/heroin.

By nature I am a very optimistic and rational person. During w/d the thought of ending my life very briefly crossed my mind. It never got past just the thought but still. I have no sympathy for people that commit suicide and in my opinion it's the path of a weak individual. So in other words I don't take even the thought lightly.

I could not even Imagine the depression of a hard opiate w/d coupled with the psycology of a person with diagnosed depression. It would be absolutely horrendous.
 
before i took tramadol for a year once daily i would get depression and mania- after that year my mental health improved though this coincided with a regimen of b-vitamin supplements i have taken daily now for about 5 years.

either way tramadol changed me for the better, weather chemically or by changing my personality
 
This is some pro- information.

morphine as an anti-psychotic:
http://opioids.com/antipsychotic/index.html

more to above article (the theory was originally postulated in The Lancet): http://reocities.com/hotsprings/9740/antipsycheffect.html

morphine as an anti-depressant:
http://opioids.com/morphine/antidepressant.html

morphine an an anti-psychotic/antidepressant
http://opioids.com/antidepressant/history.html

case study of three treated with opiates for depression:
http://opioids.com/antidepressant/opiate.html

buprenorphine as an anti-depressant:
http://opioids.com/buprenorphine/buprefdep.html

-many more links on the same site

opiates as anti-depressants:
http://www.ncbi.nlm.nih.gov/pubmed/19442177

opiates as general psychiatric medicines:
http://www.ncbi.nlm.nih.gov/pubmed/6961853
 
no, most definitively not, in the end you are just going to end up dependent on opiates, and for those with depression, you could end up with a permanent downregulation of mu receptors, which would permanently hinder your bodies natural endorphins and reward center. causing the depression to worsen.
as for anxiety, its pretty much the same thing.

opiates are great for pain management, not for psychological disorders, all they're going to do in the end is make your psychological problems worse, and possibly turn you into an addict.

and yes I read the articles and researched this subject, but my opinion remains the same, no they are not a long term solution, and really shouldn't be considered for a short term solution either.

the only permanent solutions you are going to find are LIFESTYLE CHANGES, for example, exercise, dietary changes, get on a good sleep schedule, meditation, find hobbies that you enjoy that make you happy.
 
PoppyLlama said:
no, most definitively not, in the end you are just going to end up dependent on opiates, and for those with depression, you could end up with a permanent downregulation of mu receptors, which would permanently hinder your bodies natural endorphins and reward center. causing the depression to worsen.
as for anxiety, its pretty much the same thing.

opiates are great for pain management, not for psychological disorders, all they're going to do in the end is make your psychological problems worse, and possibly turn you into an addict.
Click to expand...

You do realize that the same can be and has been said for every FDA-approved antidepressant, yes?

Honestly
 
I'd be more interested in whether opioids can prevent a mania. SSRIs make me manic in a few days. Opioids have never induced a mania, though. I have had far fewer of them as I've aged, too, directly corresponding to my introduction to opioid use.
 
maybe some of the things I said could apply to antidepressants as well, but for the most part no. and here's why:

antidepressants don't fuck with your brains natural reward center like opiates do, and they don't cause a permanent downregulation of receptors, and don't act on mu or any other opioid receptors.

are they still addictive? yes antidepressants are addictive, but they are far less addictive than opiates, which can turn even people with the strongest willpower and mental fortitude into junkies.

antidepressants, while they can be taken indefinitely, are often taken for extended periods of time until the symptoms are cleared up by lifestyle changes, for example, exercise, healthy diet, finding hobbies that make you happy. they are meant to help get people out of the vicious circle of depression and actually make changes in their life that will help them be a better person in the long run.

opiates on the other hand, usually cause people NOT to exercise, to be more lazy so as to seek out less healthy food, and they usually make people sit and chill out in front of the tv or video games instead of making them want to go outside and have fun and be active.

I don't know how you could even say that opiates would be a valid course of action to treat anxiety or depression, it really makes no sense. and IM NOT SAYING THAT ANTIDEPRESSANTS ARE THE MAGIC BULLET. alot of them are totally horrible, and sometimes they make things worse. I have nothing against opiates, I need to take them daily for severe chronic pain, but the fact is that they truly are not a good treatment for depression or anxiety.

Honestly.
 
Why would you automatically conclude that they can't cause a permanent down-regulation in receptors? There are tons of anecdotal reports supporting that they do cause permanent changes.

That they don't directly act on opiate receptors or the reward pathway is irrelevant; we're talking about use as an anti-depressant, and if you want to randomly conclude that this means they can't act as a long-term antidepressant then be my guest.

They're more addictive than anti-depressants but that doesn't matter if you plan to stay on it for life at a controlled dose.

The best psychiatrist in my town (which is affluent) said that people should stay on their medications for life, that you're wrong about the drugs being somehow designed for short-term use so that people can make life changes, especially for someone with a serious biochemical disease. Any drug is a band-aid.

You seem to think that opiates can just make someone lazy, but I've heard of people becoming very energetic, competent, self-driven workers on opiates the same as some people gain fifty pounds and don't do anything because of their Prozac. I don't think your generalization means anything unless you have a source.

And yet it somehow makes no sense to treat psychiatric disorders with opiates? That's easy for you and your chronic pain to say.

Of course they're a lot more serious class of drugs to be on than antidepressants, but if used carefully, I don't see the extraordinary problem.
 
Play nice you two.
1) standard monoamine targeted antidepressants are well known to cause persistent receptor changes, as are opioids and virtually every other drug out there. SSRI's are well documented to induce transcriptional
and functional changes in MOR as part of their therapeutic mechanism of action.
2) Opioids have a, as best I can tell, narrow dosage window in which they have any positive effects on depression.
3) Biochemical issues are also linked to lifestyle choices.

Either get more scientific with your positions or this gets moved to OD.
I'm of the opinion that opioids are like ketamine, in regards to depression, as in they both have promising molecular mechanisms but are nowhere near refined enough for anything other than one off retardedly treatment resistant cases or research settings.
 
I suggest that you experiment with a beta-2 adrenergic receptors like clenbuterol to stimulate delta opioid receptors as they have positive effect on depression. You should look into glutamate/glycine/gaba. Your depression may be induced by an overactive glutaminergic signaling. Opiates induce down-regulation of glutamate transporters. NAC, Magnesium and mementine may be an option.You should also research nitric oxide as a mood enhancer. Tadalafil seem to cure depression and anhedonia.

I can provide extended explanation if needed.
 
Please do, sir.

Wait...talking glutamate decreases glutaminergic signaling?

And while I agree that my problem might be caused by an over-abundance of glutaminergic signalling, I want to stress that Depakote/Lithium increase my depression.

I also just want to clarify that I'm not just talking about myself. Its actually kind of ironic that their doesn't seem to be much interest in this since if the answer to my initial question is no then there is literally no reason for anyone to become dependent on opiates for psychiatric maladies as the addiction and pain of withdrawal (including PAWS) almost certainly outweighs a couple months of efficacy--coupled with the fact that so many bluelight posters are dependent on opiates.
 
Opiates are never a good idea for long term use due to tolerance and addiction issues. Enough said.
 
there is literally no reason for anyone to become dependent on opiates for psychiatric maladies as the addiction and pain of withdrawal (including PAWS) almost certainly outweighs a couple months of efficacy-
Click to expand...

Just tell that to all the people who use opioids (apparently) successfully. It's only ever after therapy stops (or they lose efficacy) that they pose a problem,

Humans are terrible at risk assesment, lots of people figure "it won't ahappen to me" or that the reward simply outweighs the risk when it comes to self-medicating.
 
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