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Are opioids the next antidepressant?

FlyingDutchman342

FlyingDutchman342

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Opioids have been used for depression before SSRIs/tricyclics/tetracyclics/MAOIs (and so on) were available.

The antidepressants listed above are certainly helpful and effective for some people, but many cases of depression are treatment-resistant and being on these drugs feels unnatural/emotionless for some.

Do you think depression should be treated with opioids again (advantages/disadvantages)? Would it be a good idea to make them legally available for that purpose (at least for people who don't get better on the currently used drugs)?

Here's a NY Times article about their potential: https://www.nytimes.com/2016/06/05/opinion/sunday/are-opioids-the-next-antidepressant.html
 
there have been discussions on this before. one of the problems though is that long term use will often result in induced-disphoria. there have been a lot of times where using made me like suicidally depressed. i remember one time in particular i did i shot and spent the next 6-8 hrs wanting to off myself, until the dope wore off and then i was fine. plenty of other times where disphoria was clearly an effect too.

shipping to DITM cuz of the NYT article.
 
Um, no.

I don't think they are a good long term solution. Maybe a small dose of buprenorphine could work for this purpose, but I still don't think a doctor would seriously consider opiates for depression. Especially with the epidemic happening now. Sounds like a good way to get sued. Then there is obviously the issue of tolerance and withdrawal...

I just don't think it would happen.
 
S.J.P. said:
DitM -> BDD (DitM is for recent news)
Click to expand...

my bad, i'll keep that in mind. OD is prolly the best fit for this then, because thats where past threads of this topic should be located.

Pickledlemons said:
Um, no.

I don't think they are a good long term solution. Maybe a small dose of buprenorphine could work for this purpose, but I still don't think a doctor would seriously consider opiates for depression. Especially with the epidemic happening now. Sounds like a good way to get sued. Then there is obviously the issue of tolerance and withdrawal...

I just don't think it would happen.
Click to expand...

for a short term solution i think there's some good potential there, but absolutely not long term. maybe pair up some opioids with behavioral cognitive therapy? might make the BCT easier to do while high, but then the issue is whether or not it'll stick. lots of risks about ending up fully dependent too and ending up in a far worse situation, but the biggest factor in becoming addicted is using opioids without a prescription, to get hgh rather than for medical purposes, so having your therapist script them and only using them exactly as prescribed might work.
 
I will start out by saying that i understand the addictive potential of opioid drugs and the problems prescribing them could cause.
BUT after reading the article i can completly relate to the womans statement 'that the only time in her adult life when she had been able to socialize easily and function at work was when she had been hooked on heroin'.
Myself, I have never tried h, but use dhc (dihydrocodiene) 5 out of 7 days of the week, and will use 30-40mgs of oxycodone every few months to treat myself.
I believe this is an avenue that needs to be researched, the ssri, nsri, and anti psychotic route has been championed as basically the only route to treat depression and it fails more than it succeeds.
Even if the research started with suboxone as this would actually impede a patient's ability to abuse opioids and would deter current users from seeking opioid based drugs.
I really believe there could be help/hope for people with crippling depression, there is just the need for research to be done and proper strategies put in place.
Sorry if this is abit rambly and incoherent iv just finished work and have had a few beersies
 
^^You made some good points here Hyam. Many long-term opioid users (according to some studies around 60-70% are suffering from mental disorders. They obiously treat themselves with these drugs and if it wasn't effective at all, this wouldn't be so common.

Unfortunately, because of a lack of studies, we don't know for sure if tolerance stops the antidepressant effect.
 
I could see it for maybe short time relief, before switching to a typical SSRI, however with the attention to the "opioid epidemic" I don't see any possibility of it happening any time soon.
 
Opioids are great short-term antidepressants, but their long-term efficacy is questionable. Of course there are exceptions, and many opioid users (including heavy users) have benefited from opioids as ADs whether in the past or with ongoing (self)treatment. However, with the political climate nowadays, they're the least likely candidate to be approved for mood improvement. I mean, they are illegal mainly because they're such great mood enhancers (read: you get high) after all.

What opioids lack that SSRIs supposedly do, is continued AD effect after discontinuation. Opioids cease their AD effect as soon as you discontinue them, with potentially altering the brain's reward and pleasure centers for the worse, in that many ex-opioid users have a hard time enjoying stuff. SSRIs alter the brain's circuitry in a way that once discontinued, one continues to feel happier than baseline.

Of course, I'd go for opioids over SSRI any day, and I've tried both classes, but single anecdotal experience is useless in this debate.
 
I don't think opioids are an appropriate treatment for depression long term. They can be very helpful short term provides its done in a careful and controlled manner. But in the long term I think people should try and get help from more psychological therapies combined with more conventional antidepressants. They are far from perfect but they are also generally less risky and non addictive.

I think one big problem is that doctors keep using SSRIs as the first and sometimes only course of action. Despite the fact they are so frequently ineffective. I've seen SNRIs be a lot better on average. Certainly they're far from perfect too, but in my experience they're still a bit more reliable. I've known a lot of depressed people and a lot of people given SSRIs but I've never seen SSRIs ever woke in the long term. SNRIs seem a lot more effective for that. But really medication alone is often ineffective if it's not combined with more tangible courses of action to solve the real life problems that depression feeds off.
 
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I've tried a wide variety of antidepressants and I would have to agree that SNRIs are probably the most effective. With that said though, I believe 99.9999% of ADs are malignant garbage pills. Tramadol was the only one to ever work for me, and I would attribute most of the effects to the opioid mechanisms.

I don't believe the answer to depression is opioids though by any means. I went that route before and ended up with an even more abysmal case of it with extra bonus anxiety. Not to mention their efficacy would be a fraction of what it starts as a very short amount of time into therapy.

Short term though? Fuck yeah.
 
Very high. Smoking weed atm, and constantly smoking H. Got a g of nice tan powder. And some from another batch. Also bought some furanyl fentanyl and another analogue but I won't mess with those unless I need to. (got liquid dosed furanyl fent, and the other one is cut with caffeine. But I still don't feel to comfortable with those substances.

So I'm smoking H. Also ate 80mg oxy, xr. Think I'll add 12mg bromazepam now. And then I'll smoke more H. :P
 
I could see this working for some. I know I seem "happier" after a good over due shot of dilaudid.
Dosing once a week or every other might help overall mood.
Microdosing psychedelics might also be the next anti depressant too though. Lots of good is being
said about that.
 
^I also see much potential and I recently found an article on the potential use of buprenorphine as an antidepressant. Buprenorphine is also a kappa-antagonist, which could be one of the reasons it improves mood.
Unfortunately, combining buprenorphine with an mu-opioid antagonist (samidorphan) seemed to diminish the antidepressant action in clinical trials. ALKS-5461 → (https://en.wikipedia.org/wiki/Buprenorphine/samidorphan) According to that, the mu-receptor seems to be a viable target for antidepressant research, but I think prohibition hinders reasearch.
 
FlyingDutchman342 said:
Unfortunately, combining buprenorphine with an mu-opioid antagonist (samidorphan) seemed to diminish the antidepressant action in clinical trials.
Click to expand...

Not surprisingly. Buprenorphine is after all a partial MOR agonist, which is most likely responsible for its AD effects similar to classical opioids.

@4meSM I'll try to reply soon when I have more time to write a proper reply.
 
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