Prescription Painkillers Increase Risk of Depression

painkillersLong-term use of opioid painkillers can increase the risk of developing major depression.[1] A study conducted by Saint Louis University analyzed the medical record data of 50, 000 veterans who did not have a history of depression or opioid use but were recently prescribed opioid painkillers for chronic pain.1 The researchers found that patients who remained on prescription opioids for 180 days or longer were at a 53 percent increased risk of developing major depression.1 For those who took opioid painkillers for 90 to 180 days, patients were at a 25 percent increased risk, while those who did not use opioid painkillers for longer than 89 days did not have a significant increased risk for depression.1

According to chief investigator of the study, Jeffrey Scherrer, Ph.D., opioid painkillers are widely known to relieve pain; however, there are many adverse effects—some still unknown and emerging.1 Scherrer also stated that while there is currently no clear understanding of the mechanisms by which opioids contribute to the development of depression, there are several factors that can lead to the disorder.1

Opioids reset the brain’s reward pathway to a higher level, meaning that long-term use of opioid painkillers can elevate the threshold for a person’s ability to experience pleasure from natural rewards, such as food or sexual activity.1 Other factors include body aches that occur months or years after the use of opioids has been stopped and adrenal, testosterone, and vitamin D deficiencies, as well as glucose dysregulation.1

Scherrer and colleagues also suggest that the higher the dose of opioid painkillers, the greater the risk of depression.1 Preliminary evidence suggests that if a person’s daily dose is lower, their risk of depression is lower.1 Unfortunately, other studies have shown that the use of prescription opioid painkillers have increased fourfold recently, with more than 200 million prescriptions issued in 2009.1 Although a small number of patients are prescribed prescription opioids long term, the medicines have the ability to kick off a depression that will affect the person’s quality of life and capacity to handle chronic pain.1

This study was released a week after the FDA released suggested regulations for tighter controls of how doctors prescribe common opioid painkillers containing hydrocodone, making  them controlled as strictly as more powerful painkillers, such as morphine.1 The FDA has become increasingly concerned about the abuse and misuse of opioid painkillers as their use has reached epidemic proportions in the United States.1

Although the risk of developing major depression is not overwhelming, it is still large enough to be considered when prescribed opioid painkillers.1

[1] Nauert, R. (2013). Prescription Painkillers Can Up Risk of Depression. Psych Central. Retrieved on November 4, 2013, from http://psychcentral.com/news/2013/11/01/prescription-painkillers-can-up-risk-of-depression/61446.html

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