Clinical Topics   /   Pharmacy

Long-Term Opioid Use Increases Depression Risk

By U.S. Medicine

LOUIS — While opioids can cause short-term improvement in mood as patients experience pain relief, long-term use of the drugs increases risk of new-onset depression, according to a new study.

The research, published recently in the Annals of Family Medicine, also pointed out that the problem was not significantly greater for veterans than other patients.1

The study team, led by St. Louis University Medical School researchers and including representatives from VAMCs in St. Louis and Temple, TX, called on clinicians to consider the contribution of opioid use when their patients develop depression.

“Opioid-related new onset of depression is associated with longer duration of use but not dose,” the report stated. “Patients and practitioners should be aware that opioid analgesic use of longer than 30 days imposes risk of new-onset depression.”

The authors also urged more research to identify which patients are most vulnerable to opioid-related depression.

For the study, researchers collected data for 2000-2012 from 70,997 VHA patients, 13,777 Baylor Scott & White Health (BSWH) patients and 22,981 Henry Ford Health System (HFHS) patients. Participants were new opioid users, ages 18 to 80 and without a diagnosis of depression when they began taking medication.

The research sought to determine whether taking an opioid for a longer period of time is associated with new-onset depression, while controlling for dose and whether a higher dose of opioids is associated with new-onset depression after adjusting for duration.

They also investigated whether opioid analgesic use remains associated with new-onset depression after controlling for pain scores in VHA patient data and whether results generalize to two independent healthcare populations.

Results indicated that 12% of the VHA sample, 9% of the BSWH sample and 11% of the HFHS sample experienced new-onset depression after opioid analgesic use.

“Findings were remarkably consistent across the three healthcare systems, even though the systems have very different patient characteristics and demographics,” lead author Jeffrey Scherrer, PhD, said in a Saint Louis University press release.

The study found that, in all three patient groups, longer duration of opioid analgesic use was associated with new-onset depression after controlling for pain and daily morphine equivalent doses.

Opioid drugs in the study included codeine, fentanyl, hydrocodone, hydromorphone, levorphanol, meperidine, oxycodone, oxymorphone, morphine and pentazocine.

1 Scherrer JF, Salas J, Copeland LA, Stock EM, Ahmedani BK, Sullivan MD, Burroughs T, Schneider FD, Bucholz KK, Lustman PJ. Prescription Opioid Duration, Dose, and Increased Risk of Depression in 3 Large Patient Populations. Ann Fam Med. 2016 Jan;14(1):54-62. doi: 10.1370/afm.1885. PubMed PMID: 26755784.

 

 


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