ST. LOUIS, MO — The chronic use of opioid analgesics is linked to an increase in the risk of developing major depression, according to a review of veterans’ medical records.
The study, led by Saint Louis University researchers, was published recently in the Journal of General Internal Medicine. For the study, medical records were analyzed for about 50,000 veterans who had no history of opioid use or depression and were subsequently prescribed opioid pain-killers.
Researchers found that patients who started and remained on opioids for 180 days or longer were at a 53% increased risk of developing a new episode of depression. Veterans using opioids for 90-180 days were at a 25% increased risk compared with patients who never took opioids for longer than 1-89 days.
“These findings suggest that the longer one is exposed to opioid analgesics, the greater is their risk of developing depression,” said lead author Jeffrey Scherrer, PhD. “Opioids have long been known to allay pain and suffering, but reports of adverse effects are abundant and continue to emerge.”
Scherrer suggested several mechanisms by which opioids could contribute to the development of depression, including opioid-induced resetting of the brain’s reward pathway to a higher level. That could raise the threshold for the patients’ enjoyment of natural rewards such as food or sexual activity.
Other factors might include body aches months and years after the cessation of opioid use or side effects such as adrenal, testosterone and vitamin D deficiencies and glucose dysregulation, he said.
Because the study found the greater risk of depression at higher doses of opioid analgesics, “Preliminary evidence suggests that if you can keep your daily dose low, you may be at lower risk for depression,” Scherrer added.
1. Scherrer JF, Svrakic DM, Freedland KE, Chrusciel T, et al. Prescription Opioid Analgesics Increase the Risk of Depression. Journal of General Internal Medicine, 2013; DOI: