October 31, 2013
Chronic Use Of Painkillers Linked To Depression
Brett Smith for redOrbit.com - Your Universe Online
While prescription opioid painkillers bring relief to countless individuals, they are also linked to serious adverse effects, such as addiction or potential for overdose.
According to a new study from St. Louis University researchers in the Journal of General Internal Medicine, the chronic use of prescription painkillers is associated with an increased risk of developing severe depression.
The study researchers looked at medical records of about 50,000 veterans without a history of opioid use or depression who were prescribed prescription painkillers. According to the team’s analysis, patients who began and maintained on opioid regimen for 180 days or longer had a 53 percent increased risk of developing new symptoms of depression. Those on the opioids for 90 to 180 days saw a 25 percent higher risk compared to patients who never took the drugs for longer than 1 to 89 days.
"These findings suggest that the longer one is exposed to opioid analgesics, the greater is their risk of developing depression," said study author Jeffrey Scherrer, an associate professor of family and community medicine at Saint Louis University. "Opioids have long been known to allay pain and suffering, but reports of adverse effects are abundant and continue to emerge."
He said even though there is a lack of understanding about exactly how opioids might contribute to the development of depression in a patient, there may be numerous factors leading to it.
Some factors could include a potential resetting of the brain's reward-signaling pathway to a higher setting, meaning the regular use of these painkillers could boost the threshold for a person's capacity to experience pleasure from natural sources, such as a food, social relationships or sexual activity.
Other reasons for the relationship could be continued pain months and years after the cessation of drug use, hormonal side effects, vitamin D deficiencies and the disruption of glucose regulation.
The researchers also found the higher the dose of painkiller used, the greater the risk of depression.
"Preliminary evidence suggests that if you can keep your daily dose low, you may be at lower risk for depression," Scherrer said. He added that even though a small amount of patients are chronically prescribed these drugs, the medications could kick off a depression that can affect their quality of life and their capacity to handle chronic pain. Recent studies have found the use of prescription painkillers has quintupled recently and that more than 200 million prescriptions were written to American patients in 2009.
"Even though the risk is not huge, there is enough exposure that we may have a public health problem," Scherrer said.
The new study comes a week after the FDA released suggested regulations for tighter controls on how doctors prescribe common, widely-used narcotic painkillers containing hydrocodone, making them controlled as strictly as powerful painkillers such as morphine.
In announcing the recommendations, the FDA said it had become "increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States."