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Prescription-based narcotic painkillers have long been known to reduce pain, but new reports suggest that there is a link between chronic use of these medications and an increase in major depression.
The study analyzed 50,000 veterans who had no history of opioid use or depression and were later prescribed opioid painkillers.
Patients who started and remained on opioids for 180 days or longer were at a 53 percent increased risk of developing depression. Those who used opioids for 90 to 180 days were at a 25 percent risk when compared to those who used the opioids for fewer than 90 days.
"These findings suggest that the longer one is exposed to opioid analgesics, the greater is their risk of developing depression," said Jeffrey Scherrer, Ph.D., associate professor of family and community medicine at Saint Louis University and principle investigator of the study. "Opioids have long been known to allay pain and suffering, but reports of adverse effects are abundant and continue to emerge."
While there is no causal link, Scherrer suggests there are many ways the two could be related. It could be an opioid-induced resetting of the brain’s "reward pathway," which causes chronic use of narcotic painkillers to elevate the threshold for a person’s ability to experience pleasure. Another possibility is that deficiencies in adrenal, testosterone and vitamin D, as well as glucose dysregulation, could be causing the depression.
“Preliminary evidence suggests that if you can keep your daily dose low, you may be at lower risk for depression,” Scherrer said.
Scherrer concluded: "Even though the risk is not huge, there is enough exposure that we may have a public health problem."
Sources: MedicalNewsToday, Journal of General Internal Medicine
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