Posted by Dr. Bob on April 14, 2001, at 23:32:57
In reply to Richelson: use of opiates for depression, posted by ShelliR on April 11, 2001, at 20:03:37
> There are a few of us on this board who have been treated with small amounts of opiates to augment antidepressants for treatment resistant depression. Do you believe that some people are particularly responsive to the anti-depressant effects of opiates? In some cases (on this board) and on the internet in general, there are patients who have been treated with opiates (e.g., hydrocodone), and have found the same amount to continue to be effective for many years, and others who have had to increase because of tolerance. Do you know why that might be the case? What is your feeling about using opiates as part of treatment for depression, when no other drug combinations have succeeded in treating the depression? Do you think targeting opiate receptors will play any role in the development of future anti-depressant medications?
Long before the established antidepressants were available, opiates and opioids were used to treat depression. However, for various reasons today, I would not use this class of compounds to treat depression. The mechanisms of tolerance to a drug is very complex and not well understood for most drugs. Some mechanisms involve increased metabolism of the drug and adaptive changes at the cellular level. The theory about tolerance to opioids is that there are adaptive changes at the level of receptors for these compounds. Why tolerance would not develop in some patients, but not others is a mystery.
poster:Dr. Bob
thread:59488
URL: http://www.dr-bob.org/babble/20010411/msgs/59892.html