What if your body didn’t like the drugs you took?
You might want to consider a new pill or two to ease that discomfort.
That’s the conclusion of a new study, published online February 24 in JAMA Internal Medicine.
The results are a sobering reminder that drugs aren’t always safe.
“We found that patients who took opioids as their first drug therapy actually had lower levels of depression, anxiety and pain when compared to those who did not,” says Jennifer N. Shook, M.D., Ph.
D. and lead author of the study.
“This finding suggests that patients might be better off starting with a different drug or two that might help them to tolerate the drug in a more tolerable way.”
The study involved 1,200 patients from a population of mostly African American men and women, ages 18 to 59.
They were randomly assigned to one of four groups: 1) people who received opioids as first-line therapy, 2) people receiving an opioid replacement therapy, 3) people taking a placebo, or 4) no treatment at all.
All of the patients were tested three months later, to assess their responses to the drugs and to measure their overall mood, mood symptoms, and overall quality of life.
The drug group received opioids for four weeks and the placebo for two weeks.
The patients who received the opioids were then asked to take the drugs every other day for six weeks.
Patients who were randomized to receive the opioids had higher levels of mood symptoms and more pain compared to the placebo group, the study found.
Overall, those who received opioid therapy were more likely to have lower levels (median) of depression and anxiety.
The opioid group also had lower rates of pain.
“Our data suggests that opioid-induced depression and pain relief is beneficial for opioid-treated patients, although not always the same patients,” Shook says.
“We can hope that more research is done on the benefits of different opioid treatments for depression and other pain problems.”
Shook’s team found that opioids are most effective in treating depression and the opioid replacement drugs are most likely to be effective in relieving other symptoms of depression.
“If you think about pain, opioids are the ones that work the best,” says Dr. Andrew S. Cohen, M .
D., a psychiatrist and professor of medicine at the University of Texas Southwestern Medical Center.
“It’s the only drug that is safe when it comes to pain and depression, and it’s also the drug that can relieve anxiety.”
The findings add to the growing body of evidence linking opioids to the development of mental health disorders.
There are currently two approved opioid treatments, including methadone, and another, naltrexone, is on the market.
“When you start thinking about opioid medications, they are not the same drugs as they were 20 years ago,” says Shook.
“There is some evidence that they work better than other opioid drugs.
However, it’s still important to be aware of the potential risks of opioids.”
For example, the authors say that there is a risk that opioids can increase the risk of serious cardiovascular events.
“The longer you take opioids, the greater the risk that the opioid will get into your system and lead to death,” says Cohen.
Another complication of opioids is that they can increase blood pressure.
In the study, patients who were on opioids for at least six weeks had significantly lower levels in the blood of triglycerides, which are markers of inflammation in the body.
“Some people have higher levels in their blood of inflammatory markers, which is linked to cardiovascular disease,” says N.R. Cohen.
“That is one of the reasons we need to be careful with prescribing opioids.”
The new findings, Cohen says, are a reminder that the drugs we use and the drugs that we give to others should not be interchangeable.
“What is important to remember is that people have to have their own preferences when it to be used in therapy,” he says.
If you’re worried about the effects of your opioid treatment on your mood, feel free to talk to your doctor about your treatment plan.
N.N. Shakes work was supported by the National Institutes of Health (grant UL1 CA152782).
The study was funded by the Howard Hughes Medical Institute, the National Institute on Drug Abuse, the Johns Hopkins University Comprehensive Cancer Center, the U.S. Department of Health and Human Services, and the National Cancer Institute.
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