Depression Can Recur After Opioids Initiated For Non-Cancer Pain

MedicalResearch.com Interview with:

Dr-Jeffrey-ScherrerJeffrey F. Scherrer, PhD
Associate Professor
Research Director
Department of Family and Community Medicine
Saint Louis University School of Medicine
St. Louis, MO 63104 

Medical Research: What is the background for this study? What are the main findings?

Dr. Scherrer: We initiated a series of studies on chronic opioid use and risk of depression about 3 years ago and obtained an NIH R21 to study prescription opioid use and risk of new onset depression, depression recurrence and transition to treatment resistant depression.  The rationale comes partly from clinical observations of the research team (I am not a clinician, just a epidemiologist).  We also observed the large field demonstrating patients with depression are more likely to get opioids for pain, take them longer and develop abuse.  We wanted to switch the direction of effect to determine if the reverse exists.  After publishing two papers demonstrating longer use of opioid was associated with increasing risk of depression, our next step was to look at recurrence among patients with a recent history of depression.

Medical Research: What should clinicians and patients take away from your report?

Dr. Scherrer: Our main recommendation is clinicians should repeatedly screen patients for depression.  While screening at time of starting opioids is common, repeated screening is worth consideration.  Patients with depression who may experience temporary euphoria should not expect opioids to cure depression and they may increase risk for worsening mood and or recurrence after long term use.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Scherrer: The retrospective observational cohort design has many inherent limitations.  To overcome these we seek to collect symptom level data, obtain lifetime diagnostic histories and confirm if there are factors such as poor mood, but not full blown depression, that worsen after initiating opioids.   We are planning to prospectively collect data to answer these questions and overcome limitations of our existing approach. 

Medical Research: Is there anything else you would like to add?

Dr. Scherrer: Our study does not seek to argue for restricted access to pain medications.  We hope it improves informed prescribing of opioids and contributes to better pain management.

Citation:

Increased Risk of Depression Recurrence After Initiation of Prescription Opioids in Noncancer Pain Patients

Jeffrey F. Scherrer, PhD (2016). Depression Can Recur After Opioids Initiated For Non-Cancer Pain

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