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Medication Treatments for Opioid Use Disorder: What Is the Impact on Mood and Mood Disorders?

  • Dual Diagnosis (T George and A Hassan, Section Editors)
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Abstract

Purpose of Review

There has been an interest in evaluating the effect of opioid medications on mood in patients with or without opioid use disorder (OUD) because of potential mechanistic relationships between the opioid system and mood. In this review, we will summarize the prospective clinical trials that used opioid medications (naltrexone, methadone, and buprenorphine) to evaluate the effect on mood and anxiety in patients with and without OUD.

Findings

Buprenorphine and buprenorphine/samidorphan combination have shown promising short-term effect for depressed patients without OUD but the effects are modest. Naltrexone does not worsen mood in patients with OUD and is in fact associated with improved mood for adherent patients. Methadone and buprenorphine treatment for OUD are both associated with substantial improvements in mood.

Implications

Buprenorphine or buprenorphine combined with a mu receptor antagonist may be effective for treatment-resistant depression among patients without OUD, and large randomized controlled trials with longer trial lengths are needed to further evaluate this effect. Among patients with OUD, effective medication treatment for the OUD is the priority, and with any opioid medication mood often improves.

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Authors and Affiliations

  1. Addictions Division, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON, M6J 1H4, Canada

    Ahmed N. Hassan

  2. Department of Psychiatry, University of Toronto, Toronto, Canada

    Ahmed N. Hassan

  3. Department of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA

    Edward Nunes

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Correspondence to Ahmed N. Hassan.

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Conflict of Interest

Dr. Nunes reports grants from NIDA/NIMH, Braeburn, and Alkermes during the conduct of the study. Dr. Hassan has nothing to disclose.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Dual Diagnosis

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Hassan, A.N., Nunes, E. Medication Treatments for Opioid Use Disorder: What Is the Impact on Mood and Mood Disorders?. Curr Addict Rep 5, 303–311 (2018). https://doi.org/10.1007/s40429-018-0215-x

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