Question about depression while on opiate medication

[Skyfoxglitter]

I was wondering if anyone else taking opiate medications have started suffering from some form of depression??  Before starting my medications I never had a problem with depression but since starting opiates I have been having mood swings and deprssion....I know the depression isn't coming from my pain because it's pretty well controlled on the medication, my Dr tried me on Cymbalta and Pristique and both ended up with seratonin syndrome which left me horribly ill and hospitalized.. Can anyone tell me what antidepressants are safe to take while on opiate therapy?? or your experience with them??? Thanks for any advice I recieve

                                                                    Sky

[Skyfoxglitter]

Thank you so much for your kind words and encouragment....I have switched my meds a couple of times hoping that would indeed change my mood but I get the same depression no matter what the medication is....I am currently on a low dose Oxycontin and a short acting Oxycodone for breakthrough, and I do feel it is the opiates causing my depression as I never had any symptoms prior to taking these meds....I will inquire at my Dr"s appt August 10th and thank you again for taking the time to respond it means alot to me as I have no one at home to talk to about these issues because no one understands what I am going through and it's easier for them to just say "snap out of it" because they really don't understand....I can feel through your post that you do understand so thanks and I will keep posting and help when I think its appropriate for me to do so :-)

[Tuckamore]

Hello Sky,

Welcome to our Pain Mangement forum. I am very glad that you found us and took the time to post. However I am so sorry to hear that your opiates are causing depression.

Anti-depressants have never been very effective for me. I can't tell you how many I tried in the early years before I even went on pain medication. For me it was the chronic pain that was depressing, called situational depression. Once my pain was better controlled so was my depression. However narcotics can and do produce a form of depression.

Have you consulted a PM Therapist. Sometimes they are able to help with the depression better than medications, especially if you are sensitive to them.

Another thought would be to try a different opiate. I noted mode changes when I took oxycodone for a short time some years ago. Now I can take them without any emotional side effects. I cannot tell you why it is now different. We all react differently to different medications. If may be worth the switch if your depression is bothersome as it does appear to be.

Herbal supplements is another possibility that you could discuss with your physician as mentioned above. In fact it may be a good idea to have your vitamin and mineral levels checked. Sometimes an unknown deficiency can cause depression. I have deficiencies of Vit B12 and Vit. D. When my levels are low I can feel it physically and emotionally..

I am sorry that you are feeling helpless. We have all been there. Chronic pain alone can make us feel vulnerable as well as helpless. I encourage you to remain with us and be as active as possible on our forum. I have found the support, understanding and caring of our member to be very beneficial. I am hopeful you that will find that to be true also.

We will look forward to hearing from you again soon.

Peace,
~Tuck

[jamlws]

I have heard and read that pain meds can cause depression and it is something you have to watch out for when your on them. Sometimes it does get better but sometimes it dont. I would ask your dr about when you go to see him on the 19th of Augs. And your also right chronic pain and depression go together. I know I am always down when my pain is really bad. But there are so many different meds out there that may not cause you to get depressed, something you and your dr will have to look into.
Jamie

[Skyfoxglitter]

Thank you both for your responses....I didn't take Cymbalta and Pristique together they are just the two my Dr tried me on, I have my next appointment August 10th and will ask about the herbal supplements you both mentioned....I'm just worried about the way I feel because like I said I never had any type of depression before opiate therapy but it seems to just be this ligering doom I feel all the time, I wish I didn't have to take these medications but I have tried every other treatment possible before going to meds and the first couple of months I was fine it seems since I went to a longer acting opiate is when the depression really kicked in...I feel like I have to pick the lesser of 2 evils, take the pain meds and be depressed or don't take the meds and be in constant pain which will I'm sure also lead to some type of depression.....I just feel so hopless but again thank you both for your help

[Sarajmt]

My problems with depression didn't really get going  until the pain increased to the point I needed opiates.  I'd used them from time to time for  a few years for the pain but didn't always need them.  If I felt depressed before SamE and St. Johns Wort, which is widely used in Germany for depression, did the trick.

Once I had to go into pain management because the pain got out of control, that's when the real depression set in.  I use Lortab and Cymbalta with no problems.  Except for situational depression, I'm fine.  

With your doctor's permission, you may wish to try St Johns Wort or SamE.  I'm sure there are other herbal meds to help with depression.  Someone knowledgeable about these remedies should be able to help.  But don't use anything, even herbs, without your doctor's permission.

I really hope to see you post more!  I'm sure this forum could benefit greatly from your experience and wisdom.   And I really hope a solution for your depression is found.  Pain increases depression and depression can increase pain.  Good Luck!!!!
Sara

[runitskat]

I had major depression before I started taking opiates but they did make my depression worse. I started taking Wellbutrin and Zoloft and they both help and don't interact with Vicodin, which is what I take. I also want to add that taking the Wellbutrin and Zoloft has brought out my hidden bi polar, which I didn't know I suffered from. Antidepressants can sometimes make bi polar symptoms worse. If you didn't suffer from depression before the opiates I don't think that will be a problem for you but it's worth mentioning. If you don't want to take antidepressants you can always look into Saint Johns wart or 5HTP, but do not take them together because that can also cause serotonin syndrome.

Were you on Cymbalta and Pristiq at the same time? They are both serotonin-norepinephrine reuptake inhibitors and taking both of them together can cause serotonin syndrome. If you take a selective serotonin reuptake inhibitor (Zoloft) and a dopamine reuptake inhibitor (Wellbutrin) you will not have the risk of serotonin syndrome since they both do different things.