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Re: codeine relieves depression

Posted by Elizabeth on April 5, 2001, at 7:05:43

In reply to Re: codeine relieves depression, posted by Lisa Simpson on April 1, 2001, at 14:43:32

> I've been taking codeine phosphate for ulcerative colitis for many years, and yes, I found it helps with my depression. The trouble is, though, that as time goes on, I need more and more of the drug to get the same effect. At the moment, I am taking 36 x 30mg tablets at a time, which I think you will agree, is a real addiction.

This is an old use of the word "addiction." "Physiological dependence" is probably more accurate. Most people who take codeine or similar drugs (opioid agonists) for a long enough period of time -- for whatever reason -- will develop tolerance to some of the effects (although I'm surprised that you have such a tolerance to the GI effects, which persist for years in a lot of people). "Addiction" (not really a medical term) exists when you have psychological "cravings" and (AFAIK) only happens when people take a drug to get high, develop tolerance to the mood elevating effect, and keep needing more and more in order to sustain the high. So-called "medical addicts," people who started out using opioids for (usually) pain and then became addicted to them for their mood-elevating effects, are rare. As a rule, as long as you don't abuse prescribed opioids (i.e., use more than the amount you need), you'll be able to stop taking them without too much difficulty (there may be some withdrawal symptoms, depending on which drug you are taking and what degree of tolerance you develop, but many drugs -- including antidepressants such as Effexor -- have withdrawal symptoms).

That said, codeine is not the best opioid to use as an antidepressant. It is very weak and has too many adverse effects relative to its desired effect. It would be better to use a low dose of a stronger opioid. There is not much documentation of the use of opioids as antidepressants (although before amphetamine was discovered, they were the drugs of choice for depression), but existing documentation suggests that many or most people can use them long-term without needing to raise the dose. (Buprenorphine, a partial agonist, is a good choice because it doesn't cause euphoria and has a "ceiling effect," meaning that its effects don't increase past a certain dose.)

Needless to say, it's a bad idea to use opioids without a doctor's supervision.


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poster:Elizabeth thread:1897
URL: http://www.dr-bob.org/babble/20010403/msgs/58759.html