Posted by ed_uk2010 on January 29, 2015, at 18:17:24
In reply to Re: feeling like im out of options, posted by hello123 on January 29, 2015, at 17:47:03
>I was simply hoping to benefit from from naltrexone's kappa antagonism, since it has been shown to benefit depression....
It's an interesting option.
My opinion of naltrexone as a potential treatment for depression is that its very potent mu opioid antagonism may be an issue. It is a kappa antagonist as well, albeit less potent. A selective kappa antagonist would be more interesting as an antidepressant.
Mu agonists, such as morphine and hydrocodone frequently produce short-lived (but often marked) mood elevation followed by tolerance and dependence. The potential for problems is high, including the risk of worsening depression in the long run. Chronic use of mu agonists also disrupts the endocrine system, causing sexual dysfunction. Dependence on opioids may result in a state where the ability to experience pleasure naturally is reduced. I wouldn't be surprised if the long-term use of methadone is associated with more depression than buprenorphine (Suboxone etc) maintenance. In fact, I believe I've read that it is.
Mu antagonists such as naltrexone can sometimes feel subjectively unpleasant. I would be concerned about the potential for any potent mu antagonist to block the effects of natural endorphins in the body. This could, theoretically at least, aggravate anhedonia.
Really, it would probably be best to avoid hitting the mu receptor when treating depression.
poster:ed_uk2010
thread:1075467
URL: http://www.dr-bob.org/babble/20150129/msgs/1075737.html