anti-depressants vs. opiates

[gib65]

What's the difference?

[MolotovCocktail]

Opiates are basically pain killers, such as Morphine. Anti-depressants, such as Prozac, help regulate neurotransmitters in the brain (such as Serotonin, the so-called "happy" chemical).

[gib65]

Besides be pain killing effects of opiates, what's the difference between the mood uplifting effects between each?

[MolotovCocktail]

Opiates tend to relax a person. But while they do relax a person, it is not quite the same as an anti-depressant. Anti-depressants will usually ease the symptoms of depression, such as extreme sadness, by introducing chemicals, or regulating them, that act as neurotransmitters. Opiates don't necessarily relieve negative emotional states, all they really do is relax the person and dull the senses. A little similar to alcohol.

 

Here is more information on opiates:

 

link: http://www.drugtext.org/sub/opiat1.html

[gib65]

Thanks for the link.

 

Anti-depressants will usually ease the symptoms of depression, such as extreme sadness

 

So, then, would you say that anti-depressant just remove/regulate the sadness but won't necessarily make you happy (i.e. they make you "normal")? I've had experiences with opiates and they do brighten your day.

 

Maybe the link you gave me will answer my question.

[Glider]

As a broad division, opiates work on opiate receptors system antidepressants work on serotonergic and dopaminergic systems.

 

Most commonly, depression is associated with reduced levels of the monoamine neurotransmitter serotonin (5-Hydroxytriptamine or 5-Ht). Many antidepressants are designed to elevate levels of serotonin at the synapse. The most common are Specific Serotonin Reuptake Inhibitors (SSRIs) that block the reuptake of 5-Ht by the presynaptic membrane. Others inhibit the ensyme Monoamine Oxidase (MAO) that breaks down 5-Ht (Monoamine Oxydase Inhibitors or MAOIs). These mechanisms serve to increase levels of ambient 5-ht in the synaptic cleft. This will elevate mood in depressed individuals, but not in those who are not depressed.

 

Opiates work on a number of different systems. Opiate receptors have at least five forms: Delta, Kappa , Mu, Sigma and Tau. Delta, Kappa and Tau are found in pathways mediating pain in the brain and spinal cord which makes opioid analgesics the most effective painkiller we have (although nociceptive inhibition is not their main effect).

 

However, opiates also inhibit GABA (Gamma Amino Butyric Acid) receptors in the Ventral Tegmental Area (a part of the brain's reward system). GABA is an inhibitory neurotransmitter, and if you inhibit an inhibitory mechanism, then the systems that mechanism was inhibiting is free to fire at will (like taking your foot of the brake). Inhibition of GABAergic neurons in the VTA allows dopaminergic (DA) neurons to fire more freely and and an elevation of DA in the reward system is ..well...rewarding. It's the basic mechanism that all drugs of abuse share in common.

[geoguy]

The question isn't quite posed correctly. An opiate is a physical entity. An anti-depressant is a description of an intended use of drugs. It's like asking what's the difference between an apple and foods for reducing cholesteral levels... rather than asking the difference between an apple and an orange.

[Revenged]

So, then, would you say that anti-depressant just remove/regulate the sadness but won't necessarily make you happy (i.e. they make you "normal")? I've had experiences with opiates and they do brighten your day.

 

Maybe the link you gave me will answer my question.

 

when you are looking into how anti-depressants work you should be aware that it is far from simple... the story many people are told is that depression is due to low levels of neurotransmitters in the brain... however, there are many problems with this theory...

 

Problems with this theory:

1) anti-depressants take about 3 weeks to work and no one really knows why

2) cocaine is a reuptake inhibitor - and so it should be an anti-depressant... but the only problem is that it isn't

3) 'atypical' anti-depressants (e.g. mianserin) do not affect amine levels but are anti-depressants

4) afaik, there has been little evidence to suggest that there are low levels of neurotransmitters in the brains of people with depression

 

Opiates have a completely different mechanism of action and work fairly quickly... as it has been pointed out, they are taken medically for pain relief... You give someone morphine and the drug will very quickly pass through the blood brain barrier and will bind to opioid receptors in the central nervous system...

 

The reason that they cause addiction and as you put it 'brighten the day' is because they cause activation of the reward centres in the brain... and as glider pointed out, this is because of the activation of opioid receptors by opioids cause the disinhibition of GABA, which increases dopamine levels in the reward centres of the brain... but you only get such effects if you abuse opioids as it is very uncommon to get addicted to opioids if you are taken them for pain... this is where the idea comes from that pain inhibits the reward centre activation of the brain...

 

Btw, anti-depressants can also be given for chronic pain... e.g. low dose amitriptyline may be given...

[gib65]

The question isn't quite posed correctly. An opiate is a physical entity. An anti-depressant is a description of an intended use of drugs. It's like asking what's the difference between an apple and foods for reducing cholesteral levels... rather than asking the difference between an apple and an orange.

 

Ah, so some opiates can also be anti-depressants. So there's not really an essential difference.

[Revenged]

Ah, so some opiates can also be anti-depressants. So there's not really an essential difference.

 

Opioids are NOT used as anti-depressants...

[Glider]

Revenged is quite right. The reasons why many antidepressants work is far from clear. It's known that SSRI's and MAOIs elevate levels of monoamines, and taking them aleviates depression, but that it's therefore the elevation of monoamines that alleviates depression is only an assumption.

 

There are many studies that have shown lower levels of 5-Ht (or Levels of 5-hydroxyindolacetic (5-HIAA), a 5-Ht metabolite that can be measured from cerebrospinal fluid) in depressed people than non-depressed people, but what is not clear is whether that's a cause or a result of the depression. The relationship is only correlational. To make it worse, there is more than one kind of depression, some of which are completely unaffected by elevating monoamines. It is known however that 5-Ht is also active in the reward centres and is associated with feelings of calm and wellbeing (as opposed to euphoria).

 

There's a similar problem with treatments for schizophrenia. This condition is associated with elevated levels of dopamine. So, they prescribe dopa blockers. These effectively suppress the positive symptoms of schizophrenia (but have no effect on the the negative). However, with long term use of dopa blockers, the body compensates and increases the number of dopamine receptors at the post synaptic membranes so there's as much activity in dopaminergic neurons as there was pre treatment. However, the positive symptoms don't return.

 

And no, opiods are not used as antidepressants. They are analgesics.

[Revenged]

There's a similar problem with treatments for schizophrenia. This condition is associated with elevated levels of dopamine. So, they prescribe dopa blockers.

 

the problem was caused because the newer atypical neuroleptics that target both the positive and negative symptoms of schizophrenia work by antagnosing serotonin receptors... they do not block dopamine D2 receptors like the older typical neuroleptics... this questions the dopamine theory of schizophrenia...

[Glider]

Yeah...and it was already shaky.

[geoguy]

Opioids are NOT used as anti-depressants...

 

Not true. You are still mixing up an entity with a function. An opiate, chocolate bar, up of coffee, etc...as well as any number of medications can be an anti-depressant. There is all types of examples of opiates as anti-depressants. Methadone has been used as an anti depressant for decades.

[Revenged]

There is all types of examples of opiates as anti-depressants. Methadone has been used as an anti depressant for decades.

 

 

I give up with this thread...

[geoguy]

 

I give up with this thread...

 

 

You are confused because you've neglected the number one requirement in science....define terms and compare eqivalencies. An opiate is a specific compound with physical molecular structure....an anti-depressant is a general concept that may or may not include specific molecular structure....it is an array of physical entities. One doesn't compare subsets such as 'a smile' (a physical event) with 'expressions of human emotion' (that can include a smile). In science a subset is not exclusive in a comparison. Science 101.

[gib65]

Well, it makes sense to me. The whole reason I started this thread is because I just recently got myself some kratom leaves. Before it was made illegal in Thailand, the Thai used to chew on these in order to give them a mild pick-me-up and make physical labor go by a little more smoothly (kinda' like coffee for us). When I tried it, it sure put me in a good mood, and it got me thinking whether this could be used as an anti-depressant in a clinical setting. I don't know what doctors think of using opiates as anti-depressants though (wouldn't there be a risk of addiction?), but as geoguy said, there's methadone, so I guess it's already been done.

[Revenged]

but as geoguy said, there's methadone, so I guess it's already been done.

 

no, it has not been done... methadone isn't used as an anti-depressant... what are you talking about!... that is like saying heroin is an anti-depressant... it is absolute madness... the smiley was because after all that everyone said about the differences of opioids and anti-depressants you both seem to think that opioids are used as anti-depressant when they are not... I was simply losing patience... i wasn't at all 'confused' as geoguy put... In fact it seems the other way around... I also do not take kindly to a geologist patronising me when he clearly is his own subject...

 

And no, opiods are not used as antidepressants. They are analgesics.

 

and notice how glider agreed with me...

[gib65]

no, it has not been done... methadone isn't used as an anti-depressant... what are you talking about!... that is like saying heroin is an anti-depressant... it is absolute madness... the smiley was because after all that everyone said about the differences of opioids and anti-depressants you both seem to think that opioids are used as anti-depressant when they are not... I was simply losing patience... i wasn't at all 'confused' as geoguy put... In fact it seems the other way around... I also do not take kindly to a geologist patronising me when he clearly is his own subject...

 

 

 

and notice how glider agreed with me...

 

Oh, I'm sorry, Revenged, from now on, I'll only listen to your posts and I'll completely ignore anything anybody else says, because, as you and I both know, you're where the buck stops.

 

Does this even apply to questions? I mean, I can't read the all-knowing Revenged's mind unless I begin with a question like

 

I don't know what doctors think of using opiates as anti-depressants though (wouldn't there be a risk of addiction?)

 

which clearly shows that I'm not so stupid to think heroin could be used as an anti-depressant. Obviously there are some opiates that, although way more mild than heroin, could still lead to addictive behavior (look at pain killers... and they're sold over the counter). Also, I really appreciate the , it's really constructive and it makes me want to ask more question here at SFN. If only everyone was as generous as you and handed out :doh:'s to every question posted on this forum. I think it would create a very amicable atmosphere, and would bring people back for more questions and discussion. In fact, you're so willing to help, you seem to go out of your way after having said that you're through with this thread and are too frustrated to deal with the course this discussion has taken, rather than leave it alone like anyone else would if they had nothing but nasty sentiments to express. What a guy!

[Glider]

Originally Posted by Revenged

Opioids are NOT used as anti-depressants...

Not true. You are still mixing up an entity with a function. An opiate, chocolate bar, up of coffee, etc...as well as any number of medications can be an anti-depressant. There is all types of examples of opiates as anti-depressants. Methadone has been used as an anti depressant for decades.

Rubbish. Whilst I take your point about mixing entity and function, it is not a particularly strong point in this case. Opioids are not used as antidepressants because they do not have a clinically useful antidepressant effect. If they did then so many methadone patients would not also be on antidepressants (e.g. imipramine).

 

In this case it is you who have mixed your terms. 'Antidepressant' and 'narcotic' (or 'euphoric) refer to different effects. Try prescribing chocolate or coffee to the clinically depressed and see what happens.

 

Obviously there are some opiates that, although way more mild than heroin, could still lead to addictive behavior (look at pain killers... and they're sold over the counter).

No opiate drug is sold over the counter. Opiate analgesics are controlled drugs and are available on prescription only. Painkillers are sold over the counter, but there are many kinds of painkillers, only some of which are opiates.

 

At analgesic doses, opioids have no narcotic effect (apart from in those who have an intolerance to opioid drugs) and don't affect mood. The stronger doses (e.g. those used to control cancer pain), there is a clear narcotic effect. However, far from being antidepressant, opiods at this level flatten affect, i.e. they reduce significantly the patient's emotional response to the pain, which, in effect, is the 'suffering' associated with severe pain. This essentially is the primary mechanism of opiate analgesia in controlling severe pain.

 

Also, I really appreciate the , it's really constructive and it makes me want to ask more question here at SFN. If only everyone was as generous as you and handed out 's to every question posted on this forum. I think it would create a very amicable atmosphere, and would bring people back for more questions and discussion. In fact, you're so willing to help, you seem to go out of your way after having said that you're through with this thread and are too frustrated to deal with the course this discussion has taken, rather than leave it alone like anyone else would if they had nothing but nasty sentiments to express. What a guy!

I don't think frustration is a particularly nasty sentiment, and moreover, it wasn't directed at you.

 

Your original question asked "Antidepressants Vs Opiates: What's the difference?". I think between us, MolotovCocktail, Revenged and I have answered your question quite thoroughly.

 

Geoguy has helpfully pointed out the flaw in your question and continued to do so to revenged in support of his innacurate contention that opioids are antidepressants. Hence Revenge's frustration which was directed at geoguy, not you.

 

So, of all possible outcomes, your getting annoyed at one of the people who was actually answering your question is the least understandable, unless perhaps you are not reading the posts correctly?

 

Well, it makes sense to me. The whole reason I started this thread is because I just recently got myself some kratom leaves. Before it was made illegal in Thailand, the Thai used to chew on these in order to give them a mild pick-me-up and make physical labor go by a little more smoothly (kinda' like coffee for us).

Similarly, Andean Indians have been chewing cocoa leaves for over 5,000 years for the same reason (as a pick-me-up). Although in high doses kratom leaves act as a sedative, in low doses it's a stimulant, same as cocaine and amphetamines. Although these drugs have a euphoric effect, none of them are used as antidepressants.

 

When I tried it, it sure put me in a good mood, and it got me thinking whether this could be used as an anti-depressant in a clinical setting. I don't know what doctors think of using opiates as anti-depressants though wouldn't there be a risk of addiction?), but as geoguy said, there's methadone, so I guess it's already been done.

Stimulants may produce euphoria temporarily (a cocaine high lasts ony 40 minutes), but they are not antidepressants so, no, kratom leaves could not be used as an antidepressant in a clinical setting. As I said, at higher doses it has a sedative effect and is used as an analgesic. Opiods also have a sedative effect at higher doses and also a have a motor supressive effect (e.g. opioids supress respiration).

 

I think the main problem of mixed terms here is between 'stimulant (or euphoric)' and 'antidepressant'. A stimulant drug (cocaine, caffeine, amphetamine, kratom leaves etc.) may put you in a good mood (i.e. produce a temporary euphoria) as their common end effect is to increase levels of dopamine in the brain reward centres (the nucleus accumbens, the ventral tegmental area and the medial forebrain bundle). Opiods have the same common effect (although they also have another mechanism of reinforcement), but that is not an antidepressant effect in the context of this thread.

 

In this thread, the term antidepressant is being (correctly) used as a chemical treatment for depression. The chemical treatment for depression (i.e. antidepressants) works on a different neurological system to stimulants and opioids.

[gib65]

Sorry if I misconstrued Revenged sentiments to be directed at me. It was this quote which lead me to think so:

 

the smiley was because after all that everyone said about the differences of opioids and anti-depressants you both seem to think that opioids are used as anti-depressant when they are not

 

I wouldn't argue with the answers that come my way after posting a question (otherwise, what would be the point of asking ), but when I get conflicting answers, naturally I'll follow it up with more questions that apparently frustrate some people. I don't mean to frustrate anybody. I just get more confused when I get conflicting answers.

 

That being said, it's pretty clear to me now that opiates and anti-depressants don't overlap, so I'm through with my line of questioning there. Thanks for your answers.

[Revenged]

I wouldn't argue with the answers that come my way after posting a question (otherwise, what would be the point of asking ), but when I get conflicting answers, naturally I'll follow it up with more questions that apparently frustrate some people. I don't mean to frustrate anybody. I just get more confused when I get conflicting answers.

 

Ok, no worries... I will refrain from using the ":doh:" smiley in future as it clearly is not popular ...

[gib65]

Okay, thanks Revenged.

[armygas]

 

However, opiates also inhibit GABA (Gamma Amino Butyric Acid) receptors in the Ventral Tegmental Area (a part of the brain's reward system). GABA is an inhibitory neurotransmitter, and if you inhibit an inhibitory mechanism, then the systems that mechanism was inhibiting is free to fire at will (like taking your foot of the brake). Inhibition of GABAergic neurons in the VTA allows dopaminergic (DA) neurons to fire more freely and and an elevation of DA in the reward system is ..well...rewarding. It's the basic mechanism that all drugs of abuse share in common.

 

Are you sure that opioids directly inhibit GABA? I don't believe that to be correct. I do agree that they may indirectly inhibit the release of GABA but they do not act on the receptors themselves.

 

Also, the sigma opioid receptor has been discredited as an opioid receptor recent consensus is that it is not an opioid receptor.

 

And I have been doing anesthesia a long time and have never heard of the Tau receptor in opioids. There are various Mu, kappa, and delta opioid receptors...is Tau a newly discovered orphan receptor?

[madyus]

Tricyclic antidepressants abuse, with or without benzodiazepines abuse, in former heroin addicts currently in methadone maintenance treatment (MMT)

European Neuropsychopharmacology...