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Mood-Elevating Effects of Opioid Analgesics in Patients With Bipolar Disorder

Received April 4, 2007; revised August 14, 2007; accepted August 15, 2007. C. Schaffer and T. Nordahl are affiliated with the Department of Psychiatry and Behavioral Sciences, University of California, Davis, California. L. Schaffer is affiliated with Sutter Community Hospitals. Address correspondence to Dr. Charles Schaffer, 1455 34th Street, Sacramento, CA 95816; schafferpsych{at}sbcglobal.net (e-mail).

ABSTRACT

Opioids can have mood-elevating effects in healthy subjects and have been used successfully to treat refractory depressed patients. A few case reports indicate that opioid analgesics can induce mania. The authors investigated the mood reaction of opioid analgesics in patients with bipolar disorder. Nine (27%) of 33 patients who took opioid analgesics for medical reasons experienced a significant hypomanic/manic reaction, and two other patients reported an antidepressant effect. None of the comparison subjects reported a significant mood reaction from opioid analgesics. These results indicate that opioid analgesics can have an important mood-altering effect on patients with known bipolar disorder.

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