Medication Treatments for Opioid Use Disorder: What Is the Impact on Mood and Mood Disorders?

Purpose of Review: There has been an interest in evaluating the effect of opioid medications on mood in patients with or without opioid use disorder (OUD) because of potential mechanistic relationships between the opioid system and mood. In this review, we will summarize the prospective clinical trials that used opioid medications (naltrexone, methadone, and buprenorphine) to evaluate the effect on mood and anxiety in patients with and without OUD. Findings: Buprenorphine and buprenorphine/samidorphan combination have shown promising short-term effect for depressed patients without OUD but the effects are modest. Naltrexone does not worsen mood in patients with OUD and is in fact associated with improved mood for adherent patients. Methadone and buprenorphine treatment for OUD are both associated with substantial improvements in mood. Implications: Buprenorphine or buprenorphine combined with a mu receptor antagonist may be effective for treatment-resistant depression among patients without OUD, and large randomized controlled trials with longer trial lengths are needed to further evaluate this effect. Among patients with OUD, effective medication treatment for the OUD is the priority, and with any opioid medication mood often improves. © 2018, Springer International Publishing AG, part of Springer Nature.