Why the study?
Does codeine improve symptoms in severely depressed patients who failed tricyclic antidepressants?
Observational (n=12)
Does codeine improve symptoms in severely depressed patients who failed tricyclic antidepressants?
Codeine is ineffective for treating severe involutional depression refractory to tricyclic antidepressants and causes severe constipation.
Answers are grounded in this paper and cite their sources.
Codeine should not be used for tricyclic-refractory depression; leaves open whether any opioids merit controlled trials in mood disorders.
The authors studied the effect of codeine on 12 severely depressed patients who failed to respond to tricyclic antidepressants. They all were in involution. Eight patients received codeine in combination with other tricyclic antidepressants and only one of them showed improvement. Four depressed patients received codeine alone and none of them improved. The patients were kept on codeine up to three weeks. The dose was gradually increased from 90 mg/day to 180 mg/day. All patients suffered from severe constipation--more than what they had on tricyclic antidepressant medication. All of the patients experienced a sedative effect. None of them had euphoria and none of them developed dependence. After the failure of codeine, the patients finally accepted electroconvulsive therapy or monoamine oxidase inhibitors, and with one exception, all improved.
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Varga et al. (1982) conducted an observational in Involutional and senile depression (n=12). Codeine was evaluated on Improvement in depression.
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