The association between naltrexone treatment and symptoms of depression in opioid-dependent patients

Abstract

Objective: To examine the change in total symptoms, and symptom clusters, of depression in newly abstinent opioid-dependent individuals being treated with depot naltrexone (Depotrex; Biotek, Inc., Wellesley, MA). Method: In a series of opioid-dependent patients (N = 34) treated with naltrexone maintenance and relapse prevention therapy, mood was assessed with a 17-item Hamilton Depression (HAM-D) Scale and subscale scores at baseline, and after naltrexone induction at 2- and 4-week post-baseline. Data were analyzed using generalized estimated equation (GEE) models. Results: Patients demonstrated high baseline affective burden and significant improvement of depression scores over a 4-week period post-baseline (F_2.66 = 8.88; p = .0004). Somatic and cognitive-affective subscale scores significantly declined as well as the seven individual item scores. By contrast, the “late insomnia” item score significantly increased at 2 weeks post-baseline. Conclusions and Scientific Significance: Naltrexone induction and maintenance in newly abstinent opioid-dependent individuals does not appear to be associated with worsening of depression; however, it may be associated with sleep impairment early in treatment.

• naltrexone
• depression
• opioid dependence
• Hamilton Depression Rating Scale

ACKNOWLEDGMENTS

The authors acknowledge the support of NIDA R01 010746 and K24 022412.

Declaration of Interest

The authors report no conflicts of interest. They alone are responsible for the content and writing of this article.