# What is the straight dope on using amphetamines or opiates to treat depression **URL:** \ **Category:** In My Humble Opinion\ **Created:** [June 12, 2018, 3:42pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970 "2018-06-12T15:42:59Z")\ **Posts on this page:** 19\ **Page:** 1
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 12, 2018, 3:42pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/1 "2018-06-12T15:42:59Z")
I don’t have depression anymore, but I’m curious what the answer is to this question. It seems like stimulants or opiates could be potent anti-depressants because they trigger reward mechanisms in the brain. However the risk of addiction, tolerance and abuse is high, and there are lots of less risky therapies to try instead. Is that why amphetamines are still used to treat ADHD but not depression, because there are so many safer alternatives as anti-depressants but not really any other ADHD options? I did find a couple articles about opiates as a treatment for depression. > **[Combination drug targeting opioid system may help relieve treatment-resistant...](https://www.sciencedaily.com/releases/2016/02/160212091543.htm)** > > A clinical trial of an experimental drug for treatment-resistant major depression finds that modulation of the endogenous opioid system may improve the effectiveness of drugs that target the action of serotonin and related monoamine... > **[Opinion | Are Opioids the Next Antidepressant? (Published 2016)](https://www.nytimes.com/2016/06/05/opinion/sunday/are-opioids-the-next-antidepressant.html)** > > The only time she felt functional was when she was hooked on heroin. This article on treatment resistant depression found that 58% of people treated with low dose amphetamines saw significant improvements. > **[Psychostimulants in the therapy of treatment-resistant depression Review of...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181580/)** > > The use of psychostimulants as an adjuvant therapy in treatment-resistant depression is not very common nowadays and has been the subject of much criticism. This article gives a brief review of the literature and reports on the findings from a... However I have no idea if these are long term therapies because the brain tends to adjust to them, and tolerance builds up. But I’m interested if they are explored as potential treatments for depression. ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [June 12, 2018, 4:53pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/2 "2018-06-12T16:53:52Z")
Bupoprion is one of the most commonly prescribed drugs for depression and it is very similar chemically to amphetamines. ---
**Author:** ![Lamoral](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lamoral/32/16078_2.png) [@Lamoral](https://boards.straightdope.com/u/Lamoral)\ **Post date:** [June 12, 2018, 5:09pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/3 "2018-06-12T17:09:47Z")
Bupoprion, that’s Wellbutrin right? Well, I tried it at one point for depression and it did NOT HELP. It gave me a perpetual jittery feeling, like speed frankly. After about 2 weeks I could NOT take it any more. Glory to God, I was prescribed a better alternative by my very talented psychiatrist and it saved my life. ---
**Author:** ![snoe](https://avatars.discourse-cdn.com/v4/letter/s/43a26b/32.png) [@snoe](https://boards.straightdope.com/u/snoe)\ **Post date:** [June 12, 2018, 6:53pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/4 "2018-06-12T18:53:06Z")
My wild-assed guess is that most(?)\* medically supervised (or even well-thought-out-and-systematic-self-prescribed) \*treatments for depression are better than nothing, or ad hoc stuff like drinking a lot. Because doing something, even something ineffective, means you’re actually dealing with it. (This will not be true in all cases, and like I said it’s a wild-assed guess. As an analogy, I had a roommate once who quit smoking by getting a liter of Tanqueray and an eight-ball of cocaine. It was an effective treatment until both were gone, because he was committed to that regimen. It did not last much longer after that.) Scott Alexander, a blogger and head-shrinker did a good blog post a while back called [Things That Sometimes Help If You’re Depressed](http://slatestarcodex.com/2014/06/16/things-that-sometimes-help-if-youre-depressed/). He reviews various treatments, from the uncontroversial to the insane, and gives links in many cases to the scientific research available at the time. It’s worth a read if you’re looking for info on “outside the box” ideas. ---
**Author:** ![snoe](https://avatars.discourse-cdn.com/v4/letter/s/43a26b/32.png) [@snoe](https://boards.straightdope.com/u/snoe)\ **Post date:** [June 12, 2018, 7:04pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/5 "2018-06-12T19:04:30Z")
> [@snoe](#): > > My wild-assed guess is that most(?)\* medically supervised (or even well-thought-out-and-systematic-self-prescribed) \*treatments for depression are better than nothing, or ad hoc stuff like drinking a lot. Because doing something, even something ineffective, means you’re actually dealing with it. (This will not be true in all cases, and like I said it’s a wild-assed guess. As an analogy, I had a roommate once who quit smoking by getting a liter of Tanqueray and an eight-ball of cocaine. It was an effective treatment until both were gone, because he was committed to that regimen. It did not last much longer after that.) > > Scott Alexander, a blogger and head-shrinker did a good blog post a while back called [Things That Sometimes Help If You’re Depressed](http://slatestarcodex.com/2014/06/16/things-that-sometimes-help-if-youre-depressed/). He reviews various treatments, from the uncontroversial to the insane, and gives links in many cases to the scientific research available at the time. It’s worth a read if you’re looking for info on “outside the box” ideas. I’ll reiterate that my opinion is a WAG, based on my own experience with depression, and its value should be discounted as such. If you want a taster of what Alexander’s blog post says, the introductory paragraphs will give you a decent idea of the approach (emphases mine): > [@](#): > > ``` > Posted on [June 16, 2014](http://slatestarcodex.com/2014/06/16/things-that-sometimes-help-if-youre-depressed/) by [Scott Alexander](http://slatestarcodex.com/author/admin/) > Some of my friends have depression and have asked me for some suggestions. > > ``` > > These will be inferior to reading official suggestions, but **you will probably not read official suggestions, and you may read this**. Just so we’re clear, all opinions here are my own, they are not endorsed by the hospital I work at, they do not constitute medical advice, **I have a known habit of being too intrigued by extremely weird experimental ideas for my own good** , and you read this at your own risk. I am still an intern (a very new doctor) and my knowledge is still very slim compared to more experienced professionals Also remember it’s like four years old. You can read more recent stuff on his blog, but I find this post refreshingly clear and fairly comprehensive (for this sort of thing). ---
**Author:** ![mbh](https://avatars.discourse-cdn.com/v4/letter/m/a6a055/32.png) [@mbh](https://boards.straightdope.com/u/mbh)\ **Post date:** [June 12, 2018, 7:15pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/6 "2018-06-12T19:15:09Z")
There are a lot of different drugs for treating depression, and nobody really knows what which particular drug will work for which particular patient. The psychiatrist and the patient have to go through a lengthy trial-and-error process to find something that works. Then you get older, and your body chemistry changes, and that drug stops working. And then you have to go through the trial-and-error process again, until you find something else that will work. For a little while. ---
**Author:** ![road\_lobo](https://avatars.discourse-cdn.com/v4/letter/r/d78d45/32.png) [@road\_lobo](https://boards.straightdope.com/u/road_lobo)\ **Post date:** [June 13, 2018, 8:49am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/7 "2018-06-13T08:49:33Z")
This is a recent article on the subject: [https://www.independent.co.uk/news/health/psychedelic-drugs-brain-repair-lsd-depression-anxiety-lsd-dmt-amphetamines-ketamine-a8395511.html](https://www.independent.co.uk/news/health/psychedelic-drugs-brain-repair-lsd-depression-anxiety-lsd-dmt-amphetamines-ketamine-a8395511.html) I don’t think it addresses opiates. I’m not holding my breath for any of these treatments to show up in the USA in my lifetime. ---
**Author:** ![glowacks](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/glowacks/32/5548_2.png) [@glowacks](https://boards.straightdope.com/u/glowacks)\ **Post date:** [June 14, 2018, 3:30am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/8 "2018-06-14T03:30:50Z")
Adderall (a mix of various amphetamines) finally was able to get me to be a productive member of society after years of barely being able to get out of bed. Ritalin did something, but not enough. Everything else just failed. One might say I’m now addicted to it, but what that really means is that I return to my absolutely unproductive pre-Adderall self if I fail to take it. Where my issue falls in the range of medical problems is not a concern of mine; I only care that I’m now well enough to hold a job. My doctor’s notes indicate she diagnoses me with Asperger’s, ADD, and depression. Not much in drugs to do with the first, but the Adderall is nominally for the second and I take other drugs nominally for the last. However, I didn’t really think I had ADD until I was put on stimulants, and from my view, the stimulants helped enough with whatever was going on in my brain, which seemed vastly more like just a series of major depressive episodes that never really ended. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 14, 2018, 3:38am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/9 "2018-06-14T03:38:33Z")
As a pharmacist, I’ve seen them prescribed a few times, by superspecialists when lesser measures failed. IDK if any of these people had ECT (electroconvulsive therapy or “shock treatment”) before this was done. ---
**Author:** ![DavidwithanR](https://avatars.discourse-cdn.com/v4/letter/d/3bc359/32.png) [@DavidwithanR](https://boards.straightdope.com/u/DavidwithanR)\ **Post date:** [June 14, 2018, 4:16am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/10 "2018-06-14T04:16:16Z")
> [@glowacks](#): > > Adderall (a mix of various amphetamines) finally was able to get me to be a productive member of society after years of barely being able to get out of bed. Ritalin did something, but not enough. Everything else just failed. One might say I’m now addicted to it, but what that really means is that I return to my absolutely unproductive pre-Adderall self if I fail to take it. Where my issue falls in the range of medical problems is not a concern of mine; I only care that I’m now well enough to hold a job. My doctor’s notes indicate she diagnoses me with Asperger’s, ADD, and depression. Not much in drugs to do with the first, but the Adderall is nominally for the second and I take other drugs nominally for the last. However, I didn’t really think I had ADD until I was put on stimulants, and from my view, the stimulants helped enough with whatever was going on in my brain, which seemed vastly more like just a series of major depressive episodes that never really ended. Trying to get by unaided, with autism-spectrum and ADD, would naturally be pretty fucking depressing. I suspect that with simply an anti-depressant, things wouldn’t have changed all that much for you. But who knows - everyone really is different in this regard. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 14, 2018, 4:21am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/11 "2018-06-14T04:21:52Z")
> [@nearwildheaven](#): > > As a pharmacist, I’ve seen them prescribed a few times, by superspecialists when lesser measures failed. IDK if any of these people had ECT (electroconvulsive therapy or “shock treatment”) before this was done. By them do you mean amphetamines or opiates for depression? I assume you mean amphetamines. How do you take amphetamines daily for years w/o building tolerance and needing to constantly increase your dosage? ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 14, 2018, 4:43am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/12 "2018-06-14T04:43:24Z")
Both. Really. Why most people with ADHD don’t need perpetually increasing doses of their meds is as puzzling as why most people with chronic pain also don’t need to constantly increase their opiate doses. ---
**Author:** ![buddha\_david](https://avatars.discourse-cdn.com/v4/letter/b/ee7513/32.png) [@buddha\_david](https://boards.straightdope.com/u/buddha_david)\ **Post date:** [June 14, 2018, 5:16am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/13 "2018-06-14T05:16:37Z")
> [@mbh](#): > > Then you get older, and your body chemistry changes, and that drug stops working. And then you have to go through the trial-and-error process again, until you find something else that will work. For a little while. Nobody should take this as medical advice, but I’ve been smoking weed for depression for more than 20 years, and my body chemistry has _not_ changed enough to make it stop working. In fact it’s the only antidepressant I’ve ever tried that hasn’t lost effectiveness or left me with crippling side effects. Just sayin’, really. To the OP, I don’t think amphetamines or narcotics have ever been prescribed for depression, in fact they both are known to _cause_ depression. Bupropion’s a bit of an outlier but it’s really not that closely related to amphetaimes at all. ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [June 14, 2018, 5:25am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/14 "2018-06-14T05:25:13Z")
> [@DavidwithanR](#): > > Trying to get by unaided, with autism-spectrum and ADD, would naturally be pretty fucking depressing. I suspect that with simply an anti-depressant, things wouldn’t have changed all that much for you. But who knows - everyone really is different in this regard. This shows a clear understanding of the problems presented by ADD. Anxiety and depression are common symptoms of ADD, which is treatable with stimulants. And when ADD is treated symptoms of depression and anxiety are lessened. Simply treating the anxiety or depression won’t improve the symptoms of ADD, and the ADD may be the cause of the depression or anxiety in the first place. I wasn’t aware of the use of opiates to treat depression but it sounds like a disaster waiting to happen. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [June 14, 2018, 7:17am UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/15 "2018-06-14T07:17:26Z")
Opiates were used to treat depression. Their use was discontinued because (a) Their effectiveness declined with habituation, and (b) They are addictive. Opiates were replaced with amphetamines. The use of amphetamines to treat depression was discontinued because (a) Their effectiveness declined with habituation, and (b) They are addictive. Amphetamines were replaced with Benzodiazepines. Use of Benzio’s was discontinued because (a) and (b). Benzo’s were replaced with “First Generation Antidepressants”. still in use. 1G AD were supplemented with 2G AD, because 1G didn’t work very well, and had side effects. 2G were replaced because they didn’t work very well and had side effects. 3G are used alongside 1G, but… don’t work very well and have side effects. People self-medicating for depression still use alcohol, opiates and amphetamines, alongside newer drugs like ICE. Unfortunately, all are addictive and have destructive side effects. It’s almost like the happier a drug makes you, the more addictive it is… ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 14, 2018, 2:37pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/16 "2018-06-14T14:37:38Z")
> [@nearwildheaven](#): > > Both. Really. > > Why most people with ADHD don’t need perpetually increasing doses of their meds is as puzzling as why most people with chronic pain also don’t need to constantly increase their opiate doses. Interesting. Are there any particular opiates that are used as an anti-depressant? I would assume adderall is the main anti-depressant amphetamine that is used, but with opiates there are so many on the marketplace. Seeing how there are at least 3 different opiate subreceptors, and different opiates have different affinities for them is one used more often than another as an anti-depressant? ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 14, 2018, 3:06pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/17 "2018-06-14T15:06:00Z")
> [@Melbourne](#): > > People self-medicating for depression still use alcohol, opiates and amphetamines, alongside newer drugs like ICE. Unfortunately, all are addictive and have destructive side effects. It’s almost like the happier a drug makes you, the more addictive it is… This is true sadly. My understanding is because these drugs affect the reward mechanisms of your brain your brain down-regulates receptors to avoid overstimulation of areas that are only meant to be stimulated sporadically as a reward for life-affirming behavior (mating success, food success, status success, etc). If those reward mechanisms are triggered 24/7, they lose their value. So there are feedback mechanisms in place. Having said that, there are efforts to clear up tolerance. At least with opiates. With opiates administration of an NMDA antagonist like DXM or ketamine, or using the drug ibogaine to reset tolerance. Supposedly taking an extremely low dose of naltrexone (measured in micrograms) along with an opiate also prevents tolerance. I’m not sure about amphetamines. I’ve heard NMDA antagonists (and ibogaine for that matter) can also help with tolerance there, but I’m not sure. I’m not sure if NMDA antagonists and ibogaine are some kind of universal anti-tolerance drug or if they are just being looked into for opiate tolerance. Do they also work for amphetamine, alcohol, benzo, etc.tolerance too? Not sure. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [June 14, 2018, 8:54pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/18 "2018-06-14T20:54:47Z")
This is obviously something that’s being researched, but the antidepressant effect was thought to be due to the relief of chronic pain, and that’s only part of it. It’s definitely NOT a first-line therapy. This story about ketamine was on the cover of Time magazine about a year ago. > **[A New Hope for Depression](https://time.com/4876098/new-hope-for-depression/)** > > Why doctors are turning to a club drug for treatment Did anyone else see the recent “60 Minutes” story about electroconvulsive therapy, featuring Kitty Dukakis, who says this is the only thing that works for her, and has also enabled her to remain sober? ---
**Author:** ![dada2fish](https://avatars.discourse-cdn.com/v4/letter/d/ccd318/32.png) [@dada2fish](https://boards.straightdope.com/u/dada2fish)\ **Post date:** [June 16, 2018, 11:21pm UTC](https://boards.straightdope.com/t/what-is-the-straight-dope-on-using-amphetamines-or-opiates-to-treat-depression/815970/19 "2018-06-16T23:21:14Z")
I’ve suffered from depression off and on for about 15 years. (mostly on) It seems to be getting worse. I’ve tried different anti-depressants and therapy which didn’t help. I’m at a point where I really need to do something. I can’t live like this anymore. My son was diagnosed with ADHD a year ago. I have a shelf full of different medications we tried (Ritalin, Focalin) before having success with Adderall. Now that he’s out of school for the summer, he doesn’t take his medicine regularly and has plenty of it left over. After reading your post, I am tempted to take some of his Adderall to see if it will help me. What is a normal dose for an adult?