Common opioids less effective for patients on SSRI antidepressants, study finds

Patients taking the most common form of antidepressant who are given the most widely prescribed opioid experience less pain relief, Stanford University School of Medicine investigators have discovered. The finding could help combat the opioid epidemic, as poorly managed pain may lead to opioid abuse. As many as 1 in 6 Americans take antidepressants, mostly selective serotonin reuptake inhibitors. Stanford researchers found that SSRIs reduce the effectiveness of hydrocodone and codeine, which are often prescribed to patients who have recently undergone surgery.
"This research is part of our effort to find ways to combat the opioid epidemic," said Tina Hernandez-Broussard, Ph.D., MPH, associate professor of medicine, of biomedical data science and of surgery at Stanford. "We're very interested in identifying how we can reduce opioid exposure while still managing patients' pain." A paper describing the research will be published Feb. 6 in PLOS ONE. Hernandez-Broussard and Ian Carroll, MD, assistant professor of anesthesiology, perioperative and pain medicine at Stanford, share senior authorship. The lead author is graduate student Arjun Parthipan. Antidepressant inhibits the enzyme. The researchers focused on the interaction between opioids and SSRIs because they knew that certain opioids, called prodrug opioids, need a liver enzyme to convert them into an active form that eases the pain.