Mood-elevating effects of opioid analgesics in patients with bipolar disorder

J Neuropsychiatry Clin Neurosci. Fall 2007;19(4):449-52. doi: 10.1176/jnp.2007.19.4.449.


Opioids can have mood-elevating effects in healthy subjects and have been used successfully to treat refractory depressed patients. A few case reports indicate that opioid analgesics can induce mania. The authors investigated the mood reaction of opioid analgesics in patients with bipolar disorder. Nine (27%) of 33 patients who took opioid analgesics for medical reasons experienced a significant hypomanic/manic reaction, and two other patients reported an antidepressant effect. None of the comparison subjects reported a significant mood reaction from opioid analgesics. These results indicate that opioid analgesics can have an important mood-altering effect on patients with known bipolar disorder.

MeSH terms

  • Affect / drug effects*
  • Analgesics, Opioid / pharmacology*
  • Bipolar Disorder / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outpatients
  • Pain / complications
  • Pain / drug therapy
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Sex Characteristics


  • Analgesics, Opioid