Opioids Antidepressant Impact on Oxy High

[SimplyTrinity]

Been enjoying an occasional high on Oxycodone (Percocet) for the last several years. Low doses have been my sweet spot. Usually 5-7.5mg will do the trick for what I’m looking for. Occasionally getting as high as 15mg if my tolerance gets up there (but I’ll typically take a break for several weeks when I get to this level and get it back down to 5-7.5mg twice per week).

Anyway, just started on 2 antidepressants in the last year: 20mg of fluoxetine (Prozac) and 75mg of bupropion (Wellbutrin). Originally I was just on the Prozac but we added the Wellbutrin to offset the sexual side effects. Both relatively low doses, as far as I understand.

So I noticed that my occasional oxycodone doesn’t have the same effects as it used to. The high isn’t as good when it hits, and it hits at a lower success rate. Sometimes I just end up adding a little more to try to get the high and I just end up with a bad headache and mild nausea. Kind of annoying.

So my question is - is this a known side effect of the antidepressants? I was curious to understand the chemistry of it all. I know SSRIs (fluoxetine) raises levels of serotonin in the brain. Does that mean the serotonin impact that oxycodone usually causes is now lessened as a result? Same question on NDRIs (bupropion) which I understand increases the levels of norepinephrine and dopamine in the brain.

Interestingly, and maybe not surprisingly, the indirect effect of this has actually been to lessen my cravings for oxycodone. I guess the logic being - it doesn’t work as well so what’s the point? But I also notice that some of the desired effects I seek from oxy (relaxation, motivation, happiness) I am getting on a smaller scale from the antidepressants. Same thing for alcohol cravings too. My buzzes are also hit or miss and less fun so I have been desiring them less.

 

[menidiatis]

I haven't read it myself but if you care enough I guess you could skim through it

Common opioids less effective for patients on SSRI antidepressants

Patients taking antidepressants known as selective serotonin reuptake inhibitors do not respond well to hydrocodone, such as Vicodin, Stanford researchers report.

med.stanford.edu

 

[SimplyTrinity]

Oh cool. Thanks for sharing this!

 

[menidiatis]

Just noticed you also take wellbutrin, the first time I snorted heroin I was on wellbutrin 300mg XR, I remember vomiting for 12 hours straight, since then I never vomited again from heroin (even the 2nd time), and I attribute it to that I stopped using wellbutrin. I also remember readin somewhere that they are a dangerous interaction, but might have to do with causing more seizures rather than the effect of opiates being potentiated by wellbutrin.

I guess this is an extremely complex matter where each person's body significantly contributes to different responses.

 

[SimplyTrinity]

I haven't read it myself but if you care enough I guess you could skim through it

Common opioids less effective for patients on SSRI antidepressants

Patients taking antidepressants known as selective serotonin reuptake inhibitors do not respond well to hydrocodone, such as Vicodin, Stanford researchers report.

med.stanford.edu

So this article apparently only addresses the interaction between SSRIs and prodrug opioids (hydrocodone or codeine), not oxycodone, because prodrug opioids need a liver enzyme to convert them into an active form that eases pain (and SSRIs inhibit this enzyme):

“The authors concluded that to manage pain for patients on SSRIs, prescribers should choose nonopioids or direct-acting opioids. Direct-acting opioids, which include morphine, fentanyl and oxycodone, do not need the liver enzyme to convert the drug into a form that eases pain.”

 

[SimplyTrinity]

Just noticed you also take wellbutrin, the first time I snorted heroin I was on wellbutrin 300mg XR, I remember vomiting for 12 hours straight, since then I never vomited again from heroin (even the 2nd time), and I attribute it to that I stopped using wellbutrin. I also remember readin somewhere that they are a dangerous interaction, but might have to do with causing more seizures rather than the effect of opiates being potentiated by wellbutrin.

I guess this is an extremely complex matter where each person's body significantly contributes to different responses.

Hmm that’s pretty interesting. Tough to isolate what make you vomit for 12 hours though since you mentioned it was your first time ever snorting H. But that’s an interesting observation as I was originally on just the Prozac for 6 months, without the Wellbutrin, and while I noticed a less effective high (lower ceiling), I did not get the nausea or headaches until I added the Wellbutrin in.

So if that’s the case, it’s now a priority question. The Prozac keeps me from having frequent panic attacks, the Wellbutrin allows me to actually have and enjoy sex with my wife and also has improved daily motivation and lessened fatigue, and the oxy is a fun occasional euphoria that I take recreationally. But sounds like they won’t all coexist.

 

[menidiatis]

Hmm that’s pretty interesting. Tough to isolate what make you vomit for 12 hours though since you mentioned it was your first time ever snorting H. But that’s an interesting observation as I was originally on just the Prozac for 6 months, without the Wellbutrin, and while I noticed a less effective high (lower ceiling), I did not get the nausea or headaches until I added the Wellbutrin in.

So if that’s the case, it’s now a priority question. The Prozac keeps me from having frequent panic attacks, the Wellbutrin allows me to actually have and enjoy sex with my wife and also has improved daily motivation and lessened fatigue, and the oxy is a fun occasional euphoria that I take recreationally. But sounds like they won’t all coexist.

I would only be afraid about seizures, and that in the case that you have a predisposition

If wellbutrin just potentiate oxy, then take much smaller oxy doses

Best is to use oxy rarely anyway, take this from someone who just recently became a heroin junkie. On the days you use oxy just skip the antidepressants, should not cause a problem if you take them chronically