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  • BDD Moderators: Keif’ Richards | negrogesic

Opioids Methadone/ oxicodona/ ssris

xannyhead

Bluelighter
Joined
Jul 31, 2017
Messages
118
So, ive been taking a fairly low dosage of lexapro (15/10mg a day) and ive read that it could have some major interaction w methadone which. im interest in trying. i also really want to quit lexapro as indont feel is doing me any good. how long shoukd i wait, after stopping lexapro, to try methadone or oxicodone without risking serotonin syndrome? btw i dokt think oxi interacts much with lexa as methadone, and priority is to try oxi (real bad back pain and docs refuse to give me anything stronger than acetominephin)
thanks for the att
 
A significant interaction is very unlikely if you are only now just thinking about trying methadone (since i assume the dose will be low, probably under 40mg unless you are tolerant to opioids).

The concern with respect to methadone and serotonergic antidepressants generally takes two forms: the potential for serotonergic crisis (methadone is somewhat serotonergic, particularly at high doses) and/or increased risk of cardiac arrhythmia. Generally these are dose dependent or seen in the predisposed (the elderly, people with undiagnosed heart conditions, etc).

10mg of lexapro with say 10-20mg of methadone should produce no serious interaction in a healthy individual who has no preexisting condition. The biggest risk you have here is simply the very act of taking methadone, which is easily the most dangerous commonly abused pharmaceutical opioid in terms of accidental overdose deaths (in proportion to the frequency with which it is abused).

A big part of this stems from a simple fact: most people who are maintained on methadone take a daily dose that would be either fatal or nearly fatal to a non-tolerant adult. If that gets in the wrong hands it is poison. Though I've been long off it, I once was on 380mg of methadone/day. If I took that now I would without question die within a few hours (in the absence of medical attention).

In any event your concern shouldn't really be around the interaction (unless predisposed) but more about the danger of methadone itself. For instance, what dose to take, or even, how to determine the dose since methadone often changes hands in the form of a liquid of unknown concentration).
 
Thank you so much. So the risks with oxycontin are not really relevant as far as the interaction w SSRIs go?
 
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