Potentiation of Opioid Analgesia by Psychostimulant Drugs

[KS78]

I have been taking Ritalin with opium and I think that I experience more pain relief along with more opiate euphoria. It's not something new as we know from Brompton's Cocktail which made from morphine or diacetylmorphine (heroin), cocaine, highly-pure ethyl alcohol (some recipes specify gin), and sometimes with chlorpromazine (Thorazine) to counteract nausea, it was given to terminally-ill individuals to relieve pain and promote sociability near death. . That's why I have been reading about this and I want to share with you a study on this subject.

"Experiments with animal and human subjects provide convincing evidence that d-amphetamine or methylphenidate potentiate the analgesic effects of morphine. Psychostimulant drugs have been shown in animal studies to possess intrinsic analgesic properties and to have the ability to enhance the analgesic properties of opioids when both types of drugs are given in combination."
Source: Attached

 

[izo]

found two older papers looking into this:

Potentiation of morphine analgesia by d-amphetamine - Psychopharmacology

Rats were trained to escape from aversive electrical brain stimulation delivered to the mesencephalic reticular formation (MRF). The threshold for this escape behavior was determined by a modification of the classic psychophysical method of limits. Escape thresholds were determined after the...

link.springer.com

Combinations of analgesics with amphetamines | Drug and Therapeutics Bulletin

dtb.bmj.com

i remember read somewhere that amphetamine or d-amphetamine is equipotent with morphine when it comes to certain types of analgesia, doubted that then.

 

[Tryptamite]

Caffeine is often sold in combination with paracetemol for added pain relief. A little off topic perhaps but somewhat relevant

 

[Hodor]

I think it is pretty well-established that increasing noradrenaline levels increases tolerance to chronic pain, especially in combination with opioid agonism.

Tricyclic antidepressants and SNRI's are commonly used to treat fibromyalgia; indeed, the popular "mild" painkiller, tramadol, is just an SNRI and an opioid rolled into one. Its active metabolite, O-Desmethyltramadol, which is responsible for much of the painkilling effect, is largely devoid of serotonergic effects (while retaining its noradrenaline reuptake inhibition), and so is tramadol's successor drug, the opioid/NRI tapentadol, so it stands to reason that boosting noradrenaline = potentiated pain reduction.