codeine and SSRIs

Hey everyone, I am new to the bluelight. Been reading for couple months and this is my first post. Please go easy on me as I am new.

I have a question.

My doc prescribed me Zoloft 50mg and I have been taking them for about a week now. I know that the effect of alcohol is enhanced while on SSRIs, and have not tried mixing the two.....but..last night I was feeling very down and I have not felt a change in mood from the Zoloft (doc says it will take couple of weeks), so, I decided to take some Panadine Forte (30mg codeine). I have never had a problem taking them before, but, shortly after taking them I was feeling really drunk and relaxed, way more than ever before (this lasted only for about 20 mins)I went to my bed and became worried that I was having a reaction with the Zoloft. I was nauseous and tried not to, but had to vomit, which ruined everything and just sucked. I know that nauseous feeling is normal while taking codeine and I should note it was not taken on an empty stomach, I had a milkshake before downing the pills.

Should I avoid Codeine altogether while on Zoloft? or was it the milkshake or just the codeine which made me so ill?

I can vouch for the same problems! Im in no position to really help you on this matter sorry Best be to see your preferred doctor

P.S Did u expierence any shallow breathing or trouble breathing ?

Codeine always makes me nauseous, even in very small doses. However this page indicates that SSRIs decrease the effects of codeine, so perhaps the nausea/drunkenness senstation was to do with that?
http://codeine.50g.com/info/codeine.html

thanks guys

Q. P.S Did u expierence any shallow breathing or trouble breathing ?

A. Not really, however since I have started on Zoloft I have noticed a weird feeling in my jaw and bottom teeth right down to my throat. It is like a tingling sensation, tickling the back of my throat and causing a mild need to cough. The cough is one reason I went for the codeine. Today I don't feel too bad, but last night I went to bed shaking...not good.

Oh, thanks for the link to the codeine page, gonna go have a look now.

If codeine isn't working there may be a drug interaction
This article points out that although you may have reduced painkilling effects when you take Zoloft / sertraline + codeine, you can still get the unpleasant side effects. As has been pointed out, codeine (actually all opiates) commonly causes nausea.

Zoloft itself can be pretty upsetting to the stomach, so that plus the effects of the codeine might also explain the problem. Some people find this nausea decreases over time.

I read somewhere that Prozac (and I asume other SSRI's) block the enzyme in the liver (p450 2y6 I am guessing) that normally converts codiene (methyl-morpheine) into morpheine.

I think that is why codiene dose not work on SSRI's.

That may make sense there Dr Beat, thanks.

Just arrived home from work and I have the worst feeling in my throat, it is itching and ticlking me real bad. I have only noticed this while on Zoloft...does anyone know is this a reported side effect? Maybe I should see my doc? I did some research but a 'ticklish/irritated throat' was not listed in Zolofts side-effects?....this feeling makes me want to cough constantly. Anyone else have this problem with Zoloft?

Oh, and I have tried a half dose of codeine tonight just to test it and see if it makes me sick this time. Only took it about 15 - 20 mins ago, and feel nothing at all so far. No nausea yet here's hoping..

I cant find any reference to such an enzyme any place.

Do SSRI's block metabolism in the liver? I thought thier main actions were on brain chemisty (ie. receptors)

yep mongman..think you're right cause as far a I know SSRIs are taken to balance chemicals in the brain. Do'nt know if there is any effect on the liver?

I still have this bad throat thing happening from the Zoloft and can't shake it off!!! I did the cwe method on more codeine tabs just now (35 mins ago), and think I got to drink about 90mg? so far it is not working..it's really frustrating me and is a waste of good tabs....I may have to get into the alcohol 'cause I can't relax! is codeine and alcohol a bad mix? even if I can't feel the codeine?

Zoloft, I believe, is the SSRI that least interferes with the metabolism with codeine. I was on it for a while and I noticed that although you can still get high, the effects are diminished and thus you need higher doses... so if you usually take 300-400mg hits of codeine it will probably be a waste (if you're at all tolerant to it).

smokeblow << codeine + alcohol diminishes the euphoria and increases the sedative effect. Codeine + weed, on the other hand, is excellent. I tried codeine + Xanax tonight and it wasn't that good, although I remember enjoying codeine + temazepam + alcohol (veeery cozy ). Funny, that.

I was on Zoloft for a short period but it was terrible. I felt nauseous all the time and it made my anxiety worse.

You may want to try a newer SSRI like Cipramil or Lexapro. In my opinion they are far superior.

Also, keep in mind that it can take weeks to become accustomed to SSRI's and before they have a noticeably positive effect.

From experience SSRI's do not prevent codeine from working at all. Maybe a little weaker but nothing major.

Guess what Gruboy, I just went to my doc 'cause the Zoloft was making my throat much worse, he took one look at it (my throat) and said to stop taking the Zoloft, wait 4 days, and come back and see him next week - he may give me something else.

Thanks for the advise, although I will wait to see what my doc says...he wouldn't give me a prescription for anything today...bummer, I may head to the Chemist now for some good cough syrup (also, I think he would freak if I start mentioning all these drugs, hehe)..

mongman: the link I posted in my previous post explains it all

superbabydoc: Thanks I will check it out. Im not very knowlegable about SSRI's and I couldn't find any references to the enzyme on the net so I gave up.