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Opioids The Ultimate Opiate Potentiation Thread

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Both diphenhydramine and hydroxyzine inhibit CYP2D6 enzyme (though hydroxyzine a bit less), which is responsible for converting hydrocodone into hydromorphone, so I don't see how they could potentiate it. Of course they would make you more sedated (probably at the expense of euphoria), but is that what you want?

Unfortunately, I have no personal experience with hydrocodone, so I'm only speculating.
 
Okay. Pharmacology, one of my favourite subjects and the only thing I excelled at in uni.

I apologise for not having read everybody's posts, got to be somewhere in a few minutes and only read first and last pages, so I might be repeating something that's already been put out there. GREAT thread!

Re Methadone and grapefruit - personally, yes, for me this works.

However grapefruit contains a lot of vitamin C, and is very acidic.. so I'm thinking that having a glass will potentiate, but much more than that and the acidic environment in kidney filtration speeds up the metabolising of the opoids, and I'm not sure why the Vit C overload is also a bad thing, but I read it somewhere and personal experience supports this.

SOoooo.. too much grapefruit will give too much vit C and negate the boosting effects of the enzymes from the grapefruit, or even reduce the buzz altogether, depending how much you take. Be moderate and it will be fine.

The other thing I swear by is ural sachets. Alkalising powder that's fizzes when added to water and eases symptoms of cystitis (stinging and burning on passing acidic urine being a symptom). For some reason changing the environment of the kidneys and blood to more alkaline prolongs the effect. This can be done by limiting vit C to normal levels, not overdoing it - probably not so important after you have your opoid snack, as it doesn't hang around in the body for too long and in the case of methadone I only have to go easy in the hours before my once daily dose, not after.

I'd check out alkaline high food and drinks if you don't want to drink an antacid mix, and limit juices before.

Okay.. and here's another observation with no scientific backing: diet pills, such as duramine, for me counter to debilitating sedation of methadone, so the mild euphoria and bliss of methadone is more appreciated (nothing worse than sleeping through it!). Not good for the heart taken all the time and tolerance quickly develops, so be careful. Might also be risky.. I'm too scared to research that one at present or I'll start to freak myself out!

And, being in a good mood to start with is ALWAYS a guarantee of a better time. So eating well, being healthy, having lots of exercise, sex, and naturally produced endorphins increases the high. For me playing dance music is a MUST during my Me time. (The once per day period of time my dose hits me - about 45 mins - to three hours of a lovely bliss, achieved by being on a higher dose of methadone than would probably be recommended, as it's only by your dose being too high that you feel anything much!)

For me, deciding to go on methadone was the only thing that was going to give me some kind of a life back, without the stress and risk associated with chasing prescriptions of oxycontin. Now I still get high, but mildly so, and in a limited, controlled manner, legally, with so far no change to tolerance, no negative consequences of what is daily drug taking, and relatively few side effects. One day I hope to feel ready to stop altogether, but right now I look forward to my downtime each day in the same way 'normal' people look forward to their glass or two of wine after work.

Have gotten a bit off subject. I think my point was, eat well, try to be happy and positive, if you have depression - treat it with exercise, diet, SSRI's as necessary, and some good old l-tryptophan to boost serotonin, plenty of sex for endophins, the right amount of GFJ and an antacid supplement, something to perk you like strong coffee and some euphoric music, and there's the setting for ideal opiate potentiation, IMHO.

I talk too much. :p
 
Methadone increase the amount of elavil to dangerous levels if taken over time here is a link that list everything that increases plasma levels, decreases plasma levels and unknown interactions. If you take methadone I suggest you read the entire thing. I had a cold coming on so I started my usual regiment of 7 grams of vit. c and sure enough after 2 days I was in acute and in full blown withdrawals. I searched the internet to try to figure out what the hell was happening and found this guide produced by the makers of methadone.
http://www.atforum.com/SiteRoot/pages/addiction_resources/Drug_Interactions.pdf
Here are methadone interactions

<methadone interactions put into NSFW tags to save some space -jc>
NSFW:

abacavir (ABC) ↓ Also decreases ABC peak concentration.
Accolate ↑ Proposed due to CYP450 inhibition.
Adalat &#56256;&#56362; Nifedipine increase proposed.
Agenerase ↓ Also may decrease Agenerase (amprenavir).
Aldactone ↓ Possible CYP450 induction.
Alfenta &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
alfentanil &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
alprazolam &#56256;&#56362; Potential interaction, additive CNS depression.
Alurate ↓ Due to CYP450 enzyme induction.
amiodarone ♥ ↑ Proposed due to CYP450 inhibition.
amitriptyline ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
amobarbital ↓ Due to CYP450 enzyme induction.
amprenavir ↓ Also may decrease amprenavir.
amylobarbitone ↓ Due to CYP450 enzyme induction.
Amytal ↓ Due to CYP450 enzyme induction.
Antabuse ↑ Sedation reported.
Antivert &#56256;&#56362; Increased sedative effects if abused.
aprobarbital ↓ Due to CYP450 enzyme induction.
ascorbic acid ↓ Proposed due to more rapid urinary excretion.
Atretol ↓ May cause opioid withdrawal.
Methadone-Drug Interactions, Page 19
Aurorix ↑ Possible due to CYP450 inhibition.
Aventyl ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
AZT (zidovudine) &#56256;&#56362; AZT concentration increased and side effects common.
barbiturates ↓ Due to CYP450 enzyme induction.
benzodiazepines &#56256;&#56362; Potential interaction, additive CNS depression.
Biaxin ♥ ↑ Strong CYP3A4 inhibition.
Bicitra ↑ Decreases methadone urinary excretion.
Bonine &#56256;&#56362; Increased sedative effects if abused.
Buprenex &#56256;&#56379; Displaces methadone on μ-opioid receptors.
buprenorphine &#56256;&#56379; Displaces methadone on μ-opioid receptors.
butabarbital ↓ Due to CYP450 enzyme induction.
butalbital ↓ Due to CYP450 enzyme induction.
Butisol ↓ Due to CYP450 enzyme induction.
butorphanol &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Calan ↑ Predicted due to CYP450 inhibition.
cannabis &#56256;&#56362; Proposed interaction, common CYP450 pathway.
carbamazepine ↓ May cause opioid withdrawal.
Cardioquin ↑ Proposed due to CYP450 inhibition.
Cardizem ↑ Proposed due to CYP450 inhibition.
Cat’s claw ↑ Predicted due to CYP450 inhibition.
Chamomile ↑ Predicted due to CYP450 inhibition.
chloral hydrate &#56256;&#56362; Additive effects, possibly fatal.
chlormethiazole &#56256;&#56362; Enhanced sedative effects.
cimetidine ↑ CYP450 enzyme inhibitor.
Cipro ↑ CYP3A4 and/or CYP1A2 inhibition.
ciprofloxacin ↑ CYP3A4 and/or CYP1A2 inhibition.
clarithromycin ♥ ↑ Strong CYP3A4 inhibition.
clomethiazole &#56256;&#56362; Enhanced sedative effects.
clorazepate &#56256;&#56362; Potential interaction, additive CNS depression.
cocaine ♥ ↓ Methadone elimination accelerated.
coke (cocaine) ♥ ↓ Methadone elimination accelerated.
Combivir &#56256;&#56362; AZT concentration increased.
Concerta &#56256;&#56362; Possible CYP2D6 inhibition.
Cordarone ♥ ↑ Proposed due to CYP450 inhibition.
Covera-HS ↑ Predicted due to CYP450 inhibition.
crack (cocaine) ♥ ↓ Methadone elimination accelerated.
cyclizine &#56256;&#56362; Increased sedative effects if abused.
D.H.E. ↑ CYP450 enzyme inhibition.
Dalgan &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Dalmane &#56256;&#56362; Potential interaction, additive CNS depression.
Darvon &#56256;&#56362; Possible opioid additive effects; long-acting toxic metabolites.
Decadron ↓ CYP450 induction.
delavirdine ↑ Due to CYP450 inhibition.
Delsym &#56256;&#56362; Increased dextromethorphan effects proposed.
Demerol &#56256;&#56362; Possible opioid additive effects; long-acting toxic metabolites.
Depade &#56256;&#56379; Displaces methadone on μ-opioid receptors.
desipramine ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
dexamethasone ↓ CYP450 induction.
dextromethorphan &#56256;&#56362; Increased dextromethorphan effects proposed.
Methadone-Drug Interactions, Page 20
dezocine &#56256;&#56379; Displaces methadone on μ-opioid receptors.
diazepam ↑ Effect sporadic, unknown mechanism.
didanosine (ddl
buffered tab)
&#56256;&#56362; Decrease in ddl (effect not seen with enteric-coated).
Diflucan ↑ CYP3A4 inhibition. Case reports requiring dose reduction reported.
dihydroergotamine ↑ CYP450 enzyme inhibition.
Dilantin ↓ Sharp decrease, CYP3A4 induction.
Diltia ↑ Proposed due to CYP450 inhibition.
diltiazem ↑ Proposed due to CYP450 inhibition.
Distraneurin &#56256;&#56362; Enhanced sedative effects.
disulfiram ↑ Sedation reported.
Dizac ↑ Effect sporadic, unknown mechanism.
doxepin ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Duramorph &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Dura-Tabs ↑ Proposed due to CYP450 inhibition.
E.E.S., Eryped ♥ ↑ Strong CYP3A4 inhibition.
Echinacea ↑ Predicted due to CYP450 inhibition.
Emoquil &#56256;&#56362; Increased sedative effects if abused.
efavirenz ↓ Due to CYP3A4/2B6induction, methadone withdrawal common.
Elavil ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Erythrocin ♥ ↑ Strong CYP3A4 inhibition.
erythromycin ♥ ↑ Strong CYP3A4 inhibition.
Eryzole ♥ ↑ Strong CYP3A4 inhibition.
estazolam &#56256;&#56362; Potential interaction, additive CNS depression.
ethanol (acute use) ↑ Competition for CYP450 enzymes.
ethanol (chronic use) ↓ CYP450 enzyme induction.
fentanyl &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Fioricet ↓ Due to CYP450 enzyme induction.
Fiorinal ↓ Due to CYP450 enzyme induction.
Flagyl ↑ Proposed due to CYP450 inhibition but unverified.
fluconazole ↑ CYP3A4 inhibition. Case reports requiring dose reduction reported.
fluoxetine ♥ ↑ Variable CYP450 enzyme inhibition.
flurazepam &#56256;&#56362; Potential interaction, additive CNS depression.
fluvoxamine ↑ Variable CYP450 enzyme inhibition.
Fucidin ↓ CYP450 induction.
fusidic acid (systemic) ↓ CYP450 induction.
Goldenseal ↑ Predicted due to CYP3A4 inhibition.
grapefruit ↑ Inhibition of intestinal CYP3A4 and P-gp.
Halcion &#56256;&#56362; Potential interaction, additive CNS depression.
hash &#56256;&#56362; Proposed interaction, common CYP450 pathway.
hemp &#56256;&#56362; Proposed interaction, common CYP450 pathway.
Hemineurin &#56256;&#56362; Enhanced sedative effects.
Heminevrin &#56256;&#56362; Enhanced sedative effects.
heroin ↓ Decreases methadone free fraction.
Hexadrol ↓ CYP3A4 induction.
hydrastis canadensis ↑ Predicted due to CYP3A4 inhibition.
hydrocodone &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Hypericum perforatum ↓ Significant decrease; CYP3A4 and P-gp induction.
Ilosone ♥ ↑ Strong CYP3A4 inhibition.
Methadone-Drug Interactions, Page 21
imipramine ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Imovane &#56256;&#56362; Potential interaction, additive CNS depression.
Insomn-eze &#56256;&#56362; Possible increased sedation or methadone effects.
interferon-alfa + ribavirin &#56256;&#56362; Side effects may mimic opioid withdrawal.
Isoptin ↑ Predicted due to CYP450 inhibition.
Kaletra ↓ Effect not seen with ritonavir alone.
ketoconazole ♥ ↑ Predicted due to CYP3A4 inhibition.
K-Phos ↓ Proposed due to more rapid urinary excretion.
lopinavir + ritonavir ↓ Effect not seen with ritonavir alone.
Lotusate ↓ Due to CYP450 enzyme induction.
Luminal ↓ Possibly sharp decrease in methadone.
Luvox ↑ Variable CYP450 enzyme inhibition.
macrolide antibiotics ↑ CYP3A4 inhibition (not azithromycin).
Manerix ↑ Possible due to CYP450 inhibition.
MAO (monoamine
oxidase) inhibitors
&#56256;&#56379; Potential adverse interaction.
Marezine (Marzine) &#56256;&#56362; Increased sedative effects if abused.
marijuana &#56256;&#56362; Proposed interaction, common CYP450 pathway.
matricaria recutita ↑ Predicted due to CYP3A4 inhibition.
Mebaral ↓ Due to CYP450 enzyme induction.
meclizine &#56256;&#56362; Increased sedative effects if abused.
Mepergan &#56256;&#56362; Possible increased sedation or methadone effects.
meperidine &#56256;&#56362; Possible opioid additive effects; long-acting toxic metabolites.
mephobarbital ↓ Due to CYP450 enzyme induction.
methylphenidate &#56256;&#56362; Possible CYP450 inhibition.
metronidazole ↑ Proposed due to CYP3A4 inhibition but unverified.
midazolam &#56256;&#56362; Potential interaction, additive CNS depression.
Migranal ↑ Possible CYP450 enzyme inhibition.
moclobemide ↑ Possible due to CYP450 inhibition.
morphine &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
MS Contin &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Myidone ↓ CYP450 induction proposed..
Mysoline ↓ CYP450 induction proposed..
nalbuphine &#56256;&#56379; Displaces methadone on μ-opioid receptors.
nalmefene &#56256;&#56379; Displaces methadone on μ-opioid receptors.
naloxone &#56256;&#56379; Displaces methadone on μ-opioid receptors.
naltrexone &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Narcan &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Nardil &#56256;&#56362; Potential adverse interaction.
nefazodone ↑ Variable CYP450 enzyme inhibition.
nelfinavir ↓ Possible decrease also in nelfinavir; methadone increase rarely needed.
Nembutal ↓ Due to CYP450 enzyme induction.
nevirapine ↓ Frequent opioid withdrawal syndrome.
nifedipine &#56256;&#56362; Nifedipine increase proposed.
Nizoral ♥ ↑ Predicted due to CYP450 inhibition.
Noctec &#56256;&#56362; Additive effects, possibly fatal.
Norpramin ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
nortriptyline ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Nubain &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Methadone-Drug Interactions, Page 22
omeprazole ↑ Possibly affects methadone absorption.
opioid analgesics &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
oxycodone &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
OxyContin &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Pamelor ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Parnate &#56256;&#56362; Potential adverse interaction.
paroxetine ♥ ↑ Variable CYP450 enzyme inhibition.
Paxil ♥ ↑ Variable CYP450 enzyme inhibition.
Pegasys &#56256;&#56362; Side effects may mimic opioid withdrawal.
pegylated interferon &#56256;&#56362; Side effects may mimic opioid withdrawal.
pentazocine &#56256;&#56379; Displaces methadone on μ-opioid receptors.
pentobarbital ↓ Due to CYP450 enzyme induction.
Phenergan &#56256;&#56362; Possible increased sedation or methadone effects.
phenobarbital ↓ CYP450 induction, possibly sharp decrease in methadone.
phenytoin ↓ Sharp decrease, CYP3A4 induction.
Polycitra ↑ Decreases methadone urinary excretion.
pot (marijuana) &#56256;&#56362; Proposed interaction, common CYP450 pathway.
Prevpac ♥ ↑ CYP3A4 inhibition (contains clarithromycin).
Prilosec ↑ Possibly affects methadone absorption.
primidone ↓ CYP450 induction proposed..
Procardia &#56256;&#56362; Nifedipine increase proposed.
promethazine &#56256;&#56362; Possible increased sedation or methadone effects.
propoxyphene &#56256;&#56362; Possible opioid additive effects; long-acting toxic metabolites.
ProSom &#56256;&#56362; Potential interaction, additive CNS depression.
protriptyline ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Prozac ♥ ↑ Variable CYP450 enzyme inhibition.
quercetin ↑ Predicted due to CYP450 inhibition.
Quinaglute ♥ ↑ Proposed due to CYP450 inhibition.
quinidine ♥ ↑ Proposed due to CYP450 inhibition.
Rebetron &#56256;&#56362; Side effects may mimic opioid withdrawal.
Rescriptor ↑ Due to CYP450 inhibition.
Retrovir &#56256;&#56362; AZT concentration and related side effects increased.
Revex &#56256;&#56379; Displaces methadone on μ-opioid receptors.
ReVia &#56256;&#56379; Displaces methadone on μ-opioid receptors.
ribavirin + interferon-alfa &#56256;&#56362; Side effects may mimic opioid withdrawal.
Rifadin ↓ Possibly severe; CYP450 induction.
Rifamate ↓ Possibly severe; CYP450 induction (not seen with rifabutin).
rifampicin ↓ Possibly severe; CYP450 induction (not seen with rifabutin).
rifampin ↓ Possibly severe; CYP450 induction (not seen with rifabutin).
rifampin/isoniazid ↓ Possibly severe; CYP450 induction (not seen with rifabutin).
Rimactane ↓ Possibly severe; CYP450 induction (not seen with rifabutin).
Ritalin, Ritalin SR &#56256;&#56362; CYP450 inhibition.
ritonavir + lopinavir ↓ Effect not seen with ritonavir alone.
Robitussin &#56256;&#56362; Increased dextromethorphan effects proposed.
scat (heroin) ↓ Decreases methadone free fraction.
secobarbital ↓ Due to CYP450 enzyme induction.
Seconal ↓ Due to CYP450 enzyme induction.
sertraline ♥ ↑ Variable CYP450 enzyme inhibition.
Serzone ↑ Variable CYP450 enzyme inhibition.
Methadone-Drug Interactions, Page 23
Sinequan ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
smack (heroin) ↓ Decreases methadone free fraction.
sodium bicarbonate ↑ Decreases methadone urinary excretion.
Somnote &#56256;&#56362; Additive effects, possibly fatal.
spironolactone ↓ Expected CYP450 induction.
SSRI antidepressants ↑ Variable CYP450 enzyme inhibition.
St. John’s wort ↓ Significant decrease; CYP 3A4 and P-gp induction.
Stadol &#56256;&#56379; Displaces methadone on μ-opioid receptors.
stavudine (d4T) &#56256;&#56362; Decreased d4T concentration (unclear clinical significance).
Sublimaze &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Suboxone &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Subutex &#56256;&#56379; Displaces methadone on μ-opioid receptors.
Surmontil &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Sustiva ↓ Due to CYP3A4/2B6 induction, methadone withdrawal common.
Tagamet ↑ CYP450 enzyme inhibitor.
talbutal ↓ Due to CYP450 enzyme induction.
Talwin &#56256;&#56379; Displaces methadone on μ-opioid receptors.
TAO ↑ Expected due to CYP450 inhibition.
Tegretol ↓ May cause opioid withdrawal.
Tiazac ↑ Proposed due to CYP450 inhibition.
tobacco ↓ Possible; reports mixed.
Tofranil ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Touro DM &#56256;&#56362; Increased dextromethorphan effects proposed.
tramadol &#56256;&#56379; Potential withdrawal in persons taking opioids.
Tranxene &#56256;&#56362; Potential interaction, additive CNS depression.
triazolam &#56256;&#56362; Potential interaction, additive CNS depression.
tricyclic
antidep.(TCAs)♥
&#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
trimipramine &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Trizivir &#56256;&#56362; AZT concentration increased.
troleandomycin ↑ Expected due to CYP450 inhibition.
Tuinal ↓ Due to CYP450 enzyme induction.
Ultram &#56256;&#56379; Potential withdrawal in persons taking opioids.
Ultracet &#56256;&#56379; Potential withdrawal in persons taking opioids.
Uncaria tomentosa ↑ Predicted due to CYP450 inhibition.
urinary acidifiers ↓ Proposed due to more rapid urinary excretion.
urinary alkalinizers ↑ Decreases methadone urinary excretion.
Valium ↑ Effect sporadic, unknown mechanism.
Valrelease ↑ Effect sporadic, unknown mechanism.
verapamil ↑ Predicted due to CYP450 inhibition.
Versed &#56256;&#56362; Potential interaction, additive CNS depression.
Vicks (cough med) &#56256;&#56362; Increased dextromethorphan effects proposed.
Vicodin &#56256;&#56362; Common CYP450 pathway; possible additive effects with methadone.
Videx (ddl buffered
tablet)
&#56256;&#56362; Decrease in ddl (effect not seen with enteric-coated).
Viracept ↓ Possible decrease also in Viracept.
Viramune ↓ Frequent opioid withdrawal syndrome.
vitamin C (very high dose) ↓ Proposed due to more rapid urinary excretion.
Vivactil ♥ &#56256;&#56362; Possible increased TCA toxicity; uncertain effect on methadone.
Methadone-Drug Interactions, Page 24
wine, beer, whiskey
(acute use)
↑ Competition for CYP450 enzymes.
wine, beer, whiskey
(chronic use)
↓ CYP450 enzyme induction.
Xanax &#56256;&#56362; Potential interaction, additive CNS depression.
zafirlukast ↑ Proposed due to CYP450 inhibition.
Zerit (d4T) &#56256;&#56362; Decreased d4T concentration (unclear clinical significance).
Ziagen ↓ Also decreases Ziagen peak concentration
zidovudine (AZT) &#56256;&#56362; AZT concentration increased and side effects common.
zileuton ↑ Proposed due to CYP450 inhibition.
Zoloft ♥ ↑ Variable CYP450 enzyme inhibition.
zopiclone &#56256;&#56362; Potential interaction, additive CNS depression.
Zyflo ↑ Proposed due to CYP450 inhibition.
 
Last edited by a moderator:
Ok so I’ve found some good articles on NMDA antagonists (DXM) and opiate potentiation and also the reversal and prevention of tolerances to opiates.

It should be noted however that these studies were used with morphine and various NMDA antagonists, so whilst these results will apply to morphine they may not necessarily apply to other opiates, but most opiates work in the same manner and well the development of a tolerance (as you will read) is developed in the same manner. Anyways, bit of pharmacology but simple enough to understand.

Antagonizing (blocking) NMDA receptors has a twofold effect on morphine, that is the prevention of a tolerance and also the potentiation of analgesic effects [1,2,3,4]. NMDA receptors are implicated in learning and memory [5]. It has become increasingly clear that opiate receptors interact with NMDA receptors upon activation [1,3,4]. It is this interaction and subsequent activation of the NMDA receptor that is responsible for the development of a tolerance [3,4]. Studies in mice have shown mice treated with NMDA antagonists (such as DXM, along side other antagonists) and morphine had decreased tolerance levels compared to mice that were treated with morphine alone [3]. This finding speaks for itself.

How does DXM potentiate the effects of morphine though? NMDA receptors are known to be responsible for hyper analgesia [3]. Hyperalgesia is a common sensation felt with tissue injury (such as burns), or inflammation where a whole area becomes hyper sensitive to temperature or touch. Now given that NMDA receptors are activated in by opiate receptors, [1,3] these same hyperalgesic pathways are activated too. So by blocking these pathways through NMDA antagonists, the effects of administrated morphine will be more pronounced. This can be best described by the more ‘calm’ and ‘sedating’ high that is often reported with DXM potentiation of opiates.

The most interesting finding of one of these studies was the reversal of a developed tolerance in mice using NMDA antagonists [3]. Frequent doses of a competitive NMDA antagonist were shown to significantly reduce a developed tolerance [3]. The bad news for us however is DXM is a non-competitive antagonist and the study did not test this finding with DXM. Antagonists are not all the same, that is there are many types of antagonists with different types of action, so whilst this competitive antagonist did work, I cannot speculate on the effectiveness of DXM in this regard. Still an interesting find none the less!

So, mumbo jumbo aside, DXM looks to be of worthy mention, I myself have only recently begun experimenting with it (a total of three times perhaps) and my results personally have been very promising, that is a much better high, more likely to nod off etc. It should be noted however that these studies were using ridiculous amounts of DXM, along the lines of 15mg/kg and even as high as 45mg/kg! Those poor damned mice I say! I would only use about 100mgs which is jack shit compared to those mice, and it’s only fair to assume that the significant attenuation of a tolerance buildup by these antagonists is at high doses. Not to say that I condone doses of 45mg/kg, fuck no! But still, taking DXM with your dose may prove beneficial down the road, just remember to let it do its work and take at least an hour beforehand! Also don’t mix with bloody benadryl, well in my experience.

Anyways long post, but I think an interesting read, and definitely worthy to experiment with, remember start small! Hope this is useful.

Ref

1. Plesan, A, Hoffmann, O, Xu, XJ, Wiesenfeld-Hallin, Z, 1999, 'Genetic differences in the antinociceptive effect of morphine and its potentiation by dextromethorphan in rats', Neurosceince Letters, Vol. 263, Pp. 53-56.

2. Chow, LH, Huang, EYK, Ho, ST, Tsai, SK, Tao, TL, 2004, 'Dextromethorphan Potentiates Morphine-Induced Antionociception at both Spinal and Supraspinal Sites but Is Not Related to the Descending Serotoninergic or Adreneregic Pathways', Journal of Biomedical Science, vol. 11, No. 7, Pp. 717-725.

3. Mao, J, Price, DD, Mayer, DJ, 1995, 'Mechanisms of hyperalgesia and morphien tolerance: a current view of their possible interactions [Review]', Pain, Vol. 62, Pp. 259-274.

4. Grass, S, Hoffmann, O, Xu, XJ, Wiesenfeld-Hallin, Z, 1996 'N-methyl-D-aspartate receptor antagonists potentiate morphine's antinociceptive effect in the rat', Acta Physiologica Scandinavica, Vol. 158, Pp. 269-273.

5. Villmann C, Becker, CM, 2007, 'On the Hypes and Falls in Neuroprotection: Targeting the NMDA Receptor [Review]', The Neuroscientist, Vol. 13, No. 6, Pp. 564-615.
 
When codeine is ingested it must first be converted into morphine inside the body before it has any "positive effects"...For the conversion to take place the CYP-450 enzyme must be present so inhibiting it would lead to lower conversion and thus lower "positive effects"...I would assume this also holds true for Poppy tea since the solubility of morphine in water is low and codeine is very soluble it would be safe to assume the tea is mostly codeine unless a form of calcium is added.
 
Does anyone know of anything that potentiates propoxyphene? I've heard Cimetidine does but I was hoping for personal experiences...
 
Mandark said:
Both diphenhydramine and hydroxyzine inhibit CYP2D6 enzyme (though hydroxyzine a bit less), which is responsible for converting hydrocodone into hydromorphone, so I don't see how they could potentiate it. Of course they would make you more sedated (probably at the expense of euphoria), but is that what you want?

Unfortunately, I have no personal experience with hydrocodone, so I'm only speculating.

ANtihistamines greatly potentiate opiates. But you are correct about the CYP enyzme. For using diphen or hydroxyzine for potentiating hydrocodone you should wait and ingest the hydroxyzine 1 hour after the hydrocodone. that way most of the ...codone has turned into ...morphone.. ;
 
AlphaOdure said:
Grapefruit juice/orange juice seems to just make me more drowsy and i really can't tell if its psychosomatic or not.

Cimetidine is more effecient in prolonging the effects. Although i must add; there is a direct correlation between opioid dose and cimetidine dose. My methadone dose has shot up so high that it seems the cimetidine isn't as effective as it used to be.

And also just a bit to add: i never take cimetidine before my daily methadone dose. This b/c of cimetidine's acidic repressive effect; it may inhibit some absorption of methadone. I don't know of any scientific evidence for this; but i've had some anecdotal, personal experience with this.

Cimetidine is supposed to be taken 1 hour before dosing. (approx 300mgs)

This is how it is able to potentiate the methadone. The main reason for using cimetidine is to make the methadone last longer in your system.

I was on methadone maintenance for 10 years, so believe me, I know all to well what it does and how to take it.

In all of my research and experience and with what I have been told by methadone doctors.

When a person is under-dosed, cimetidine is often used to make ones dose last longer in their system.

Peace,
Hana
 
I have found that Papaverine HCl tablets, between 80-120 mg's, potentiate any opiate high a little bit, not that much, but definitely noticeable, and it makes the stomach relax which is nice.

Does anyone else have papaverine opiate potentiation experiences???

Peace /C.
 
Psykoton said:
I have found that Papaverine HCl tablets, between 80-120 mg's, potentiate any opiate high a little bit, not that much, but definitely noticeable, and it makes the stomach relax which is nice.

Does anyone else have papaverine opiate potentiation experiences???

Peace /C.


where in the hell do u get those and what are they used for traditionally? are they over the counter?
 
I get them from my doc (Scandinavia) in tablets containing 40 mg Papaverine Hydrochloride. They are traditionally used as a smooth muscle relaxant, eg. stomach cramps from high opiate doses, and IBS etc.

And no, they are not over the counter, but they are not scheduled either, so they are easy to get.
 
Psykoton said:
I get them from my doc (Scandinavia) in tablets containing 40 mg Papaverine Hydrochloride. They are traditionally used as a smooth muscle relaxant, eg. stomach cramps from high opiate doses, and IBS etc.

And no, they are not over the counter, but they are not scheduled either, so they are easy to get.

in australia? that would come in handy is it aval or something similar
 
The way I have been taking opana to knock me on my ass is with a high in fat meal, some fresh grapefruit and some unisom
 
anyones thoughts on adding Ketamine, tramadol then some opiates together. was going to try after lots of K last night some tramadol benzos and a sub or naltrex? dangerous combo?
Adding catapres, soma, a benzo, dramamine and other anti histamines with my opiates always good except not a big fan of clondine (catapres)'s effects on the penis cause of lowering blood pressure
 
So i was doing some research on the first generation H-1 receptor antagonists, the ones with strong anticholinergic and sedative effects and i came across Promethazine which is prescribed for reducing the nausea associated with use of opiates for analgesia. I found out that it dramatically potentates the effects of morphine and IMO probably its other analogs...interesting read...

http://www.anesthesia-analgesia.org/cgi/content/abstract/56/6/801
http://forums.firehouse.com/archive/index.php/t-36607.html
 
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