Opiates and MAOIs: Contradicted?

[johnnyzero]

Thanks, MobiusDick

Very good info on Emsam, MAOI's in general, & contraindications.

I've had a similar experience with a low dose (6mg/day) of Emsam. For whatever reason, MAOI's are the only type of medication that have ever helped me conquer the often crippling depression I've suffered with all my life.

SSRI's have literally no effect on me at all - I might as well be eating an M&M. Like you, I also experienced hypomanic episodes with the more common MAOI's (Nardil/Parnate), primarily dose-dependent. Eventually I would experience an MAOI poop-out after about 4-6 months. Also, I found the reversible-MAOI Manerix (Moclobemide) to be of little or no benefit.

For about 18 months now I've been using the 6mg/day Emsam patch, and under most circumstances I can even get away with using 1 patch every other day. So far, so good - no tolerence/poop-out that I can discern, and certainly no hypomanic episodes at all. Perhaps that's partly due to the more even delivery of the Selegilene via the transdermal patch? With Nardil, I could actually feel that stuff kick in; rather like Gary Oldman in The Professional...

As an adjunctive medication, I also take 6mg of Deplin per day. Deplin is basically a super-bioavailable form of Folate, and for me it seems to somehow boost the benefits of the Emsam.

For a significant subset of depressed patients, I still believe that MAOI's are their best bet. Unfortunately, most doctors today will automatically blow right past them in favor of the SSRI's, resulting in a failed trial - not to mention additional undue suffering for the patient.

best,
JohnB

 

[mitragyna]

For the sake of this discussion lets consider the alkaloids found in poppy tea.

Although most Opiates are ok to use with MAOIs, I would stay away from Poppy Tea. Due to the presence of Thebaine and other alkaloids, I would assume that this could lead to a hypertensive reaction or convulsions.

I'm on Emsam and have noticed no negative effects from most Opiates besides potentiation (not necessarily negative).

 

[Limpet_Chicken]

Thebaine exerts its toxicity through a similar method to strychnine, antagonist at strychnine-sensitive glycine receptors, not something I would want potentiating, but I'm not sure it would (or wouldn't) cause a pressor-type response, its a physical stimulant, but a pretty unconventional one.

 

[mitragyna]

Thebaine exerts its toxicity through a similar method to strychnine, antagonist at strychnine-sensitive glycine receptors, not something I would want potentiating, but I'm not sure it would (or wouldn't) cause a pressor-type response, its a physical stimulant, but a pretty unconventional one.

Interesting. Do you know of anything in poppy seed tea that could cause a hypertensive crisis when combined with an MAOI?

 

[CheckCall]

FWIW, I thought I'd chime in in this discussion with my own personal experience. I'm still a little new around here so please be kind I have been dosing deprenyl (MAO-B inhibitor) at about 2mg/day now for about a month and having good luck with it. I also occasionally dabble in opiate use, but haven't for a bit of time.
The other night, after thoroughly researching for any contraindications between MAO-I's and opiates, I felt comfortable enough to take a trial run of oxycodone along with the MAO-I in my system. My girfriend was around, should something go very wrong (unlikely) and I needed to be taken for medical treatment. Because of my infrequent use, I'm relatively intolerant to opiates, so about 40mg is my dose of choice. Since I was unsure of how I'd react, I cut it down to 30 for tonight. NO other potentiators were used.

Results- I was quite impressed with the combination. Not only did I not suffer any apparent ill effects (took my heart rate and blood pressure every so often just to check) but I noticed some definite potentiation. I generally don't get too many effects from the so-called "potentiators", at least the pure ones that supposedly inhibit the breakdown of drug (grapefruit, Cimetidine) and not the type that "add to the experience." However, the effects were definitely prolonged in this case. Intensity of the experience was somewhat enhanced, but the length was the biggest difference.

I tend to give little regard to anecdotal evidence regarding drugs and pharmcology, but seeing as though there wasn't much else out there regarding the combination of these two substances, I figured I'd share my experience. Of course, it's only one trial and everyone reacts differently to everything, so exercise caution as always. Hope it helps and be safe

 

[mitragyna]

^^
I had the same experience with Poppy tea. I'm on 9 mg of Selegiline daily, and I dose Poppy tea daily also. No ill effects noted. Maybe some potentiation if anything.

 

[mitragyna]

^ then what do you think accounts for the potentiation I experienced on pod tea + b caapi + DMT???

It definitely was potentiated after smoking that stuff...

maybe its all in my head......

No, I certainly believe MAOIs potentiate Opiates. Pod tea at least. I combine the two everyday, and after I added the MAOI (Selegiline) to the mix, the Opiate effects were definitely increased.

 

[rolls]

No, I certainly believe MAOIs potentiate Opiates. Pod tea at least. I combine the two everyday, and after I added the MAOI (Selegiline) to the mix, the Opiate effects were definitely increased.

So it just makes the tea stronger and this is all you have to take into account? it doesn't make it more toxic?

So what I am saying, lets say it increases pod teas effects by 50%, it would also increase any toxicity you experience from the thebaine by 50% but no greater?

Also what have people experienced from using codeine with MAOIs?

For reference the MAOI I've been prescribed is Moclobemide.

 

[rolls]

I've just been prescribed moclobemide recently. Today was my first day so I had 150mg in the morning and 150mg in the afternoon.

I decided to experiment with poppy tea in the late afternoon and used 500g (usually use 1kg) and only drank half the tea. Felt it come on fairly nicely so I did the full 1kg. Overall it felt exactly the same as when I was not taking the anti-depressants.

I think tried 500mg of codeine on top of this, the codeine did absolutely nothing which was very odd. I then read up and found out that moclobemide is metabolised by the same enzyme that converts codeine to morphine.

So I don't know what all this potentiating crap is as it made my codeine infinitely weaker and didn't make the poppy tea any stronger.

 

[fastandbulbous]

I don't believe they are too dangerous, if carefully combined.

There are always warnings of possible contra indications, if MAOI's and opiate will becombined (in pharmaca books which I know)

Carefully combined - not really a common attribute among drug users...

They can also lead to hyperthermia when combined (probably what leads onto convulsions, rhabdomyalysis etc)

 

[shady4091]

I've just been prescribed moclobemide recently. Today was my first day so I had 150mg in the morning and 150mg in the afternoon.

I decided to experiment with poppy tea in the late afternoon and used 500g (usually use 1kg) and only drank half the tea. Felt it come on fairly nicely so I did the full 1kg. Overall it felt exactly the same as when I was not taking the anti-depressants.

I think tried 500mg of codeine on top of this, the codeine did absolutely nothing which was very odd. I then read up and found out that moclobemide is metabolised by the same enzyme that converts codeine to morphine.

So I don't know what all this potentiating crap is as it made my codeine infinitely weaker and didn't make the poppy tea any stronger.

If I'm not mistaken, I think Codeine itself inhibits the same enzyme that converts it into morphine, so any Codeine you may have gotten from the tea would render any re-dosing, useless. I've certainly found re-dosing on Codeine before six hours or so to be pretty ineffective.

 

[Trine]

MAOI and opiates is NO NO but mayby, becuase the effect mayby bee more strong but you chould be cerefull. , MAOI and opiodes is only NO NO NO They kill You same whit MAOI and MDMA is NO NO NO they KILL YoU

 

[DJHENRU]

Hmm I would suspect that it just can lead to bloodpressure problems, but harmaline has use in stopping the self adminstration of morphine, ive verified this in my worst kratom withdrawl, 3 g tea of syriansue made me feel a bit calm and normal for a half hour.

 

[d-kong]

i may be an idiot but i dont fully understand this...so to try and clear it up could someone try and explain something to me in my idiotic terms...i learn more from experience so i'll just ask a situation here....so if i drank a few cups of yerba mate (maoi inhibitor) and then took my normal shot of smack or oxy what would the difference be?

 

[sekio]

Yerba mate is not an appreciably strong MAOI. The major active component is caffeine.

 

[d-kong]

Yerba mate is not an appreciably strong MAOI. The major active component is caffeine.

i was just using it as an example...im not super familiar with maoi's...it's just the first one that came to mind. regardless...would it potentiate the opiate or just basically make it last longer like other histamines do? i've also heard benadryl and tagament increase the duration of opiates but i think thats better info for a different thread which has probably been said over and over anyways

 

[DJHENRU]

Surian rue makes me feel super sedating like the drunken spins, so it be alot more psychologically inhebriating