Need advice antidepressants while also taking Opioids

[ColoradoBoy90]

It looks like Effexor XR is off the table, leaving only Tramadol and/or Remeron.
I took Effexor XR for only 2 days (37.5mg per day) and it HEAVILY blocked my pain meds at one point I took 2.5X my dose to get pain relief and feel it actually kicking in. It was like that all day on day 1 on Effexor XR, and even worse on day 2. I stopped it.

So my question is this: does TRAMADOL (being also an SNRI) have any interference with hydro/oxy? Like in metabolism do they use the same liver enzymes? I heard Tramadol is very similar to Effexor ER in nature so that concerns me... But I don't recall Tramadol completely blocking my other pain meds in the past, but it's been so long I don't know. Anyone know or have person experience? I assume Tramadol being a very mild on the mu receptor should only increase its effects if anything? But I dunno could be wrong.

That means Tramadol and Remeron seems like the best option, I just hope Remeron doesn't block the hydro like
Prozac and Effexor did...

 

[Snake_Eyes]

I never said tramadol was a bad idea I was just stating that mirtazapine and tramadol (not technically an AD) have been the only two antidepressants I've been on.

I don't think I've ever mixed tramadol and an opiate other than kratom and they seemed to synergized decently. One thing that I will say about tramadol is since it tickles the opioid receptors it can and probably will raise your tolerance to the good stuff.

 

[ColoradoBoy90]

Gotcha I misread it, sorry about that! But since Tramadol is so weak on the mu receptor, if one where to go back into something stronger like Vicodin or Percs shouldn't their tolerance be lowered to the the stronger Vicodin/Percs?

I'm going to try mirtazapine, thanks for the idea glad it doesn't mess with pain meds! Just wondering did you take mirtazapine and Tramadol at same time? And how did Tramadol work for your depression? Or was it mainly the mirtazapine?

Sucks that all SSRI's and SNRI mess with with meds. Maybe I can try Wellbutrin during day and mirtazapine at night? I don't know if that will be enough to help my very low serotonin problems. That's why I thought of Tramadol because I know it slightly releases and is a re-uptake inhibitor of serotonin which I badly need. I don't know how mirtazapine even works really so not sure if it will help balance out and increase my low serotonin and dopamine problem or I need to add in an SSRI/SNRI to hit serotonin.

 

[mankind]

I could only skim through your post due to time constraints, but it seems to me that you are getting tolerance withdrawal to your opiates. Anti depressants will do nothing to make you feel better about that. It seems like you built up your tolerance where you need to be constantly dosing. Anti Depressants wont help with any type of withdrawal. I may have misunderstood your post though.

 

[JebJebJeb]

I would reccomend two paracetomols to counter the negative effects of the drugs

 

[ColoradoBoy90]

No, it's not that. I'm not trying to use antidepressant for W/D.

I need them because RIGHT NOW, the ONLY way to be happy is to take a hydro every 30 mins to 2 hours (depending on what I ate, etc). If I do NOT take a hydro/Roxi constantly then I become super super depressed where I cannot smile, no energy, I'm just a dead zombie.

Here's the thing: I can go 4-8 hour without taking any pain meds before withdrawal kicks in. So me taking a pill every hour or two is over doing it just to "try feel mentally okay". I'd rather instead take antidepressants to make me feel "mentally okay" then then take the opiates every 4-8 hours instead. That's my plan. I just need the right Antidepressant combo

 

[nomilila]

We are all different, and thats the thing that sucks about antidepressants. What works for one won't work for another. I've tried them all, and Lexapro and Welbutrin were the only ones that worked for me. Welbutrin works great for depression, but it gives you the jitters when you are on it initially. But if you are using opiates, they are sucking away all your serotonin, so it's a bit of a moot point.
Good luck my friend, I've been in your shoes and I know it sucks.

 

[ColoradoBoy90]

Question though: if opiates are sucking away and depleting all my serotonin, would an SSRI or an SNRI help STOP that (at least somewhat) or no?? As
in would an SSRI or SNRI help keep
a decent amount of serotonin levels in the brain, even when taking opiates/opioids that deplete serotonin? I'm assuming because SSRI'S and SNRI work by re-uptake action they should PREVENT opiates from Depleting you of serotonin, but I could be wrong. I'm assuming if the SSRI does prevent opiate/opioids from taking all your serotonin then the "feel" from the opioids would be diminished due to less serotonin being released -- BUT that is good for someone who wants to balance out serotonin levels while STILL taking opiates/opioids at the same time. Anyone know? That's the biggest question of all actually!!

Because if I figure that part out, then I'm sure antidepressants will help some it's just a matter of which one..I actually tried Remeron last couple nights and it does not interfere with the pain mess one bit, it helps me sleep and wake up easier, but too early to tell on the mood part. I also tried Wellbutrin during the day both those days and got a lot more energy for most of the day. Although I have a feeling I'll have to add some form of serotonin reuptake inhibitor into the mix (unless Remeron is enough for serotonin, I've read conflicting stories) and since all SSRI and SNRI all interfere with my pain meds it's hard to figure out what.

 

[zagor11]

ColoradoBoy you still here?

 

[Larimar]

Super jealous you have and can afford to be popping pills every 30 mins But seriously you need to figure out why you are so depressed , try a holistic approach.

 

[Scrofula]

ColoradoBoy you still here?

He sure is! Saw him just the other day, in this very forum.

A better way to get his attention than bumping a three year-old thread is by simply clicking his username and choosing "Send Private Message". It's like a personal email or text message, just between the two of you; as intimate or awkward as you'd like.

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