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Misc Warning: Not so common potentially deadly combinations of drugs.

T

Timber

Bluelighter
Joined
Dec 22, 2012
Messages
52
Its been 30 days since my best friend passed on, and I finally have (a somewhat redacted) the toxicology report from the medical examiners office. My friend had been tying to clean himself up from long term opiate/opioid, amphetamine, and benzodiazeapine use.

I had expected that since he died in his sleep, and had been suicidal off and on that there would be a massive amount of opioids, benzos, and alcohol in his system in the toxicology report. He was/had been successful in staying off of opioids, amphetamines (primarily mixed amphetamine salts, and dexy), and had been cutting down radically on his benzo use.

According to the report he had: Lyrica, temazapam, diazapam (which he was attempting to find a doctor to switch him over to to taper him off), carisoprodol, trazodone, and a trace amount of alcohol in his system. Apparently there is a potentially very serious interaction between lyrica and carisoprodol -- depending on how your enzymes work in your body this can produce a barbiturate that can be fatal in combination with lyrica. Adding temazapam only increases this effect, and tends to suppress breathing. Also interesting is that the effects of the lyrica, and carisoprodol (soma) can be cumulative over short periods (24-36 hours or so), and that common household aspirin may increase the risks of accidental overdose, and that it *may* be possible for ginger, an even other NSAIDS to increase this risk.

Since this is harm reduction, I am posting this here. Lyrica + soma (and by extension soma + neurontin) can be deadly. Alcohol plus benzos only increases this risk. Other than the amounts of lyrica, and soma -- everything else was in very small amounts in his system. I do not know if he was taking it to deal with PAWS or to get high or try to end his life (the latter I now very much doubt). I do know that 38 years old is far too young to end up in a pine box in the ground.

Tons of people mix benzos or soma with opioids, and know the risk. Not so often does the idea of mixing lyrica or neurontin with soma and benzos come up -- I strongly recommend not mixing them. This combination may be just as deadly, if not a great more so than those who combine opioids with small doses of soma or benzos (not a wise idea either, but one I'm sure plenty here have done). The synergistic effects of these combinations can be highly unpredictable.

Be safe out there. I've been to enough funerals this year (3).
 
Last edited:
Thank you for the information. This is new to me. I'm very sorry to hear about your friend.

I think a general rule of harm reduction that needs to be more important is that mixing prescription drugs is really, really dangerous. I'm not talking opiates or benzos, that's a different story. I'm talking about prescription drugs that aren't abused often (like trazodone and lyrica). These drugs aren't scheduled, are easy to get, and they aren't thought of us as dangerous, usually. Although they are usually safe by themselves (though nothing should ever be assumed to be safe, except maybe weed ;)) they are rarely mixed when used medically and often lead to dangerous side effects. These effects are usually well documented in literature but are not anecdotally common because they are rarely abused.

Again... mixing unscheduled prescription drugs is just as dangerous as using schedule I narcotics. You are doing a great service to us all by warning us. It could have been me who passed. I've used both and I never knew you shouldn't mix them

I really feel for your friend, especially since he was doing so good. I also hope you're alright. If you need to talk to peeps, The Dark Side forum is really great for support.
 
Every time you take something it is a roll of the dice, but I never really thought much of lyrica and soma having a cumulative effect due to how the enzymes they use interact. Individually I never considered either of them that big of a deal.

I miss my friend, its a major hole in my life that cannot be filled. Its not as much fun for the people left behind. He was always far too cavalier about mixing things. I hope no one else will go down that same road.
 
Well thanks for posting, b/c i take both of these drugs almost daily,well lyrica daily. Sometimes with higher lyrica and soma dosages and i personally have never had any trouble, but will try to avoid this combo in high amounts in the future. Thanks again for posting
 
Thank you for posting this warning and my sympathies for your loss.
I think it would be great if someone could link with some solid info on exactly how this rare but fatal interaction occurs.
Apologies that i cant do that at the moment but im stuck on a bloody phone!lol
 
bennyZA said:
Thank you for the information. This is new to me. I'm very sorry to hear about your friend.

I think a general rule of harm reduction that needs to be more important is that mixing prescription drugs is really, really dangerous. I'm not talking opiates or benzos, that's a different story. I'm talking about prescription drugs that aren't abused often (like trazodone and lyrica). These drugs aren't scheduled, are easy to get, and they aren't thought of us as dangerous, usually. Although they are usually safe by themselves (though nothing should ever be assumed to be safe, except maybe weed ;)) they are rarely mixed when used medically and often lead to dangerous side effects. These effects are usually well documented in literature but are not anecdotally common because they are rarely abused.

Again... mixing unscheduled prescription drugs is just as dangerous as using schedule I narcotics. You are doing a great service to us all by warning us. It could have been me who passed. I've used both and I never knew you shouldn't mix them

I really feel for your friend, especially since he was doing so good. I also hope you're alright. If you need to talk to peeps, The Dark Side forum is really great for support.
Click to expand...

Lyrica is a schedule 5 drug.

I mix lyrica and temazepam/alprazolam on a weekly basis but the amount I take isn't recreational. Even the back specialist gave me the go ahead on combining the two.
 
bunge said:
Thank you for posting this warning and my sympathies for your loss.
I think it would be great if someone could link with some solid info on exactly how this rare but fatal interaction occurs.
Apologies that i cant do that at the moment but im stuck on a bloody phone!lol
Click to expand...


All of those are CNS depressants. They can have an additive effect especially when combined with alcohol. Some drugs inhibit the metabolism of other drugs causing a higher than normal plasma levels which can lead to overdose, but I don't think any of those are major CYP inhibitors.
 
This is my first time hearing of this interaction between pregabalin and carisoprodol. A cursory web search found only descriptions of additive sedation and impairment. Carisoprodol is metabolized hepatically by CYP2C19, while pregabalin is excreted unchanged, so I don't see any interaction via hepatic enzymes. While carisoprodol exerts barbiturate-like action at GABAA, I don't see how it could combine with pregabalin to form a barbiturate.

So anyone who knows something more specific about the interaction, please expound (but really, I think the OP's friend died because he took 4 GABAnergic depressants at once).

ebola
 
thkx a lot for the information

i have some lyrica stored, fot these WD days, and when had mixed lyrica with clonidine, is not recreational but tend to heavy sleep, i think it may be more probably to us, to die when trying to avoid the nasty WD than when being active with oppies

that kind of info is very useful
 
@pilll_head, i am aware of the obvious dangers in mixing cns depressants. I am prescribed lyrica, mirtazepine and various opiates, all three cns depressants with different MOAs.
What i was referring too (i prob should have clarified) was the OPs claim that during metabolism barbituate could be formed by carisoprodol and pregabalin.
I found this particularly interesting for the same reason that ebola? outlined, pregabalin is excreted unchanged, so where would this metabolism into a barbiturate happen?.
That was my meaning behind a request for a link, hope that clears things up abit. :-)
 
"Lyrica, temazapam, diazapam (which he was attempting to find a doctor to switch him over to to taper him off), carisoprodol, trazodone"

I have never heard of these drugs before, I am checking them out now out of curiosity but in my 28 year long life, I never had a need where these drugs would pop as a solution.
 
^
seriously?lol
I could understamd you not having heard of trazodone, carisoprodol and to some extent lyrica (pregabalin)..but diazepam? temazepam?diazepam is on the WHO list of drugs every doctor should have access too.
Unless of course you were making fun of the OPs spelling of said chemicals? In which case....thats abit low!
Just by reading the content of the OP, you should be able to tell this isnt a someone you should be poking fun at.
 
Snake_Eyes said:
Lyrica is a schedule 5 drug.

I mix lyrica and temazepam/alprazolam on a weekly basis but the amount I take isn't recreational. Even the back specialist gave me the go ahead on combining the two.
Click to expand...

First, Lyrica is only a schedule V drug in some states, not all.

Secondly I agree with Ebola and the others. I can't imagine that the lyrica and soma itself would be deadly, this is actually a very commonly prescribed combination for chronic pain patients. I think the combination of SO many depressants taken together even in fairly small amounts would be enough to cause some people some serious trouble. When you are talking about 6 drugs all taken together, all with depressant type activity, I would have been surprised if it HADN'T caused some problems!

I am very sorry for your loss. It is so sad because yes 38 is soo young.

But I think the tru warning you should be giving out is about mixing alcohol (even in small amounts) with 5 other depressants. Again soma and lyrica are a VERY commonly prescribed combo for pain patients.
 
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