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Codeine-will it work? using SSRI

http://books.google.com/books?id=Sn...i=book_result&ct=result&resnum=1#PRA1-PA35,M1



http://http://books.google.com/books?id=SnwB_fmjr2MC&pg=RA1-PA34&lpg=RA1-PA34&dq=antidepressants+CYP2D6+interaction+with+Codeine&source=bl&ots=3z_UR1ifT-&sig=2_ijF3G4Zlb-Alx7kIubm0RkoTA&hl=en&ei=-xwCSoH4G5nNjAeanOWGBw&sa=X&oi=book_result&ct=result&resnum=1#PRA1-PA35,M1

Another I had a look at above.

http://http://www3.interscience.wiley.com/journal/75500464/abstract
^^
"Based on these parameters, selecting an antidepressant medication, such as venlafaxine, that has a low potential for drug interactions at the Cytochrome P450 (CYP) enzyme system, and is easy to monitor and dose, facilitate successful treatment of patients. Venlafaxine has been evaluated in clinical studies that demonstrate low to negligible drug interaction potential at CYP2D6, CYP1A2, CYP2C19, and CYP3A4. Its short half-life and time to steady-state, when coupled with the extended release characteristics of the preferred dosage formulation allow for once daily dosing and rapid attainment of therapeutic effects".

http://http://pn.psychiatryonline.org/cgi/content/full/43/6/1-a

The above sys that Venlefaxine inhibits CYP2d6 so weakly that it would be like you were not taking one.

http://http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=1085
^ this one quotes Sertraline somewhere as being weak at low doses i.e. 50mg but higher doses seem to inhibit CYP2d6 somewhat highly.
 
I couldn't get high off codeine on citalopram..

But then again i didn't get high off codeine when i wasn't on it :\
 
^ Did you have an opiate tolerance?

I really hope this doesn't lead me to going to my Dr's suggesting I try venlafaxine 'because the cit' isn't working anymore'. I have loads of codeine, no opiate tolerance but even taking half a gram of the stuff does nothing. I know opiates can work on me. A few years back I got some 5mg palfium tablets. 2 of those under my tounge and I was in la-la land within 30 mins.

Thanks for your replys everyone. Some of you have done some serious research on my behalf : ).

What are anyones thoughts on taking a 'drug holiday'? No, not a trip away where you get messy the whole time, but say not take 2 doses of the cit (i dose once a day) and then try the codeine? I've also read that alcohol is a CYP2d6 inducer. So maybe a couple beers before dosing?

Thanks again everyone,

SS
 
Right, well on Sunday I'm not gonna take my dose of citalopram, or on Monday either, then Monday afternoon try 512mg codeine from a CWE (so actual amount will probably be well under 512mg).

I'll report back...

Any tips on potentiation? I think an empty stomach is a must, and possibly a couple beers before hand since alcohol is a CYP2D6 inducer. I also have some st johns wort lying around which I've read induces CP2D6 too, though I'm wary of taking this while I'm on an SSRI.

SS
 
serotonin-system said:
Right, well on Sunday I'm not gonna take my dose of citalopram, or on Monday either, then Monday afternoon try 512mg codeine from a CWE (so actual amount will probably be well under 512mg).

I'll report back...

Any tips on potentiation? I think an empty stomach is a must, and possibly a couple beers before hand since alcohol is a CYP2D6 inducer. I also have some st johns wort lying around which I've read induces CP2D6 too, though I'm wary of taking this while I'm on an SSRI.

SS
Click to expand...

Do Not take St. Johns Wort while taking an SSRI, or even within 14 (possibly more) days since last taking an SSRI.
 
I was on 40 mg Prozac, and 300 mg Wellbutrin XR, and I still could get a decent buzz off codeine, i think it was around 300 mgs codeine or so i would take. I have a really high opiate tolerance though, so thats most likely the reason I didn't get a better high off codeine.
 
I've experimented with fluoxetine(Prozac) in combination with several drugs, including codeine (in this instance 60 and 80mg doses respectively). At T+ 3:00 between 370 and 400mg CWE codeine was ingested on an otherwise empty stomach. Onset was slightly delayed, peak somewhat nullified, histamine reaction seemed normal. Remember fluoxetine is also a mild inhibitor of CYP3A4.

Does anyone have information or experience with regards to rifampicin + codeine, or carbamazepine + codeine?
 
Tchort said:
Do Not take St. Johns Wort while taking an SSRI, or even within 14 (possibly more) days since last taking an SSRI.
Click to expand...

That is an excellent point. Thank you. I have actually suffered a case of serotonin syndrome before (check out some of my earlier posts if anyone's interested) and it is not something I wish to repeat.

I'm actually a little pissed at myself for not recognising this interaction myself.

SS
 
October said:
I was on 40 mg Prozac, and 300 mg Wellbutrin XR, and I still could get a decent buzz off codeine, i think it was around 300 mgs codeine or so i would take. I have a really high opiate tolerance though, so thats most likely the reason I didn't get a better high off codeine.
Click to expand...

That's encouraging, thanks. I didn't take my citalopram today (40mg) and wont take it tomorrow morning, then in the evening I'll CWE 512mg codeine and see how it goes. I'm also gonna have maybe half a bottle of wine (not a lot for me, I have a very high tolerance to alcohol due to large useage. Last night I had 5 cans of stella artois and a bottle of wine and didn't even feel that drunk, and feel absolutely normal today. Note: not dick-sizeing there :)) before dosing the codeine, being that alcohol is a CYP2D6 inducer.

I'll let you guys know how I go!
 
Citalopram isn't the worsed AD or SSRI to take while using codeine it seems to be prozac an seroxat that are the worse. I recently switched to Effexor from seroxat as I'm on DHC 120 mg x 2 daily and wanted to get the full conversion into dihydromorphine. I haven't really had a chance to test the effects as 1. I've been using heroin and have had no need to use the DHC and 2. The seroxat will take time to fully leave my system, but by tomorrow I should be able to see if the DHC affect me more due to swapping to Effexor, so will let you know.

BTW I'm taking the DHC as a bridge until my local drug and alcohol service initiates Suboxone. But as I haven't used many of the DHC I am hoping that they will work much better due to more CYP2D6 because of the Effexor and due to having more pills : )
 
Just as an update guys, I didn't take my citalopram yesterday, or today, and now I've got terrible diareaha, although psychologically I feel fine (a link do you think?). I think it's ironic that this evening I'll be dosing codeine which induces constipation.

Anyone else have this side effect when abruptly stopping an SSRI (I'm on 40 mg citalopram)?
 
Mr Blonde said:
It's CYP2D6 that turns codeine into morphine; CYP3A4 breaks it down into mostly inactive metabolites like nor-codeine, nor-morphine, etc...

See here for an article on someone who apparently metabolizes codeine into morphine quite well.
Click to expand...

I keep getting that backwards, heh, I feel dyslexic. Anyway, yes you're right. My bad. I used to have the damn CYP450 interactions chart on my desktop, but I've upgraded my OS a bunch of times and now it's probably buried in my endless pile of documents.
 
to seritonin system i also take citalopram/celexa and when i dont take it my bidy get really really light and i get crazy headaches the the body feeling is really tingly and it annoys the shit out of me i havent had diareha as a side effect of not taking it..it may work other people bodies different
 
i never feel high or good from pain killers unless its morphine :{ like even 110 mg of percs i only get a bit of joy thats it.....my tolerance is too high wit dat shit for sum reason... :[ lolol
 
johnnyknoxville said:
i never feel high or good from pain killers unless its morphine :{ like even 110 mg of percs i only get a bit of joy thats it.....my tolerance is too high wit dat shit for sum reason... :[ lolol
Click to expand...

That sucks man. Are you on anti-depressants? My regular dose is 25-40mg oxycodone (unless I quit SSRIs for a bit in which case I get baked good n proper from 10-30mg).

It drives me nuts when something doesn't work. Usually time to move on since something is bound to click.

When you say 110mg percs, do you mean you CWE'd 22 5mg pills?
 
Hi!

I was prescribed prozac like an hour ago, and of course, it's the worst one to combine with codeine. In my town it's impossible to get a doctor. I talked to one today finally and get prozac, I argued to get another one prescribed against depression, however I want to be able to use my codeine tabs while the anti-depressant start to work (like 1 month)

I have xanax, codeine and diazepam so I can get through it with no problem :)

I don't have a lot of codeine. Do I dare to try, I have high tolerance?!

Thanks.
 
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