Anti depressant and opioid interaction

[starfarer]

I have been taking 20mg citalopram daily for the past 2 weeks at 20mg in addition to a combination of the former with 20mg sertraline a couple of nights ago. However it reduces the efficacy of opiates really significantly so I ned to discontinue the anti depressants. However even after 2 days or so of discontinuation the subduing effect is still evident

How long must I wait before the interaction stops or rather how long must I wait before the anti depressants are totally swept from my system (does this correspond to the half life? of the anti depressants)

 

[starfarer]

Getting really anxious and frustrated- hoping I dont have to wait days for a response

 

[phatass]

do you take opiates recreationally? are you addicted? are opiates worth more to you than your mental wellbeing?

(a half-life is the time it takes to get half of "x" product out of your system... i think)

 

[thelung]

I don't think that SSRI anti-depressants have any effect on opiates. You can get high on opiates and still take citalopram or lexapro or whatever without any problems. I don't see what the issue is

 

[starfarer]

Deleted - Accuracy concerns

 

[Sean McDevitt]

so if your taking an ssri. i could take oxycotin and not have a problem?

 

[monstanoodle]

Not all SSRIs inhibit CYP2D6. I do know that Citalopram does though.
So, if you are taking Opiates that must be metabolized by said enzyme then it's best to either:

A. Get on another effective Antidep that doesn't inhibit said enzyme
or
B. Use a different Opiate
or
C. Don't take Opiates.

 

[starfarer]

I am almost certain that all SSRI's inhibit CYP2D6 - could you provide evidence of some that dont?

 

[monstanoodle]

Fluoxetine is metabolized by it but doesn't inhibit it.
Sertraline doesn't.

A great deal of them are metabolized solely or atleast partially by CYP2D6 but that doesn't automatically make them inhibitors of that enzyme

 

[starfarer]

Right you are but they inhibit the levels of CYP2D6 in the body. I'l concede that lower would be a little better. Its all about degree really. All SSRI's (correct me if im wrong) will lower (therefore inhibit) the levels of CYP26 in the blood.

 

[flacky]

Not all SSRIs inhibit CYP2D6. I do know that Citalopram does though.
So, if you are taking Opiates that must be metabolized by said enzyme then it's best to either:

A. Get on another effective Antidep that doesn't inhibit said enzyme
or
B. Use a different Opiate
or
C. Don't take Opiates.

or
D. Take a small fraction of a regular dose and work up very slowly to find a workable amount. 8)

 

[starfarer]

That's probably the most sensible idea, but at the optimum level (where cyp2d6 competition is equal) there will still be a reduction in the efficacy of both. They use the same pathway so they are constantly in competition, unless I were to drastically raise the levels of CYP2D6 ...