Do my medications effect opiate highs??

[Mentalhead]

I take the following medications daily for bipolar disorder and ADHD:

Depakote (valproic acid) 1500mg
Invega (Paliperidone) 6mg
Strattera 50mg
Celexa (citalopram) 20mg

I have recently been experimenting with oxycodone, and it effects me surprisingly lightly. With no tolerance, I have recently taken 5 doses over a few days ranging from 20mg oral to 45mg oral + 30mg intranasal, and the high has always been very light. I weigh around 200lbs, and I know that tolerance builds quickly to OC, but still it seems that 75mg should get a relatively inexperienced user pretty high. Even when I do get a buzz, it's mostly just a body buzz and isn't very euphoric. Also, I feel the effects far more significantly when I take it intranasally than when I take it orally.

I'm not sure of the exact mechanisms of all of my meds, but I know that Invega inhibits seratonin and dopamine actions (not sure whether it's the neuron releasing the transmitter or the receptor which is inhibited), and I believe Depakote has similar effects. Additionally, I've read that risperidone, which is similar to paliperidone (Invega) chemically, can nullify the effects of tryptamines, because it acts on the 5ht2 receptor.

Does anyone know if any of my medications are making it difficult for me to feel recreational effects of oxycodone? Or is this just normal tolerance building?

 

[MattPsy]

paliperidone is a dopamine antagonist, which will reduce your ability to get pleasure from the reinforcing dopaminergic effects of drugs.
i'm not sure nor have time to look up whether any of these drugs are inhibitors of the enzyme cyp2d6, but if they are, this will prevent oxycodone from working properly, as it is metabolised to oxymorphone (a much stronger opioid, just as codeine is metabolised to morphine) via cyp2d6. peace.

 

[PLUR2000]

paliperidone is a dopamine antagonist, which will reduce your ability to get pleasure from the reinforcing dopaminergic effects of drugs.
i'm not sure nor have time to look up whether any of these drugs are inhibitors of the enzyme cyp2d6, but if they are, this will prevent oxycodone from working properly, as it is metabolised to oxymorphone (a much stronger opioid, just as codeine is metabolised to morphine) via cyp2d6. peace.

True, True.. IMO the S/NRI Depacote together makes any high a bit lower... mood stabilizers are potent and finiky...

 

[SynAmnesia]

Does anyone else think that giving celexa, an SSRI, to a person with bipolar is a bad idea? What was the reason of throwing Celexa into the mix. Honestly, this seems like an awful combination of drugs that are all likely to cause rather bad side effects and conflicting reactions. Bipolar depression isn't usually mediated by serotonin, so what is up with the SSRI? If it works, go with it--I am just questioning your psychiatrist's motivations in prescribing this regiment.

If you really want to figure this stuff out, look up the drug name and go to rxlist.com. rxlist lists the PDR entries for each drug on the market. In the pharmicokinetics and drug reactions page it should list what CYP enzymes that these drugs interfere with. It should also indicate whether or not they increase serum concentrations of opiates. Some drugs just interfere with opiate absorption. In addition, certain drugs potentiate certain types of opiates while interfering with the action of other opiates.

Are you taking any acid reducers like pepcid? (Any of the ones that interact with histamine to reduce levels of stomach acids.) Those drugs are common inhibitors of CYP enzymes. However, I think those inhibit Cytochrome P450. If any of those drugs are inhibitors of CYP 2D6 they might be useful as a stop smoking aid. They have found that those people who are slow metabolizers of nicotine are deficient in CYP 2D6 and those that have an easier time quitting and tend to quit most successfully are slow metabolizers.

 

[DBirk]

At least, it's not leathally dangerous to iv opiates on invega & depakin! My detox doctor said, that such practice could kill me, letting me out after a month in there. "It will keep you from cravings, boy!" Can't say I believed him.

 

[JamtasticX]

SynAmnesia: Your right its Cy P40 CYP3A4

To Op: I don't think there's any inherant contradictions, might not feel the opiates so much. I'd be careful is those have a sedating effect for you, as opiates will cause cps depression