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Opioids Drug interaction (clonazepam, sertraline, dihydrocodeine)

C

chetmanley

Greenlighter
Joined
Sep 24, 2013
Messages
23
Hey guys!

I've been on sertraline (Zoloft) and clonazepam (Rivotril) about 5 months now. I'm taking 100mg of sertraline per day and 2mg of clonazepam. I've been on and off from SSRI's and benzodiazepines about 4 years now.
I got prescribed recentley dihydrocodeine 60mg and 60 pills, they have extended release.

So, today I popped 4 of them, I was hoping for an euphoric effect, but instead of that, I got a bit anxious. I intentionally missed my sertraline doseage today and took 2mg of clonazepam 8 hours before trying DHC. I have also tried codeine before, around 500mg, experienced euphoria only for a few times.

My question is, is it due to Zoloft that I don't feel the cloud nine feeling? Or clonazepam plays some roll? And what's the safe amount of dihydrocodeine to take in milligrams (male, around 75kg)?

Thanks!
 
Its likely because their extended release because even a seasoned opiate addict should feel 240mg of dihydrocodeine.
Search for a thread on how to beat the time release (theres loads) and 180mg should be more then enough.
So far as I know, ssri's dont really affect opiates so dont think skipping that makes a bit of difference.
I will warn you to aviod the clonazepam if your taking the dihydrocodeine though, opiates and benzos are a nasty mix and kill plenty of people, even experienced users.
 
bunge said:
Its likely because their extended release because even a seasoned opiate addict should feel 240mg of dihydrocodeine.
Search for a thread on how to beat the time release (theres loads) and 180mg should be more then enough.
So far as I know, ssri's dont really affect opiates so dont think skipping that makes a bit of difference.
I will warn you to aviod the clonazepam if your taking the dihydrocodeine though, opiates and benzos are a nasty mix and kill plenty of people, even experienced users.
Click to expand...

Thanks for the answer!

How much time should be between clonazepam and dihydrocodeine intake? And also, when it's safe to take clonazepam after dihydrocodeine?
 
Last edited:
Um SSRI's definitely do affect opiates. They don't affect heroin but they inhibit a certain enzyme that breaks down codeine into morphine. Sorry to bring the bad news but you will not be able to feel euphoric off hydrocodone and codeine etc while taking zoloft. I've had personal experience and even taking LARGE doses wasn't really doing anything. I think its cyp 2d6 that is inhibited, i may be wrong but you need that to break down codeine into morphine. This is one thing i hate about SSRI's, they ruin the highs of certain drugs.
 
Probably skipping a few days won't help either? Need to stop taking it for a weeks? In that case will save for better times. :)
 
As a harm reduction forum - I must point out that both the codeine and the clonazepam are both respiratory depressants, so be careful with mixing the two. they will have synergistic effects and may lead to complications if you raise the dosages too high. how high is too high depends on the individual.
 
F1n1shed said:
Um SSRI's definitely do affect opiates. They don't affect heroin but they inhibit a certain enzyme that breaks down codeine into morphine. Sorry to bring the bad news but you will not be able to feel euphoric off hydrocodone and codeine etc while taking zoloft. I've had personal experience and even taking LARGE doses wasn't really doing anything. I think its cyp 2d6 that is inhibited, i may be wrong but you need that to break down codeine into morphine. This is one thing i hate about SSRI's, they ruin the highs of certain drugs.
Click to expand...

While it's true that a lot of drugs (including many SSRIs) are metabolised by Cytochrome P450 enzymes, there are few that inhibit their production to the degree necessary to have any biological effect on the metabolism of other substrates. And codeine's metabolites aren't present in blood plasma in high enough quantities to have any significant effect on the experience. Codeine itself (and dihydrocodeine in this case) is what's primarily active, not its metabolites.
 
F1n1shed said:
Um SSRI's definitely do affect opiates. They don't affect heroin but they inhibit a certain enzyme that breaks down codeine into morphine. Sorry to bring the bad news but you will not be able to feel euphoric off hydrocodone and codeine etc while taking zoloft. I've had personal experience and even taking LARGE doses wasn't really doing anything. I think its cyp 2d6 that is inhibited, i may be wrong but you need that to break down codeine into morphine. This is one thing i hate about SSRI's, they ruin the highs of certain drugs.
Click to expand...
Dihydrocodeine isnt broken down into morphine like codeine so inhibition of the enzymes isnt a problem with this.
Dihydrocodeine is broken down into dihydromorphine and dihydromorphone but in such small amounts that it has little to none therapeutic effect.
All of DHC therapeutic effect comes directly from itself as it binds to receptors unchanged.
I have practical experience of this in that my mother in law is prescribed both dihydrocodeine and ssris (also codeine) so I think you maybe getting a little muddled up there.

@OP, the duration of action for dihydrocodeine is 6 hours so I would leave at least that long before dosing with clonazepam.
 
I really don't want to mix them, I just wonder if it's okay to take my daily dosage of Clonazepam 8 hours before I take DHC or after 8 hours of DHC intake. My clonazepam tolerance is really really high, I have popped around 100 (2mg) pills at once with alcohol, had good night sleep, that's all. Any benzos don't give me any feeling of being high, I take them just for anxiety.
 
Lmao you popped 200mg of clonazepam along with alcohol and just had a good nights sleep? Hmm sounds odd, but in that case i would not worry about mixing codeine and clonazepam , you are fine :)
 
F1n1shed said:
Lmao you popped 200mg of clonazepam along with alcohol and just had a good nights sleep? Hmm sounds odd, but in that case i would not worry about mixing codeine and clonazepam , you are fine :)
Click to expand...

Yes, I have done it once more 90x2mg clonazepam + 30x7.5mg midazolam with alcohol. Again just a good night sleep. One time I was not so lucky though, had around 60x6mg bromazepam + 20-30 pills of carbazepine and alcohol. I slept for 24 hours, after that I woke up, I tried to stand up, but my legs didn't carry me, it lasted for a couple of days.

I do not recommend anyone to do such experiments, was really depressed, will not repeat it.
 
I still don't understand how you didn't go into coma?
Were you taking 2mg a day before that or high doses every day, those are extreme doses and deadly doses.
 
Usually 2 or 4mg per day and not for so long time. I guess I have really good liver, healthy heart (used to do sports on daily basis) and fast digestive system. Also, it seems that it's quite hard to kill yourself with benzos.
But yeah, I've seen people taking 2mg of clonazepam and they have been really knocked out. Really makes me wonder how it didn't affect me.
 
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