Is it Safe To Mix Dihydrocodeine + Amitriptyline or Mirtazapine?

[pally pete]

Just wanted to know if either Amitriptyline or Mirtazapine are safe/good to ouse with Dihydrocodeine?

I want to keep my dose of DHC to around 600mg (As il usually puke) and feel all the unwanted side-effects yet none of the wanted saide-effects.

The other day i took 600mg DHC and felt quite nice but then doubled the dose and foolishly added Xanax, Gabapentin and Tramadol do the mix, needless to say the next day i was ruff as a dog and puked up etc

I realise Mirtazapine + Amitriptyline are both sedating Anti-Depressants so i assume they will help with the nod (sedation) but are they safe and at what doses?

I usually use Benzos for this purpose and i have Benzos to hand (Xanax) If i need it, but due to my massive Benzo tolerance im trying to keep away if i can help it.

Any imput appreciated, thanks.

 

[effie]

Hi Pete

Although sedating, AFAIK combining either mirtazepine or amitriptyline with an opioid doesn't carry quite the same risks of CNS depression as say a benzo would - in the same way that taking a sedating antihistamine such as promethazine wouldn't - in fact mirtazepine has significant antihistamine action which is responsible for it's sedative/hypnotic properties.

Mirtazepine is actually probably more sedating at lower doses, looking at trials, because at lower doses it has strong antihistamine action but little alpha-adrenergic action (which is stimulating) - at higher doses the latter increases and counteracts the sedation - so I would take a low dose (15mg is the usual starting dosage).

Amitriptyline IME is sedating at low doses too, 10mg can knock me out if I've not had it in a while. YMMV however, but as with anything, start with a low dose.

Remember that antidepressants have other effects apart from sedation and be careful casually using them for something like this.. are you taking any other regular medications at the mo other than benzos?

 

[pally pete]

Hi Pete

Although sedating, AFAIK combining either mirtazepine or amitriptyline with an opioid doesn't carry quite the same risks of CNS depression as say a benzo would - in the same way that taking a sedating antihistamine such as promethazine wouldn't - in fact mirtazepine has significant antihistamine action which is responsible for it's sedative/hypnotic properties.

Mirtazepine is actually probably more sedating at lower doses, looking at trials, because at lower doses it has strong antihistamine action but little alpha-adrenergic action (which is stimulating) - at higher doses the latter increases and counteracts the sedation - so I would take a low dose (15mg is the usual starting dosage).

Amitriptyline IME is sedating at low doses too, 10mg can knock me out if I've not had it in a while. YMMV however, but as with anything, start with a low dose.

Remember that antidepressants have other effects apart from sedation and be careful casually using them for something like this.. are you taking any other regular medications at the mo other than benzos?

Im not on any other prscriptions meds right now.

The 1200mg DHC taken in 2 seperated doses over an hour apart, and ive also use 50mg Diphenhydramine, 40mg Promethazine and 10mg cetirize Before/During that opoid use, to help with the icheas and to keep Nausea to a minimum. (I do not find any of the frist generation Ah's sedating (Maybe im under-precribing msyself...hhhmm " me under= prescribing myself...i doubt it!
================
I dont feel too bad but i know i can get more out of what i want and from what i have at my disposal, id would just like make it a possibly most enoyable time i can! (and safe)

Im temted to take Gabapentin right now? How much 300mg? 1200mg? I always knowi can titrate unpwards. But i also read Gapentin can take some of the good effects of Dihydrocodeine away, yet on the flip side i have also take xxmg Xanax, which i know Gabapentic Potentiates.

What doseage of Gabapentin would you reccomend?

i have some 15mg Mirtazapine, but as you mention there Anticholinergic effects im saying towards the Amitryptyline of which i have in 10mg tabs.
What doses do you recommend my friend?

Thanks for the quick reply, if you could reply in the same lightling speed, then Gold Star it is for you Miss/Mrs/Ms effie.

Thanks a lot, not just for this but for everything, and also you being an A* Moderator.

Btw please correct me if im wrong or was tripping (Lot littereabjrat the time but did i catch glimpse of a thread saying something about pjkt2501 no longer being a Moderator..

Such a shame as he seemed a TOP Guy/gal and a great Moderator (IMO/IME)

Anyway thanks again in advance.

I think il send Pjkt2501 a PM right now to expess my sincere gratefullness to him/her.

 

[pally pete]

Anymore imput anyone please.

Over the past 12 hours ive consumes 1200mg Gabapentin (just after midnight around 20 hours ago) since then ive just had 40mg Promethazine which was taken over 12 hours ago, and ive had another 200mg Tramadol split up into 2 seperate 100mg doses, the last 100mg Tramadol dose being 8 hours ago.

Not sure whether to go for the 200mg Tramadol dose or 1 x 100mg Tramadol dose followed by another 100mg Tramadol dose an hour or 2 after that.

Or maybe take some more Gabapentin? with Tramadol or take more benzos? I know the Gabapentin Potentiatyes the Benzos but im not sure how it works with Tramadol or Mirtazapine or Amitriptyline?

Time now : 19:35pm - Just orally consumed 100mg Tramadol, nowi shall wait 30-60 minutes and then reasess how i feel.

I think i will leave the Dihydrocodeine for now as my olerance to it has skyrocketed! 1200mg on the past couple of consecutive days and it was doing nothing for me! I was barely even gettng a histamine release, which is something i dont get from Tramadol.

I know it's the weakest of the lot and not even really a proper Opoid yet i get no itches hardly at all.