Opiate question reguarding use of ssri

[shpongle1987]

I have found out that setraline (zoloft) acts as an inhibitor of the same enzyme that breaks down opiates. So I was wondering if I could bypass the inhibitory effect by taking the opiates before i take my 50mg setraline dose, would this work? Also, if indeed that would work....could i take my dose of setraline once I feel the effects of the opiates have kicked in without the setraline effecting the opiate buzz or will the effects diminish as soon as i dose the setraline? I figure it wouldnt diminish the effects if my liver has already processed the opiates but im not quite sure. Thanks for any responses!

 

[effie]

Inhibiting the metabolism of opioids will extend the effects of the drug if the opioid is active in itself and is not a prodrug (a drug which needs to be metabolised to take effect). This could be good, if you want to potentiate the opioid, or bad, if you are concerned about overdosing. For a prodrug like codeine you need it to be metabolised into active metabolites, so inhibiting the metabolism could reduce it's effects.

Sertraline inhibits CYP-2D6, which metabolises many opioids including morphine, methadone, fentanyl, codeine, hydrocodone, oxycodone and tramadol. It also inhibits CYP-34A which metabolises a lot of benzos.

What opioid are you thinking about?

Do you take sertraline daily? It has a long half life (24 hours ish) so even if you delay taking your pill there will still be some in your system if you took one the day before - even more if you have been taking it regularly for a while. Even if you had not taken any for ages, delaying and taking it after the opioids may well still have an effect, as the opioids are still being metabolised by the liver at that point.

 

[shpongle1987]

Ive been taking it daily for the past 5 months, and the opiate in question is tylenol 3's....so codeine. And im not worried about overdoseing at all...pretty much the opposite haha. I was under the impression that if setraline inhibits the same enzyme as codeine then it would have a decreased effect but it looks like i mite have been wrong....meh i think im just going to take em and see what happens its 150mg of codeine all together, and i pretty much have no opiate tolerance so I think il be fine..

 

[Pjkt2501]

150mg of codeine isn't too large of an amount. I would consider an antihistamine, however.

 

[RoboRobot]

dude, if I were you I WOULDNT inhibit it if you're using codeine, as you WANT the codeine to metabolized to morphine, and the inhibitor would stop that action to a certain extent.