Possible interaction between amitriptyline and demerol

[paranoid android]

Hi im new here so if this is the wrong form im sorry.

Ive been taking 100 milligrams amitriptyline at night for nerve pain for awile now. I also have neck and back pain so sometimes i need to take a narcotic painkiller. I usually take either codeine or oxycodone for the pain and ive had absolutly no problems with drug interactions.

The past few days i came into possesion of some demerol. I havent had this drug in quite some time so i was eager to try it out. When i first took it years ago i got the best euphoria ive ever gotten off a opiate. I loved the stuff.

Yesterday i decided to try it out. I hadent taken any painkillers whatsoever in the 4 or 5 days prior to this. I took 2 50 mg pills and instead of getting the usual nice warm opiate feel i started to feel very nervous and irritable. About an hour after ingesting the pills i started feelling very weird and angry for no reason.

My question is this. Since demerol is somewhat of a atypical opioid could it have interacted badly with the amitriptyline? What would be the specific reason this drug interacted badly with it? None of the other opiates ive had have given me this reaction. I couldnt find anything specific about the interaction between tricyclics and demerol besides the usual such as increased sedation. thanks in advance.

 

[BilZ0r]

Yeah, I'd be cautious in mixing tricyclics (at least the serotoninergic ones, like amitrip) and miperadine, because of the serotonin syndrome like effects.

 

[AlexxRed]

might I add that I understand that for nerve pain low doses of amitriptyline are used. Around the 20mg - 50mg range.

If 100mg is working for you, then all good, although I would have thought at 100mg you would be getting some of the more un pleasant side effects.

I have a relative who also suffers chronic back pain, having had (unfortunately) more back surgery than you can imagine. They can't even give him an MRI cause of all the metal.

He has primarily been treated with Morphine over the last 4 years but lately has had some good results from GabaPentin.

 

[fastandbulbous]

Also, they both have anticholinergic activity; combining the two might just be enough to push you into the realms of the beginning of anticholinergic hallucinations (and they're frightening and rather unpleasant to say the least)

 

[paranoid android]

I take 100 milligrams of amitriptyline with almost no side effects. The only thing it does is put me to sleep, and since i take it at bedtime this is a good thing. I only get a little bit of dry mouth during the day time thats it.

I wasent to worried about the anticholinergic action of the meperidine as i have taken other anticholinergic drugs such as diphenhydramine, and i have not experienced any of the usual symptoms of anticholinergic toxicity such as the hellish delerium.

Now that i think of it the serotonin syndrome thing kinda fits. Looking back on it what i experienced was probley hypomania. I was very aggitated and irritable the rest of the night after taking the demerol and i didnt end up sleeping untill about 10 o'clock in the morning. I just didnt realize that a lousy 100 milligrams of demerol would have such a a strong effect. Oh well stupid me. I feel really lucky that all i took was 100 milligrams.

Anyway thanks alot for all your help. Ive been a long time lurker but this is the first time ive made a post. I figured if anyone would know what the hell happened to me it would be someone on here.

 

[raybeez]

I take amitriptyline (albiet a much lower dose; 10-20mg/day), but have never had any symptoms characteristic of 5HT-syndrome when combining it with serotonergic drugs (phenethylamines, amphetamines, tryptamines, and triptans) or with a number of natural/synthetic opiates (although demerol was never tried).

I have experienced wierdness/iritability/dysphoria with heavy doses of (pure) codeine before, but had attributed it to low level OD/toxicity due to the high dose (400mg-ish). Is it possible that you just overshot your usual opiate dose?

 

[paranoid android]

I take amitriptyline (albiet a much lower dose; 10-20mg/day), but have never had any symptoms characteristic of 5HT-syndrome when combining it with serotonergic drugs (phenethylamines, amphetamines, tryptamines, and triptans) or with a number of natural/synthetic opiates (although demerol was never tried).

I have experienced wierdness/iritability/dysphoria with heavy doses of (pure) codeine before, but had attributed it to low level OD/toxicity due to the high dose (400mg-ish). Is it possible that you just overshot your usual opiate dose?

No it didnt feel like an opiate buzz at all so i dont think it was because i took too much demerol. I felt very strange and angry and i stayed up all night pacing the floors even though the demerol should have worn off completly in 3 to 4 hours.

I have taken 300 milligrams of codeine with no bad effects at all while ive been on amitriptyline.

 

[Morninggloryseed]

I was on amitriptyline a decade ago, and definitely experimented with demerol during that time. There were no specific side-effects for me.