Opioids Safety with hydrocodone and sertraline, and codeine-sertraline interactions

[isaaccain]

My psychiatrist has prescribed me 50mg sertraline (zoloft). I was happy about taking them until I found out that it completely dulls the effects of codeine, which I'm quite fond of. I figured it would be better to try something like oxycodone or hydrocodone, but I researched zoloft and oxycodone interactions and found out it can cause serotonin syndrome. I couldn't find anything about hydrocodone though, so I was wondering if anyone here knows if taking recreational doses of hydrocodone will anything particularly harmful with my daily 50mg of zoloft.
If it would be a bad idea to take them together, could you suggest another drug that would be fine to use with sertraline? Preferably an opiate, since that's what I've become accustomed to.

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Also, I heard the reason most antihistamines potentiate the effects of codeine (like promethazine, found in lean) is because they block the enzyme that metabolises codeine into morphine, meaning more of the codeine can be converted into codeine-6-glucuronide, the major active ingredient in codeine, so is it just a misconception that zoloft dulls the effects of codeine, since it's actually the C6G getting you high?

Thanks

 

[Keif' Richards]

Hey there isaaccain and let me give you a belated welcome to Bluelight!

First off, if the Sertraline (Zoloft) is to have any effect at all on Codeine, according to all the available literature, it is very mild. It is so mild, that there is generally no need to make any alterations to either medication when both are taken in conjunction. The effects can be dulled somewhat, but will the effects be dulled to the point that it's even noticeable? The answer seems to be no. I wouldn't worry about it. If it's a huge problem, bump your dose up by 10%.

As far as your concerns about the potential for Serotonin Syndrome from these drugs, you really shouldn't have anything to worry about. Although Opioids do effect Serotonin to a certain extent, sure, they don't effect it to an extreme degree like say, MDMA would. Now, there are certain Opioids which are the exception to this rule; Pethidine/Meperidine (Demerol), Tramadol (Ultram; Ultracet), Dextromethadone and Tapentadol (Nucynta) to name a few, can all cause adverse reactions through increased Serotonin.

Your question about antihistamines; Yes, there are certain antihistamines like Hydroxyzine (Vistaril) for example, that potentiate Opioids through enzyme activity, but this activity is generally pretty mild. The truth is that it's probably the straight-up sedative action of these antihistamines that we go for with our Opioids. I've always assumed it's a kind of Pavlovian response, in that we take our Opioids with sedating antihistamines and the sedative action of the antihistamine in conjunction with the Opioid, tricks us into thinking we are actually higher on said Opioids than we actually are... if that makes any sense.

Case in point, the effect that you're Sertaline will have on most Opioids should be practically inperceptible.

 

[isaaccain]

Thanks, man, that's some top shelf info