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Opioids STARTING SSRI WHILE ON OPIOIDS TREATMENT

C

CobakuSamsara

Bluelighter
Joined
Mar 1, 2019
Messages
64
Hello my friends, I'm here to ask you something that happened to me and it's a bit weird. I've been taking large doses of opioids for months, mostly oxycodone and morphine. Well, I'm bipolar and it's been 3 years or so since I stopped using antidepressants. Lately, I had some hard depressive feelings and decided start taking paroxetine. Strangely, it's been 12 hours since my first dosage in years and I'm feeling super manic! I thought it was going to take a lot of time to feel some "good" effect, mania is a lifeguard for me right now and I don't understand how it's possible, since I don't have knowledge of opioids acting in serotonin. I don't have any explanation for this, I don't take anything but opiods, I don't even drink alcohol or smoke cigarettes. Placebo is not a thing in here since I was expecting all the time to get more anxious and have a really hard time, till it starts to kick in. Does anybody know anything that can explain this? I appreciate your help. PS: Not taking opiods on a daily basis now.
 
It maybe an anomaly, or what is know as the the AD jump lead effect, as most Reuptake inhibitors work immediately on a molecular level, at general onset of action within an hour let’s say, as a compound it gets straight to it. However The build up of your cerebral network blocking 5ht on a therapeutic scale is still subject to the usual 2-6 weeks or so!!
 
I'm moving this to other drugs. I think you will get a better response there.
 
I'm very sure opiates and SSRIs have no effect on eachother. I started taking Sertraline/Zoloft before I started using opioids and everything's always been fine.
 
Jekyl Anhydride said:
Codeine analgesia is due to codeine-6-glucuronide, not morphine.
The PhaseII metabolism into Codeine-6-Glucuronide wouldn't make it useless, although possibly take away some of it's magic. (using the word magic for codeine is a stretch)
C-6-G (50-70 %) is considered to do as much if not more than Demethylated Morphine(5-15%) alone, though losing either on something as weak as codeine is going to be problematic.

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Fluoxetine and paroxetine are potent CYP2D6 inhibitors, whereas fluoxetine's main metabolite, norfluoxetine, has a moderate inhibitory effect on CYP3A4. Fluoxetine deserves special attention as inhibitory effects on CYP-activity can persist for several weeks after fluoxetine discontinuation because of the long half-life of fluoxetine and its metabolite norfluoxetine.

Losing 2D6 would render Tramadol nearly useless without it's M1 metabolite, O-Desmethyltramadol, which is a metabolite that is FAR stronger than (+)-/(-)- Tramadol.

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I was not aware of the novel nature of Fluoxetine metabolites so thank you. :)
 
The cumalitive affect of some compounds which work on 5ht in the background, are often overlooked. However unless I am wrong, the only designed opiated with SRI SRE effects attached on purpose, is Tramadol.
 
I've been thinking if I may need some antidepressant.... Been smoking weed, but could not smoke it anymore, because stupid medical crew is on my back (sort of big monkey:eek:).
 
Well oh yeah, I'm on methadone maintenance, and feeling relatively depressed, because I COULD NOT SMOKE WEED..
 
Canis aureus said:
I've been thinking if I may need some antidepressant.... Been smoking weed, but could not smoke it anymore, because stupid medical crew is on my back (sort of big monkey:eek:).
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Not following the relevance pal?

Jekyll We should be giving codeine a knighthood, without it there would be no poppy as we know it!!
 
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