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Oxycodone/Oxycontin and SSRI's, leads to sratonin syndrome?

Diacetylus

Diacetylus

Bluelighter
Joined
Nov 17, 2005
Messages
1,500
Hi there,
first of all, I decided to put this thread in Advanced Drug Discussion, because I was hoping to get an educated response (hopefully bilz0r is floating around at this time :) )
I vaguely remember reading somewhere that there was possible risk of getting "seratonin syndrome" from using Oxycodone in conjunction with SSRI (in this case, Citalopram) treatment. I am hoping that maybe either that was a really freak occurence and rarely happens, or it was somehow a typo/misprint. Or, maybe the poster that did post this information was misinformed.

I will hopefully be trying Oxycodone the first time in the near future, but if someone can please provide me with anecdotal and other evidence, that it does lead to "seratonin syndrome", it will sway my decision and possibly save me having to have such a horrible experience.

Any help would be appreciated, and if this is the wrong forum, please feel free to move it and aplogies in advance.
 
Opioids and SSRIs can lead to serotonin syndrome, it's pretty rare, and the most common one is meperidine, (as reviewed here) but you can get it with oxycodone to (2].

But it's something to think about if you start getting badly confused, if you're mixing the two.
 
Jesus, it's really nice I wasn't even warned of these fucking dangers. My doctor, nor did my psychiatrist warn me of mixing opioids. I bought a 24 pack of Nurofen Plus the other day and the pharmacist didn't even warn me (I told her I was on Citalopram)
I swear to God, if I had've known this, I would have never, ever been put on SSRI's.
This shit really stinks.
 
Codeine and SSRIs probably isn't that dangerous. Don't blame your doctor, no one has probably ever told him. There's a lot of things to know, being a doctor.

Do blame your pharmacist, or more, the governments of the world for allowing pharmcists to become little more than pill counters (if their computer doesn't tell them there is an interaction, they don't care).
 
This probablly is not what you were looking for but, uou could stay off you're SSRI's for 2 weeks or so and then use.
 
I doubt it, I've used High doses of codeine, oxycontin, and dihydrocodeine while being on Escitalopram and nothing 'bad' ever happened. There is no interaction here, the danger is if you combine with an MAOI. SSRI's + Opiates are usually completely safe. The only side effect I can think of combining the two is more sedation, but not serotonin syndrome. Opiates or Opiods don't effect the serotonegetic system.
 
I've also used OxyContin while being on Paxil and have beem fine, although I did have some mild anxiety from the oxycontin, but I am assuming it was because I was nervous because it was my first time trying Oxy. But Codeine and SSRI's have never been a problem with me.
 
I had minor surgery very recently and received IV pethadine/meperidine (Demerol) post-op along with about 2 oral doses of opioid tablets (dihydrocodeine) before I tried to go to sleep that night. I am currently on 40mg citalopram and have been for a good few months, previously taking 20mg per day.

Then the fun started. I experienced acute sleep myoclonus (those spasms/jerks you get sometimes just before falling asleep). One or two would be fine but I was getting them so often and not necessarily just at the moment of falling alseep but slightly before. I did not sleep one minute. They were so sever that I had to put my arms under my pillow or my sides as a few times I slammed them into the area where I had been operated on! It went on for about 5 nights. Having read that myoclonus is a symptom of serotonin syndrome and that it can be brought about by mixing SSRIs and opioids I stopped taking the take home dihydrocodeine which I had been prescribed. Thank god the spasms have stopped. As an aside, I had a strong histamine reaction with some rashes arising and spent all of the first night itching mildly.

So, you are not alone, although the doctors knew I was on citalopram there was no word of any side effect or contra indications.

By the way, although the idea of codeine etc. interests me, when I do take it. I feel irritable. Also, after the IV pethidine the pain lifted almost instantly and although i felt high i was also anxious and slightly depressed.
 
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I'm currently taking Citalopram (Celexa) 40mg daily. I found someone with 50mg Demerols which contains Meperidine. Could this possibly be deadly? Does anyone know the statistics or any specifics on how SSRI and opiates don't go well together? Specifically Demerol.
 
I think its only an issue with tramadol

I remember this bluelighter (robofrance?) dieing not so long ago from a normal dose of tramadol after he was put on an ssri.

however watch out ssri's can greatly potentiate the effefts of opiods

I remember giving this friend like 200 mg with some grapefruit juice , he ruined my high by being so goddamn happy ,nodding out and breathing shallow as if he was on heroin

id like some input on which ssri's are the worst or best in potentiating opiates (and not the seretonin syndrome or is this linked?)
 
This surprises me since oxycodone is not even thought to interact with the 5HT system.
 
Just like to add a little something
I was taking 7.5mg of hydrocodone twice a day during the winter months up until this event.
I was going to go to see the new Willy Wonka movie at the theatre (bored? Yes) so I took 7.5mg hydrocodone like usual at this time of day. I was fine through the whole movie but on the way home I experienced confusion, anxiety, shortness of breath, and panic. I was freaking out basicly. I realise that the only interaction would have been my Paxil I was on. To this day i have no idea what it really was but if its possible to get Seratonin syndrome from opioids and SSRIs... well... that was probably what this was

Oh uhm... codeine effects are not affected by zoloft but most if not all other SSRIs reduce effects with Prozac causing the most reduced effect
 
For about the 25th time I've had to say this on this forum. Opiates + SSRI's is completely safe. There is no interaction. I've called numerous pharmacists, looked it up on drugs.com for drug interaction checker, and I've experienced this myself. The anxiety you get from opiates is normal if you are already pre-proned to anxiety. Tramadol is not an opiate, and that WILL cause an interaction with an SSRI. With an MAOI, I'm not sure about that. But I'm sick of people saying there are interactions with SSRI's and opiates, thats utter bullshit.

Some people need to get some facts straight before posting here.]

I've used OxyContin while on Paxil, and while on Lexapro. No interaction whatsoever. Same goes for codeine.

Tramadol, yes, there is going to be an interaction there because tramadol hits the the 5HT receptor as well, and tramadol is NOT an opiate or opioid.
 
ttocs said:
But I'm sick of people saying there are interactions with SSRI's and opiates, thats utter bullshit.

Some people need to get some facts straight before posting here.
Click to expand...

Ok then D.r. bullshit! care to explain these studies then:


http://www.ncbi.nlm.nih.gov/entrez/..._uids=16051647&query_hl=2&itool=pubmed_docsum

http://www.ncbi.nlm.nih.gov/entrez/..._uids=16368927&query_hl=2&itool=pubmed_docsum
???

Just because you seem to have no adverse reactions with the combo of SSRI's and Opiates, does NOT mean it won't happen to another individual.

I would think bilz0r and the studies he linked to Pubmed would know slightly more about the possibilities, consdering how well bilz0r is versed with pharmacology and all.

...and just because something is a rare case, does not mean it should be completely dismissed and deemed not completely possible to happen.

In case you didn't know... this is actually a harm reduction board.
 
Oh but i can vouch for opium causing panic attacks... :( it happened to me last night when i read something about the world ending (it had scientific evidence of it happening May 26 but then i read NASA saying that the meteor actually broke into even more peices so its not going to put us in danger)
 
ttocs said:
For about the 25th time I've had to say this on this forum. Opiates + SSRI's is completely safe. There is no interaction. I've called numerous pharmacists, looked it up on drugs.com for drug interaction checker, and I've experienced this myself. The anxiety you get from opiates is normal if you are already pre-proned to anxiety. Tramadol is not an opiate, and that WILL cause an interaction with an SSRI. With an MAOI, I'm not sure about that. But I'm sick of people saying there are interactions with SSRI's and opiates, thats utter bullshit.

Some people need to get some facts straight before posting here.]

I've used OxyContin while on Paxil, and while on Lexapro. No interaction whatsoever. Same goes for codeine.

Tramadol, yes, there is going to be an interaction there because tramadol hits the the 5HT receptor as well, and tramadol is NOT an opiate or opioid.
Click to expand...

sry the 200 mg i gave to my friend was codeine

and he was extremely sedated , shallow breathing and all!

i think ssri's potentiate the sedative effects of downers but reduce the euphoric effects
 
Diacetylus is right, those are the two studies I knew off the top of my head. There is also this study, which shows the effect of two SSRIs inhibiting methadone metabolism.

Fluoxetine is a serious CYP2D6 inhibitor [2]. That study reports a 9x inhibition of CYP2D6 mediated DXM metabolism.
 
I have done percocets a couple times and a ton of hydros while on zoloft, no problems here.
 
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