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Harm Reduction ⫸DANGEROUS Drug Combos⫷

when reading a lot of general googled literature there are multiple sources claiming opiates with other opiates, and even opiates alone in higher doses can cause serotonin syndrome, yet so many say the mix is fine; the sole opiate SS cases seem almost anecdotal.

With the exception of Tramadol, for which the literature is clear in it acting as an SNRI, I was wondering if there was truth to this and which are the ones to specifically look out for if so. I have noticed fentanyl and methadone being mentioned. I would like to know (as I am sure other less educated users would also) regarding SS rather than the increased risk of a typical respiratory depressed opiate/opioid overdose which is clear.
 
A review in New England Journal o' Medicine, 2015 lists:

meperidine, fentanyl, tramadol, and pentazocine as "associated" with SS

Duragesic, Sublimaze, and ultram as associated with severe SS along with:

"And Tramadol, venlafaxine and mirtazapine."

Yes, I know those are brands and generics of the same drug mixed up, and it's not clear if it's combo or not (these are the opioids out of a list I can't copy/paste).

Problem is, what does "associated" mean? That's a pretty loose word in a Journal, for a syndrome with no test. Toxicology may stop when a patient has tramadol in his system, because it makes sense, and miss all the homemade 3-FEA he ate.

And I know a lot of cases are anecdotal, because there is no test for it. Doctors are told that there's "easy to miss" subclinical forms, and nothing to do about it, except to say, "stop taking this". So your flu goes away, and your awful case of SS becomes legend.
 
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There's plenty of peer-reviewed literature on the topic of tramadol inducing seizures and SS--even at therapeutic doses without co-administration of other drugs.

Usually seizures that occur at therapeutic doses are associated with patients that are seizure prone in some way (such as previous history of using benzos or alcohol).
 
Having surgery tomorrow and will be put to sleep and given iv pain medication, SWIM is on methamphetamine. Will the methamphetamine interact with the pain medicine and cause an increase in pain?? SWIM had a reaction before while on it and given morphine which caused pain to worsen and caused shoulders to tighten up. SWIM is dehydrated from disorder called achalasia where food and liquids are unable to pass down esophagus to the stomach. Would anesthesia and iv drip during the surgery flush most of the meth out so that this reaction won't happen again??
 
We don't allow "SWIM" on this site. It doesn't provide you any legal protection. Please edit your post

I think methamphetamine can affect the effectiveness of anesthesia. You probably shouldn't take any meth before surgery and consult with your doctor
 
I know someone who was high and had surgery. He was put under and he was fine. Didn't affect the anesthesia that was given.
 
It might be fine, but it's best to make sure your doctor is aware.

The anesthesia won't flush the meth from your system. It will be eliminated at more or less the same rate as if your weren't put under

And please edit SWIM out of your first post...
 
Tramadol and cocaine are a mixture that has killed before also, tramadol is junk but unfortunately easy to come by and many of our youth have found that out.. Mdma and methamphetamine took out a dear friend and it was directly due to not knowing the Mdma was mixed with his regular choice of substance and long story short is took the normal dose but the cocktail sent him into Serotonin syndrome and shortly after that was the end. These two substances go hand and hand in the party scene and are combined more often than not. There is a study done on rats with these two subst. being combined with humbling results showing their toxicity when used simultaneous (mix together as in one dose of both subst. At the same time)
 
I am prescribed psych meds: zyprexa, depakote, Prozac and neurontin. I?ve wanted to take my zyprexa and/or depakote after a Cocaine binge as I feel it might help me sleep (Prozac I know I should probably stay away from.) however I haven?t done this because I?m worried about serotonin syndrome. Are any of these a bad combo with cocaine or crack?
 
The Zyprexa/olanzapine probably blocks a lot of cocaine effects. The Depakote/valproate is a weird med whose MOA isn't really understood. The Prozac isn't gonna be a problem.

My concern is that you are prescribed this trio for major mental health issues, and certainly the Depakote and Neurontin shouldn't NOT be taken, as that'll lower your seizure threshold by a lot, along with the cocaine.

Bottom line is, this is not a safe combo, even leaving out some of the meds is dangerous. You just can't use cocaine or other stimulants while you're being treated, I'm sorry.
 
Hi, What about Effexor and SNRIs? I've been looking for this info for a while and can't get an answer. Thanks!

EDIT: I was actually replying to someone's question about SSRI's and meth? Or coke? Regarding serotonin syndrome. Is Effexor so much diff than Lexapro, Prozac? I've been reading a lot about serotonin syndrome today. I never really took it seriously before but looks like I should do my research.
 
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Effexor is an SNRI, and it's usually not a good idea to combine different SNRIs due to the risk of serotonin syndrom
 
replying to someone's question about SSRI's and meth? Or coke? Regarding serotonin syndrome. Is Effexor so much diff than Lexapro, Prozac? I've been reading a lot about serotonin syndrome today. I never really took it seriously before but looks like I should do my research.

Effexor/venlafaxine is kind of a messy drug compared to the SSRIs like Prozac, Lexapro, Zoloft. It's related to tramadol, and it has a lot of other side targets in your brain. Tramadol has that annoying seizure risk that still isn't really figured out. So there's a possibility that Effexor might have a seizure risk too. There's just a lot of unknowns with it.

And there's a lot of unknowns with serotonin syndrome. The official word is that stimulants in general, combined with an SSRI or SNRI, have a risk of serotonin syndrome. Well, there are case reports of specific drugs interacting, but then they generalize to the entire class of drug. Just how over-cautious are they (drug manufacturers & FDA) being about it? No way to know.

But given all the folks running around with their brains pickled in Prozac, who casually take drugs, if the reaction was common, we'd know about it. So it's at least safe to assume it's a rare event. So all you can do is know the risks, and weigh them for yourself.

If you want a single case report first hand, I mixed Zoloft and way too much meth for several months, and never noticed a difference one way or the other. But, that's just me.
 
SSRI's like Prozac mixed with tramadol can induce a serotin-like syndrome. I have seen this happen to two people who seizured as a result.

Alcohol is my real problem. I can drink a bottle of liquor, however this impairs my judgement and I will sometimes take Ambien or alprazolam and this has resulted in falls that have broken bones and/or required sutures maybe 4 times in the last year. Most recently 10 days ago after a bottle of Wild Turkey or before not sure mixed Xanax and butorphanol. I blacked out for a few hours but know I fell into the coffee table and broke the lamp ( and two ribs). So yeah, I'm feeling wonderful now. You don't want to break ribs as you have to breathe and move.
 
Never EVER try to use propanalol while doing coke or another stim. It doesnt relieve the negative effects of stimulants but it make it worse. If you want to relieve a stimulant bad trip, prefer benzos or clonidine.
 
I have been doing street drugs for about 4 years maybe 5 now and was getting prescribed 8mg hydromorphone before i did any street drugs for about 4 years prior to my doctor retiring and leaving me with nothing to ween me off but my dad had already been going to methadone clinic for i dont know exactly how long but its way up there about 10+ years and was going once a month and getting prescribed 120 a day and he only needed 40 a day so if it wasn't for him i'd of been in a very bad situation but 1 year and 3 months ago he quit cold turkey and with all these new laws on pain meds its very hard to get prescribed legally anyway sorry for the small rant but just wanted to give you a little background.

also i've never shot up anything except in the hospital where they give me the pain medicine through IV but I'm not stupid i've NEVER mixed drugs that obviously should not be mixed such as heroin and oxymorphone or something like that. The only drugs i've done at least once is crack, cocaine, theres to main pain pills to list i've tried so ill just say i've tried the strongest except for fentyl or however you spell it the strongest ive tried is either 8mh Hydromorphone or 40mg oxymorphone idk which is stronger but i think oxy is, ive tried meth once it was ok and for me didnt leave me up for days like people say it does just made me really happy basically, i've tried heroin about 10 to 15x and ive only tried it from 2 different people one guys stuff was garbage which i didnt know at the time because i hadnt tried it before, the second guys stuff was waaaay better i'd already been taking 1-2 40mg oxymorphones a day and was out of state so couldnt get anything but H anyway 1 point of his would leave me feeling gooooood, 2 points made it very hard to stay awake (BTW i snorted it every time) and actually only did 2 points of his once because it was too much for me,

lets see i've done marijuana i dont do it much anymore maybe once a week sometimes once a month sometimes i dont want to for 3-4 months but i've tried tons of different kinds (Its illegal in my state so i can only get what my dealer has but i know at least 10 dealers that can get it.) i was doing it everyday for about 1 year and a half maybe 2 first tried it when i was still on the hydros so i've mixed hydromorphone and weed but thats not dangerous in my opinion you cant OD on green, ive done xanaxs off and on for 2-3 years (BTW i only do crack off and on when i feel like it and never more than 2-3 days at a time and also if you didn't know this the best thing to stop the withdrawal effect you feel like 10-15min after you run out 1mg of xanax is the best it stops it completely but ive never been addicted to crack its more of a when i feel like it/have the extra cash what i mean by the withdrawal is the jonesying effect of wanting more and more.

ive done adderall but that was in like 4th to 6th grade because idiot doctor thought i had ADD and i dont but i didnt mind i liked it helped me pay attention and get better grades during that time so whatever haven't done it since never seen any around OTS. ive tried klonopin but didnt like it at much prefer xanax. Lets see thats it besides from salvia just to see if it was like weed like so many people said and its not dont do it, it sucks ass i hated the feeling. I stay away from hallucinogens i just dont think i'd like it, the only drugs i've mixed it klonopin and pain meds but the normal amount i never take anything extreme, xanax and pain meds normally only near bedtime and i do 1-2mg but normally 1mg xanax with 10-20mg oxymorphone but normally 10mg, only do 2mg and 20mg if im hurting bad (I have chronic pancreatitis). I've mixed weed with alot of drugs pretty much every drug i've listed that ive tried except meth, salvia, crack, and adderall.

I havnt exactly mixed crack and xanax but after i run out of crack i do 1mg xanax about 10min after. Thats all i've ever mixed that could potentially be dangerous but i know my tolerance and have a very high pain med tolerance so im sure mixing some of what i have mixed for a newbie to pain med would lead to a OD but you have to know your tolerance. Be safe don't mix it unless you've had the drug by itself before and know what it does to you and also dont over do it, it wont hurt to try a small amount see how that does then do a little more until you reach the desired effect. Sorry for long post but i've done alot and mixed alot but i am as safe as i can be when mixing and don't mix anything that would lead to a OD to me personally but like i said before every drug effects everyone differently.

Oh also i've done suboxone before but i wouldnt really call that a dangerous drug unless youve never done pain meds and take a sub but i dont know for sure, Ive mixed subs with xanax before with green before and with oxys before but it blocks most of the pain med if not all depends on how long youve been taking subs and how much a day. When i do have to take it i only take half a strip twice a day but normally dont have to do it longer than 1-2 days but soon i'm going clean and suboxone and marijuana will be the only drugs ill be on so wish me luck guys i'm going cross country in an RV with my brother for a long time so we can stop together. Wish us both luck and if your addicted it's your choice to stop or not i dont see anything wrong with any of these drugs except meth, and heroin. As long as you dont over do any of these drugs ive done then i see no problem with it but im at the point where they dont do anything for me but keep me from getting sick so me and my brother are done and getting clean our way. Hope you guys take this to heart and don't do anything stupid. and have a happy new year.

Razorian, you should break your post up into paragraphs, its reeeeeeaaaaallllly hard to read what you wrote when its just a single wall of text. Also, PUNCTUATION! I don't think I saw a single period or comma in your post, which also makes it really hard to understand and follow what you wrote. I read it with the voice of a rambling speed freak speaking as fast as humanly possible without stopping to breath haha.
 
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Hypothetically speaking, how long would someone have to wait to start taking their prozac again after 3 month meth relapse?
 
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