Harm Reduction ⫸DANGEROUS Drug Combos⫷

[BellaJewel]

Just 48 hours ago I took 20mg of Baclofen, with a 20mg Oxy, about 8 ounces of wine.
I had taken 20mg of Baclofen earlier in the day, as well as 2 Oxys, 20mg each, 600mg Gabapentin and I had a Vyvanse, as well. I passed out >12 hours and when I got up I was completely shaking, I experienced muscle spasms and I kept dropping things. I went back to bed and I felt better only after about 35 hours had elapsed since I’d taken anything. I hope never to repeat this undesirable experience again!
Edited to include Gabapentin, which I’d forgotten about until now.

 

[sewerslide.666mg]

Just 48 hours ago I took 20mg of Baclofen, with a 20mg Oxy, about 8 ounces of wine.
I had taken 20mg of Baclofen earlier in the day, as well as 2 Oxys, 20mg each, 600mg Gabapentin and I had a Vyvanse, as well. I passed out >12 hours and when I got up I was completely shaking, I experienced muscle spasms and I kept dropping things. I went back to bed and I felt better only after about 35 hours had elapsed since I’d taken anything. I hope never to repeat this undesirable experience again!
Edited to include Gabapentin, which I’d forgotten about until now.

dam that sucks, I always get shaky after I drink n pills, but my nerves are sencitve,
how u feeling, are u back to base line,
that shit can get scary

 

[mokele]

CYP2D6
Cytochrome P450 2D6 is an enzyme that in humans is encoded by the CYP2D6 gene and a member of the cytochrome P450 mixed-function oxidase system.It's one of the most important enzymes involved in the metabolism of xenobiotics in the body. In particular, CYP2D6 is responsible for the metabolism and elimination of approximately 25% of clinically used drugs, in a process referred to as O-demethylation.

CYP2D6 shows the largest phenotypical variability among the CYPs, largely due to genetic polymorphism.
There are 4 types:

poor metabolizer – little or no CYP2D6 function (those people won't feel much from codeine, as codeine is a prodrug and needs to be metabolized into morphine)
intermediate metabolizers – metabolize drugs at a rate somewhere between the poor and extensive metabolizers
extensive metabolizer – normal CYP2D6 function
ultrarapid metabolizer – multiple copies of the CYP2D6 gene are expressed, and therefore greater-than-normal CYP2D6 function

Warnings:
poor metabolizer -> Don't take Dextromethorphan, as even normal therapeutical doses can make you trip for hours or even days, because you don't metabolize DXM well. This could potentially be lethal
ultrarapid metabolizer -> Don't take codeine, as you will metabolise codeine rapidly into morphine, thus increasing the risk of an overdose


Drugs that are metabilized by CYP2D6:

All tricyclic antidepressants, e.g.
imipramine, amitriptyline
Most SSRIs , e.g.
fluoxetine, paroxetine, fluvoxamine
venlafaxine
duloxetine
mianserin
mirtazapine
opioids
codeine
tramadol
O-desmethyltramadol
N-desmethyltramadol
oxycodone
hydrocodone
tapentadol
antipsychotics, e.g.
haloperidol
risperidone
perphenazine
thioridazine
zuclopenthixol
iloperidone
aripiprazole
chlorpromazine
levomepromazine
remoxipride
minaprine
tamoxifen
beta-blockers
metoprolol
timolol
alprenolol
carvedilol
bufuralol
nebivolol
propranolol
debrisoquine
Class I antiarrhythmics
flecainide
propafenone
encainide
mexiletine
lidocaine
sparteine
ondansetron
donepezil
phenformin
tropisetron
stimulants
amphetamine
methoxyamphetamine
dextromethamphetamine
atomoxetine
chlorphenamine
dexfenfluramine
dextromethorphan
metoclopramide
perhexiline
phenacetin
promethazine


Drugs that inhibit CYP2D6 (this will result in higher and longer blood concentration of the drugs mentioned above, this could lead to increased side effects and could even be lethal or to no effects at all):
White grapefruit juice
Strong
Certain SSRIs
fluoxetine
paroxetine
bupropion
quinidine
cinacalcet
ritonavir

Moderate
sertraline
duloxetine
terbinafine

Weak
amiodarone
buprenorphine
cimetidine
citalopram
escitalopram

Unspecified potency

antipsychotics
haloperidol
perphenazine
thioridazine
zuclopenthixol
risperidone
chlorpromazine
hyperforin (St. Johns Wort)
antihistamines
promethazine
chlorphenamine
diphenhydramine
hydroxyzine
tripelennamine
clemastine
celecoxib
clomipramine
cocaine
doxorubicin
metoclopramide
methadone
moclobemide
doxepin
halofantrine
levomepromazine
mibefradil
midodrine
ticlopidine
cannabidiol


Inducers of CYP2D6:
Strong

glutethimide

Unspecified potency

dexamethasone
rifampicin




From Wikipedia

Sorry to bump this oold Thread but i am a rapid metabolizer with methadone ,yet get NOTHING out of codein and barely to nil from DHC except unwanted sides like red face. My oral MSer dose is max to what they allow or it wouldnt hold me 24h. I take cimetidine cuz of exactly that. How can i then be a poor metabolizer AND a fast one at the same time if no cimetidine in play???? And fluoxetin would help more than cimetidine?? Worth a try? If anyone could clear that up i'd be very grateful!!!!

 

[BellaJewel]

dam that sucks, I always get shaky after I drink n pills, but my nerves are sencitve,
how u feeling, are u back to base line,
that shit can get scary

Thanks for asking, yes, I’m totally fine.
What’s interesting is that I get all of those prescriptions from the same doctor, with the exception of Vyvanse and the alcohol. I think I learned my lesson.

 

[TumajNuri]

seizures

Seizures and spams are common side effects of tramadol overdose. Some tramadol users think that redosing would enhance the euphoria and then they experience spasms that sound scary and can be avoided by anti-seizures (such as benzos)
Note that it's my own opinion. Plz do not combine trama with other drugs unless u have the idea of what u are doing. According to my personal exp. Benzos can overcome the spasms/seizures but could also put an end to euphoria caused by Trama.

 

[CuriosityMonster]

This is purely anecdotal and also likely redundant since we know the dangers of SSRIs+(most) stimulants, but since many people ignore these dangers - myself included - and even do so without ill effect (serotonin syndrome) I feel it is relevant to mention. Perhaps it might help somebody.

A friend and I are prescribed 20mg of paroxetine which we take every day. We took over the course of 11-13 hours 450-550mg of methamphetamine - a drug we had never tried before - and shortly after the last dose - we finished our halves at approximately the same time - we began experiencing serotonin syndrome. This is not something that particularly surprises me - paroxetine is an SSRI and methamphetamine is a powerful serotonin-influencing stimulant. However, we both have taken many, many different stimulant drugs - including amphetamine - whilst on 20mg of paroxetine without ill effect. We've insufflated grams of cocaine, smoked crack (for the first time), taken huge doses of LSD - all without any problems related to serotonin syndrome. I am merely stating this for reference: do not do drugs and if you do don't do large amounts or take them with drugs that dangerously interact with them.

Therefore I think it is possible that methamphetamine - again, this is purely anecdotal, but it did happen to both of us in the same manner and it makes logical sense - is more likely to trigger serotonin syndrome than many if not all other drugs. I don't think it's an unlikely theory to be true that a drug as powerful as methamphetamine that strongly and directly interacts with serotonin receptors in the brain, which involves (likely) acute neurotoxicity of these receptors - something other drugs do not do - would be a particularly dangerous combination paired with SSRIs, which also directly interact with serotonin receptors. Certainly, my friend and I will not be doing this drug again, or at least not if we're still taking any SSRI drug.

I also think taking any different drugs (meth and paroxetine in this case) which both interact strongly with the same receptor in the brain (again, other drugs are not directly neurotoxic in the brain) in vastly different manners is a bad idea inherently, perhaps as harmful in the long-term as serotonin syndrome is in the short-term. Why take an SSRI which influences serotonin receptors in a positive way to make you feel better and also methamphetamine which increasing evidence suggests is ACUTELY toxic and damaging to these same receptors? You might as well not be taking the SSRI if you're going to do that.

TL;DR: Don't take SSRIs and stimulants, but perhaps think extra hard about taking SSRIs and meth; it's potentially extra dangerous in the short-term and in the long-term would make the reason you're taking SSRIs redundant.