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Misc Counteract cyp2d6 Fluoxetine inhibition using Carbamazepine?

pally pete

Bluelighter
Joined
Feb 21, 2010
Messages
2,428
Hello OD.

First post here I think...

Is it possible to counteract Fluoxetine cyp2d6 inhibition, using Carbamazepine - a strong cyp2d6 inducer? I've been on Fluoxetine 40mg per day for around 1 year, and I'm now in quite severe back/neck/shoulderblade pain. The Codeine I have seems to have been rendered useless whilst I have been taking Fluoxetine..

Is this reversible even just in the short term? For example, would taking Carbamazepine have an instant effect? What dose would be needed?

Thanks for your time ;)
 
Well, liver enzymes will ebb and flow naturally, and rebound even if permanently inhibited.

But, right now you're complaining of severe pain, and want to use a weak opioid to treat it, but can't, because your antidepressant might be inhibiting the enzyme that converts the opioid to a better opioid, so you want to know if you should take a powerful anti-convulsant to induce more enzyme, allowing you to get more out of your shitty opioid?

Just get yourself a stronger pain killer. I'd recommend a non-opioid one, like ibuprofen. Consider long-lasting naproxen, too, but watch the gastric bleeding with that one.
 
Very complicated subject, but quick input with little research here.

I feel like if CYP2D6 is being inhibited by fluoxetine and you use carbamazepine to induce more of it, wouldn't the fluoxetine inhibit the new enzymes? Not sure, as this isn't my particular area of study.

Like Scrofula said, why don't you get a stronger painkiller or ibuprofen? If it's severe, I would recommend just stopping the fluoxetine if you think you could handle it. There appear to be moderate interactions as well with these medications.
 
That's the thing with liver enzymes, it's all dose- and person- and situation- dependent. It's unlikely that every last CYP2D6 is constantly preoccupied in the arduous task of oxidizing those nasty Prozac molecules, and that carbamezapine in sub therapeutic doses would induce the expression of just enough extra to exactly convert your codeine to morphine in a timely manner.

Maybe on Tuesday if you only eat one taco, and only with real cheese, not pre-grated cheddar shit, from the hours of 7:34pm to 11:05pm. The rest of the time you'll have terrible interactions from all these meds and the CYP1A19 inhibitiors in your Brawndo that you aren't even aware of.
 
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