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Misc Sertraline and Opiates

Michael_25

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I did a bit of research. I read that you should NOT take opiates whilst on sertraline, as it increases the risk of serotonin syndrome. If I stop taking sertraline, how long does it take to get out of my system so I can take opiates?
 

Bella Figura

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Well if that's the case then yes better not to mix them...although I'm sure there are tons of people who takes antidepressants and pain medication all the time. Sertraline has a half life of 24 hours, so your 50mg will be 25mg the next day, 12.5 the next, 6mg the next etc so call it a week.
 

Michael_25

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Thanks Bella. I found this on Google:

"Zoloft has a half-life of about one day. That means that for every day that passes without taking the medication, the level in the blood falls by 50 percent. After one day, the level is reduced to 50 percent of the original level, after two days to 25 percent, after three days to 12.5 percent, and so on. "

So my calculations are thus:

50 x 0.5 = 25mg (after one day)
25 x 0.25 = 6.25mg (after two days)
6.25 x 12.5 =0.78mg (after three days)

Can anyone chime in? Are these results correct or am I reading it wrong?
 

Bella Figura

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You're reading it wrong, the original dose divides by half every 24 hours, so it would be:

50mg x 0.5 = 25mg (after one day)
25mg x 0.5 = 12.5mg (after two days)
12.5mg x 0.5 = 6.25mg (after 3 days)
6.25mg x 0.5 = 3.125mg (after 4 days)
3.125mg x 0.5 = 1.56mg (after 5 days)
1.56mg x 0.5 = 0.8mg (after 6 days)
0.8mg x 0.5 = 0.4mg (after 7 days)
0.4mg x 0.5 = 0.2mg (after 8 days)
0.2mg x 0.5 = 0.1mg (After 9 days)

And 50mg isn't too high a dose to begin with, as long you keep your opiate doses reasonable, I don't think you'll come into any trouble.
 

Michael_25

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Thanks again, Bella. Therefore, it should be safe to take opiates after three days as only 6.25 mg will be present in my system. Thus having a very low possibility of getting Serotonin Syndrome?
 

Bella Figura

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Yep just take a dose you know you can handle and you should be good. I myself used Kratom, DHC, Heroin and Buprenorphine whilst I was on 100mg of sertraline or so.
 
Last edited:

ChemicallyEnhanced

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I just got prescribed sertraline, 50 mg. Can I use codeine and oxycodone while being on sertraline?
Yes. I take 150mg Sertraline (and started it before I started opiates). Since then I have taken high doses of: Codeine, Dihydrocodeine, Tramadol, Morphine, Oxycodone, Methadone, Buprenorphine and Fentanyl and have never had any interaction between them. Except Tramadol but that has SNRI activity.
Codeine and Oxy is both totally fine with Sertraline :).
Some people will claim otherwise, but from experience I can say it is 100% safe. And this is with 9 years of pretty much daily experience.
Codeine and Oxy do not increase serotonin, they increase dopamine which Sertaline does not (unless you take over 300mg/day).
 

Michael_25

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Yes. I take 150mg Sertraline (and started it before I started opiates). Since then I have taken high doses of: Codeine, Dihydrocodeine, Tramadol, Morphine, Oxycodone, Methadone, Buprenorphine and Fentanyl and have never had any interaction between them. Except Tramadol but that has SNRI activity.
Codeine and Oxy is both totally fine with Sertraline :).
Some people will claim otherwise, but from experience I can say it is 100% safe. And this is with 9 years of pretty much daily experience.
Codeine and Oxy do not increase serotonin, they increase dopamine which Sertaline does not (unless you take over 300mg/day).
Thanks, CE. But why have I read articles on the internet that combining sertraline with opiates can lead to Serotonin Syndrome? Can you link me any articles that state there is little risk of SS? Thanks!
 

ChemicallyEnhanced

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I don't know about articles, I'm just talking from personal knowledge/experience. The chances of Serotonin Syndrome are small, it's not really something to worry about. If you are, just keep an eye out for the effects of it and stop one of the medications if you experience them. Talk to your doctor if you're worried. Taking both is very common, though (a lot of people with chronic pain are also depressed). I've taken both (along with other drugs that increase serotonin) for 9 years and never had Serotonin Syndrome.
 

Michael_25

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My codeine intake is about 300 mg a dose, and my oxy dose is normally about 25 mg. Taking them therapeutically may cause no harm. But large levels ... don't know. But as you wrote, you've taken a shitload of opiates/opioids while on sertraline and never had SS occur.
 

sekio

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It's worth noting some opioids have a greater effect on serotonin than others, drugs like tramadol, methadone or pethidine are all way worse for SS than "classical" opioids or more selective drugs like fentanyl.

Serotonin syndrome is not a common reaction but it does happen in rare instances.
 

Michael_25

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It's worth noting some opioids have a greater effect on serotonin than others, drugs like tramadol, methadone or pethidine are all way worse for SS than "classical" opioids or more selective drugs like fentanyl.

Serotonin syndrome is not a common reaction but it does happen in rare instances.
What about large doses of codeine and oxycodone? What they induce SS in people who are on Sertraline? (I have only taken 100 mg so far.)
 

karambit

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I've been on 100mgs/day of Sertraline and about 320mgs/day Oxycodone with ZERO complications for 6 years.

Even with MAO inhibitors such as tranylcypromine and phenylzine Oxycodone poses no threat. You should google " Dr. Gillman" and check all of the painkiller interactions bc some are contra-indicated! This is obviously for those contemplating the addition of said narcotic or said MAO'I
 
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