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Opioids SSRIs and Opiates

b4rd

b4rd

Bluelighter
Joined
Nov 22, 2009
Messages
852
Does anyone know if taking opioids while on an SSRI can cause serotonin syndrome?

I am not sure where i heard this, but i remember hearing that mixing the two can be dangerous.

Does anyone know if opioids, (hydrocodone in general), increase serotonin levels?
 
I think if you use tramadol or demorol you may. I think straight up opiates would be just fine though. I am not 100% sure I would have to do research but I suspect it's tramadol and demorol that is off limits for someone with an SSRI.

I don't think hydrocodone has any action at 5HT, no. I can't be 100% sure though. I do remember taking hydrocodone *around* the same time I was on Zoloft, I just can't be sure I had both in the same day. Sorry.
 
I'm on an SSRI, and I took percocet and vicodin for pain with no issues. However, both were very low doses for a short period of time (little too much strenuous activity on my lower back). Opiates are not listed as something that can interact with my SSRI on drugs.com but even that's worth checking out. Believe half of what you read and none of what you hear I think the saying goes? Do your own research from multiple sources, don't just expect this thread to do all the work for you. :)
 
It's just the opiates that also affect serotonin that could be an issue--primarily Demerol. Tramadol blocks serotonin reuptake. Methadone also has some serotonergic properties. FWIW, I've taken all those except for Demerol while taking SSRIs with no interaction. Hydrocodone is fine w/ SSRIs too, it doesn't increase serotonin.

Some of the SSRIs do affect certain CYP enzymes and could make certain opioids stronger. Which SSRI?
 
WSB15 said:
It's just the opiates that also affect serotonin that could be an issue--primarily Demerol. Tramadol blocks serotonin reuptake. Methadone also has some serotonergic properties. FWIW, I've taken all those except for Demerol while taking SSRIs with no interaction. Hydrocodone is fine w/ SSRIs too, it doesn't increase serotonin.

Some of the SSRIs do affect certain CYP enzymes and could make certain opioids stronger. Which SSRI?
Click to expand...
Tramadol releases serotonin, it doesn't block it. that's why there's a risk for serotonin syndrome when taken with an SSRI.
 
CocksuckerNJ said:
Tramadol releases serotonin, it doesn't block it. that's why there's a risk for serotonin syndrome when taken with an SSRI.
Click to expand...

He said that it blocks serotonin reuptake, not blocking the release of it. Those are two completely different things.


EDIT: I'm not saying whether what he said is correct or not, because I'm not sure what tramadol works on because I've never looked into it (although I know it does work with serotonin).
 
oh man i should make a thread for this, but i have found that i CANNOT get high when on ssris. prozac, zoloft, paxil....i remember taking lots of vicoprofen when i had nhil newb status tolerance and i couldnt feel them. i couldnt get high on H when on zoloft. on and on. anyone experienced this?

its weird cause i actually did get high on oxy when on an ssri but i cant seem too with h. i may have actually been able to get high on h when on lexapro....cant remember. but yeah.
 
37.5mg hydrocodone seemed to be dampened a bit by 20mg of citalopram (Celexa) earlier that day, this past winter break. However, this past Saturday, only about 36 hours after my last 20mg citalopram dose, 240mg of codeine in syrup with gauifenesin actually was the heaviest opie high I had ever had. I had enjoyed a bit of whiskey (2 standard shots) a few hours earlier, with 10mg Dexedrine chewed around the same time as having whiskey. Ethanol is listed as a CYP2D6 inducer, so that may have helped metabolism, but I was sober by time of codeine dosing and it's listed as weak-to-moderate inducing.

Just occasionally breathed a slow, deep breath. Was so high that I would usually get bored with inner monologue halfway through a sentence and stopped thinking in words so much. It amazed me since so much of codeine's action comes from metabolism into morphine via CPY2D6, which Celexa inhibits. What many narcotic converters would call an equivalent amount of hydrocodone months earlier was not as heavy and euphoric. The codeine was barely itchy at all. Very perplexing, but I won't complain about being fucking blanketed in the bomb shelter.
 
Apparently, Tramadol both blocks reuptake of serotonin
-http://www.ncbi.nlm.nih.gov/pubmed/16296359?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=22
AND stimulates the release of serotonin
http://www.sciencedirect.com/scienc...serid=10&md5=ed9a28166ddab376c058061348cea6f0

So, Cocksucker and I are both technically correct (never thought I'd start a sentence like that). Both 5-HT reuptake inhibition and release increase serotonergic activity, so Tramadol shouldn't be mixed with SSRIs. I said above that I'd taken Tramadol and others with SSRIs, but I had cyproheptadine on hand in case I noticed any serotonin syndrome signs, and I also was only taking a very low dose of an SSRI (10 mg Prozac). So take what I've said with a disclaimer and a grain of salt, not as advice. Seriously, I've snorted methadone before.
 
thank you yall for your answers... i didnt know that SSRIs would dampen the effects tho... seems strange to me. I hope not, im taking hydrocodone tomorrow before i get my cavity filled =(
 
Last edited:
i dont understand it but many maaaaaaaaaany times i have taken opiates ranging from vicodin to IV heroin and they are blocked by SSRIs almost every time. there are exceptions but this is my experience.
 
Well, i am on the SSRI celexa, 20mg and have been on it for about 6 months. I took 15mg hydrocodone, and i was BUZZING.

I have no tolerance whatsoever, so this might have attributed to it, but i believe that the SSRI that i am on had no effect on the opiate.

Seems strange to me that some people report SSRIs causing a "blockage" on the opiate.

It could be that SSRIs have a HUGE range of effects on many different people, (i.e. side effects), maybe this could be a side effect of SSRI's for some people as well??
 
the ssri that i take (fluvoxamine) potentiates the methadone i take for mmt ...pretty cool
 
Fluvoxamine (Luvox) and Fluoxetine (Prozac) significantly inhibit the main enzyme that metabolizes methadone (CYP3A4, I think), which can increase the blood concentration of methadone...or in other words, potentiate it.
 
Duloxetine (Cymbalta) is a Cyp2d6 inhibitor, which is the enzyme that converts Hydrocodone to Hydromorphone.

Wikipedia says that poor cyp2d6 enzyme activity which occurs in 10% of white males will or can result in possible lessened analgesic effects. Does this also apply to the mental , relaxation, anxiolytic and euphoric properties of the drug?

I am wondering because i will be seeing a mental health physician soon and love my hydrocodone. If it will lessen its effects then fuck that shit!

Also what other opioids can it possibly effect?
 
I've known people who were on cymbalta and opiates at the same time. They never had any problems with analgesia or euphoria. Honestly most of hydrocodone's effects are due to hydrocodone itself, its a myth that its a prodrug that HAS to be converted into hydromorphone to be effective. Whether or not you have an enzyme deficiency, it will work.
 
Two things:

1. SSRI's may potentiate opiates if the SSRI you take happens to inhibit the enzyme responsible for metabolizing the opiate you take.

2. I have read in the medical literature that opiate usage can result in downstream serotonin release somewhere along the line, though it is mild at best. I would think this would only cause problems of serotonin sickness if you happened to be especially sensitive to serotonin, and if you were you would already have noticed from the SSRI.

In short, you don't have anything to worry about... aside from the possible moderate potentiation.
 
Dose-dependent inhibition of CYP1A2, CYP2C19 and CYP2D6 by citalopram, fluoxetine, fluvoxamine and paroxetine.

This mentions a change in metabolism of CYP2D6 with intake of all four SSRIs, I just got out of the psych ward and can't really comprehend this right now but is this saying that citalopram increased metabolism of the substance metabolized by CYP2D6?

sarsXdave said:
37.5mg hydrocodone seemed to be dampened a bit by 20mg of citalopram (Celexa) earlier that day, this past winter break. However, this past Saturday, only about 36 hours after my last 20mg citalopram dose, 240mg of codeine in syrup with gauifenesin actually was the heaviest opie high I had ever had. I had enjoyed a bit of whiskey (2 standard shots) a few hours earlier, with 10mg Dexedrine chewed around the same time as having whiskey. Ethanol is listed as a CYP2D6 inducer, so that may have helped metabolism, but I was sober by time of codeine dosing and it's listed as weak-to-moderate inducing.

Just occasionally breathed a slow, deep breath. Was so high that I would usually get bored with inner monologue halfway through a sentence and stopped thinking in words so much. It amazed me since so much of codeine's action comes from metabolism into morphine via CPY2D6, which Celexa inhibits. What many narcotic converters would call an equivalent amount of hydrocodone months earlier was not as heavy and euphoric. The codeine was barely itchy at all. Very perplexing, but I won't complain about being fucking blanketed in the bomb shelter.
Click to expand...

So citalopram possibly potentiated codeine? Does anyone else have experience with this?
 
I am on 20mg of paxil, 120mg of geodon, 4mg of xanax, 40mg opana er, and 60mg of oxycodone per day, I havent noticed anything weird. Ive been on ssri's and opiates for about 5 years now, the only thing that made a difference was tramadol. it was not a good experience for me to mix those. but ive mixed mscontin, hydrocodone, oxycodone, dilaudid, oxymorphone, muscle relaxers, all of them while taking an ssri and I rele havent noticed anything, I do have a high tolerance though, but thats probably because Ive been on the opiates so long and I used to abuse them. But the ssri may be increasing my tolerance i cannot know for sure. It certainly doesnt seem to potentiate any of my opiates, but maybe thats just paxil, maybe when i switch to celexa in january ill notice a difference. But in my experience it is ok to mix them and even take high dose opiates via IV and be fine.
 
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