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Bupe Subutex & Prozac

OpiumKing

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Im on 24mg of Subutex from one doctor and now my family doctor wants me to start taking Prozac 10mg for stress, and fast heart rate. My heart rate is always in the 90s. I cant find much info on this combo. Will this combo make me a zombie.? or will it bump up my dopamine levels, and give me a mood lift.?
 

OpiateKiller

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Lorne???

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What? My mother takes a lot of Buprenorphine and Prozac, and is fine. Don't know if it will help because it hasn't been long, though long enough to get Serotonin Syndrome

10mg Prozac is literally like the lowest dose, this is a fairly safe combination; you have to do something about mild yet constant tacycharydia; That is kinda how I was, though I eventually ended up on Benzodiazepines

If your worried start with 5mg, however I truly think you're fine. Of course, not a huge fan of Prozac, though YMMV
 

OpiumKing

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What? My mother takes a lot of Buprenorphine and Prozac, and is fine. Don't know if it will help because it hasn't been long, though long enough to get Serotonin Syndrome

10mg Prozac is literally like the lowest dose, this is a fairly safe combination; you have to do something about mild yet constant tacycharydia; That is kinda how I was, though I eventually ended up on Benzodiazepines

If your worried start with 5mg, however I truly think you're fine. Of course, not a huge fan of Prozac, though YMMV
Thanks Lorne??? ..!! I also take 5mg Valium 3 times a day and Gaba 600mg 3 times a day too, but yes tacycharydia has been a problem, for years untreated. Just have not heard of anyone taking Prozac with Bupe. So I was hesitant to use it. I have a lot of stress these days with so much on my plate as well. So maybe I will give it a gom, and see how it works. Thanks for the reply
 

Lorne???

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Well 5mg Valium is like.125-.25mg Klonopin. You need a dose increased

Buprenorphine is not considered a Serotoninergic drug, I wouldn't ignore this based on what one person says, it just isn't a realistic interaction
 

OpiateKiller

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Well 5mg Valium is like.125-.25mg Klonopin. You need a dose increased

Buprenorphine is not considered a Serotoninergic drug, I wouldn't ignore this based on what one person says, it just isn't a realistic interaction
I’m confused at your ignorance. There is literally an FDA study warning about opiates and serotonin syndrome. You clearly didn’t even read the study.


Here’s another one.

Just because it didn’t happen to you doesn’t mean it can’t happen. Yes some people will take Anti depressants and opiates and be fine, but what I’m saying is there is a risk for it to happen.

Opiates may not primarily operate on serotonin receptors, but they do effect it. All I’m saying is he should exercise caution.

Side note, I’m not a fan of Prozac. There are many studies it is not worth the side effects. Sexual side effects, increased depression / violence ... its not an effective drug and it is very dangerous.
 

Lorne???

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^ I agree with everything you said.
I’m confused at your ignorance. There is literally an FDA study warning about opiates and serotonin syndrome. You clearly didn’t even read the study.


Here’s another one.

Just because it didn’t happen to you doesn’t mean it can’t happen. Yes some people will take Anti depressants and opiates and be fine, but what I’m saying is there is a risk for it to happen.

Opiates may not primarily operate on serotonin receptors, but they do effect it. All I’m saying is he should exercise caution.

Side note, I’m not a fan of Prozac. There are many studies it is not worth the side effects. Sexual side effects, increased depression / violence ... its not an effective drug and it is very dangerous.
And I'm not ignorant that opioids effect Serotonin; however that is the first case of serotonin syndrome with Buprenorphine in how many years? It just isn't common, the FDA hates opioids, instead of saying "when mixed with multiple Serotoninergic drugs at large doses opioids further increase the risk" they issue a Warning

I do not like Prozac, however mild tachycardia that cannot be treated by Benzodiazepines because the Doctor won't RX them, he needs to try it unless he can get more Benzodiazepines. Just a week or two, if the side effects are overwhelming, stop the drug

You didn't tell him this, you told him to avoid the combo

AD's and SSRI's and SNRI's are a part of life, for better or worse. If you knew more about Serotonin syndrome and the drug, you would know that the Buprenorphine and 10mg Prozac simply isn't a risk for a Serotonin storm; they RX over 50mg. He would have an excessive Serotonin disorder if he got it the first time he tried it, and it would make it into medical journals.

I don't get why they treat anxiety with Serotoninergic drugs, when Serotonin is an excitory neurotransmitter (basically)
 

Lorne???

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And that person was on tricyclic antidepressants and took an unprescribed dose. Probably a bizarre reaction with someone unfamiliar with Buprenorphine 's potency; it did happen longer ago than I thought though (2008 vs 2018)

(He is on a large dose of gaba, though, on an unrelated note)

On a related note, his body has adjusted to a partial agonist by now

I agree AD's cause side effects and are potentially hazardous in and of themselves. And it HAS happened to me, I won't go into details though I've had Serotonin syndrome before, worst case, had Cyproheptadine around I got from my godmother of the time weeks earlier, and it reversed it
 
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OpiateKiller

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^ I agree with everything you said.


And I'm not ignorant that opioids effect Serotonin; however that is the first case of serotonin syndrome with Buprenorphine in how many years? It just isn't common, the FDA hates opioids, instead of saying "when mixed with multiple Serotoninergic drugs at large doses opioids further increase the risk" they issue a Warning

I do not like Prozac, however mild tachycardia that cannot be treated by Benzodiazepines because the Doctor won't RX them, he needs to try it unless he can get more Benzodiazepines. Just a week or two, if the side effects are overwhelming, stop the drug

You didn't tell him this, you told him to avoid the combo

AD's and SSRI's and SNRI's are a part of life, for better or worse. If you knew more about Serotonin syndrome and the drug, you would know that the Buprenorphine and 10mg Prozac simply isn't a risk for a Serotonin storm; they RX over 50mg. He would have an excessive Serotonin disorder if he got it the first time he tried it, and it would make it into medical journals.

I don't get why they treat anxiety with Serotoninergic drugs, when Serotonin is an excitory neurotransmitter (basically)
Yeah I’ve never taken anti depressants so I really don’t know their dosages or strengths to be honest.

I also had a case of SS from suboxone, MDMA, cocaine and L dopa / 5 HTP. It was a brutal week.
 

Lorne???

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^ Oh I bet that was rough

I can't believe he has an elevated resting heart rate and they are giving him 10mg Prozac; 20mg is more of a starting dose, well after the first week.

Do you take Benzodiazepines?



Yeah I’ve never taken anti depressants so I really don’t know their dosages or strengths to be honest.

I also had a case of SS from suboxone, MDMA, cocaine and L dopa / 5 HTP. It was a brutal week.
 

DeadManWalkin'

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Jun 30, 2019
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What? Bupre increasing serotonin? Maybe, but not much. Specially after long use.
My fiancee eats some form of SSRI, not anymore but she ate them in winter now she's feeling better and we did bupre during all time and we IV it so really the serotonin syndrome is not a chance.
I get your concern, but i think this post is misinformation.
 

OpiumKing

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Tampa, Florida
Thanks everybody for your heart felt concerns. Im good ..still just taking one 10 mg prozac a day for my high resting heart rate. No problems so far, and its been over a week. Doc thinks my high heart rate is due to stress. I just hope it helps without causing any other problems that i have not discovered yet.? ...and Yes, the other meds listed above ive been on for years.
Cheers All
 

OpiateKiller

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Feb 14, 2019
Messages
703
What? Bupre increasing serotonin? Maybe, but not much. Specially after long use.
My fiancee eats some form of SSRI, not anymore but she ate them in winter now she's feeling better and we did bupre during all time and we IV it so really the serotonin syndrome is not a chance.
I get your concern, but i think this post is misinformation.
There is specific scientific studies I posted about it. What is there confusing about scientific proof of SS from bupe?
 

dopamimetic

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I’m confused at your ignorance. There is literally an FDA study warning about opiates and serotonin syndrome. You clearly didn’t even read the study.
This is almost the only report of serotonin syndrom from buprenorphine and we had a discussion about that in NPD. They publish all the novel things but as long as they don't say 'high risk, don't do' then it doesn't mean that. Probability for other drugs, which the patient didn't admit and didn't cause a positive test (actually a majority of drugs out there today don't) is much higher than buprenorphine alone causing serotonin related toxicity, it isn't even a serotonergic which means it has at most statistically irrelevant affinity. Some metabolites might be different but still it's not an usual cause. The syndrome is overall pretty rare and usually involves a MAO inhibitor + something else, also with titrating you are more likely to develop mild symptoms like headache, agitation, temperature and not directly the full-on deadly thing. It's important to be wary about yes, but bupe + prozac is an often used combination and should be safe besides the usual side effects & risks.
 
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