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Re: Opiates and MAOIs » SLS

Posted by Elizabeth on April 23, 2002, at 23:56:15

In reply to Re: Opiates and MAOIs » Elizabeth, posted by SLS on April 22, 2002, at 11:57:42

> I guess I screwed-up. I only have two 5mg tablets to work with.

Well, I may be overestimating. Different people need different amounts. The one time I had hydrocodone (after having my wisdom teeth removed), I got Vicodin HP: 10 mg hydrocodone and (I think) 660 of APAP. I thought it was pretty mild. That might just be me, though.

> I am very happy to know that MAOIs and opioids can be taken concurrently. Do you know if hydrocodone is safe to use in such a combination?

I know a few people who've done it, and there aren't any reports in the literature of interactions. The semisynthetic morphine and codeine derivatives (hydrocodone, oxycodone, hydromorphone, oxymorphone) should all be okay.

> I will probably be starting Nardil soon. I see my doctor on Wednesday. I was originally going to try the Vicoden thing without his knowledge, but I think I'd feel more comfortable working with him on that. If nothing else, my asking him will force his hand and demonstrate to me to what lengths he is willing to go to treat me.

Good luck with it. Unfortunately, a lot of doctors aren't willing to go out on that limb.

> I'd also like to try S-AMe before beginning Nardil. I'm currently taking imipramine and Lamictal. Any thoughts? Do you think it can be safely combined with MAOIs?

Which "it?" (Lamictal: yes. Imipramine: maybe. S-AMe: no.)

BTW, I was never taking Effexor and a TCA at the same time (I only ever combined TCAs with MAOIs). I had a seizure (at least, that's what the doctors in the hospital thought) when I was taking desipramine, and it turned out that my serum level was way high (600 or so). Technically I could have kept taking it, but I would have needed to get the serum levels checked a lot until I found a safe dose, and then I'd still need to have the level monitored regularly. This wasn't worth it to me -- desipramine worked about as well as Parnate but I didn't need to have blood tests when taking Parnate. I decided to give Effexor XR a try before going back on Parnate, though, and it works about equally well, too (not good enough to go off buprenorphine, but good enough to substitute for Parnate). I had tried Effexor XR once before, but when I'd been on it about a month, I became very sick and was diagnosed with the serotonin syndrome. After that I was scared away from Effexor. More recently I'd been thinking about it in retrospect and decided that it might be worthwhile to try it again, with caution; there wasn't a very clear link between the Effexor and the sickness. This time it seems to be fine.

-elizabeth


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