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MedHelp Member's Question

Possible drug interactions for Methadone

by maximus, May 22, 2001 12:00AM
I was severely injured at work over 2 years ago.  I have been taking Paxil for depression and was also recently switched from morphine to Methadone for pain treatment.  I read on the Internet that Paxil (or any SSRI drug) can cause a spike in blood pressure and possibly a stroke when mixed with Methadone.  My doctor is now recommending Effexor in place of Paxil.  Isn't Effexor also an SSRI? and to your knowledge, does it pose significant risk(s) when taken with Methadone?  If so, is there an anti-depressant that can be safely used with Methadone?
Member Comments (99)

by Thomas, May 22, 2001 12:00AM
To: maximus
I'm afraid I have no medical info to help you with (doc dan, if you're out there, please help this guy!). But I can observe, if I were getting enough methadone to control pain, I can't imagine being depressed. I just can't quite see it. Perhaps it wouldn't hurt to try going off the anti-depressants entirely for a week or so and seeing how you feel. Effexor is an SSRI, like Paxil. You can compare the two by going to:

www.rxlist.com

You will get access to all the manufacturer's info, the same stuff they send to the doctors. That may shed some light on the subject for you.

It's just that I can't imagine feeling anything but happy on a pain-killing dosage of methadone! Perhaps if you can get in any aerobic type exercise, like stair climbing, fast walking, swimming, bicycling, jogging -- these will all improve your mood, and that's not just a seat of the pants guess -- any doctor will tell you aerobic exercise is a highly effective mood elevator. Perhaps your answer is to find an alternative to SSRIs period.



P.S I mentioned "doc dan." He's a college-trained councelor at a methadone clinic. His e-mail address is "***@****." He's quite knowledgeable about methadone and all related material. You can trust him to give you solid, professional-quality answers that will be better than the doctor, if you can even get him to reply. Write Doc Dan. He'll help you, maximus. He's a good man who's dedicated his life to doing some good for society in this arena. You can rust what he tells you. Good luck.

by maximus, May 23, 2001 12:00AM
To: Thomas
I appreciate the enclosed e-mail address and your taking the time to respond to my question--I will try "Doc Dan"; however, I was completely disgusted with other parts of your response. I am not sure exactly who you are or what your qualifications are, but your response, "if you're getting enough methadone to control pain, I can't imagine being depressed" is quite uneducated, insensitive and way off the mark.  I can assure you it is quite possible to be both clinically depressed and on methadone and yes, I have recently gone off all anti-depressants for a 2 week period with no success.  I would give anything gladly to to be involved in an exercise program (yes, I know the incredible benefits of exercise for depression!) but, DUH, I also mentioned that I was seriously injured at work.  I have four different levels of injury now in my back and am not able to exercise.  Over the past two years I have undergone pain management, physical therapy, facet blocks, epidurals, and even an implanted morphine pump with no help.  I am now facing an extensive surgery with a fusion that will cover the entire lumbar region of my back.  Methadone is the first thing I have been given that has actually given me any pain relief.  I am a hard worker, (formerly  80 hours a week), formerly very active person and have never suffered from depression in my life.  Last fall, I began suffering from severe depression, suicidal thoughts and paranoia. I would gladly ditch the SSRI's but am finding them quite necessary at the time.  I don't believe sanity OR pain relief should have to be a choice, I just would like to make sure I am being as safe as possible with my meds.  Whoever the hell you are, you might pay attention more closely to the details of a question and also not discount what a person tells you by saying, I can't imagine being depressed and on methadone.  Get a grip, *******.

by Frankinscense, May 23, 2001 12:00AM
To: maximus
No need to be so defensive, friend. People are just trying to help with your problem. I realise depression accompanies pain.

In most cases if you remove the depression pain relief will follow.                                                           Methadone is being used as an antidepressant in some indiviuals that do not respond to traditional treatments. There is some research that indicates NARIs help depression that accompanies chronic pain.                                                              Methadone has a tendency to lower blood pressure in certain individuals. So it is essential to monitor blood pressure youself while on methadone.  Good Luck!

Dan..

by J.B. to Brian and Vicky, May 23, 2001 12:00AM
To: Maximus
We don't appreciate remarks and name-calling such as your's here. You are the *******, Maximus.  ******* Maximus shall be the name that most suits you and your condition.  J.B.

by Wizard, May 23, 2001 12:00AM
To: Maximus
Ditto to J.B.'s response. Why don't YOU get a GRIP!!!!!!!!!!

Mean spiteful attitudes will get you no sympathy here..

I will pray for you,

Wizard

by Jimenez, May 23, 2001 12:00AM
Not fair to maximus...especially in light of the fact that Thomas has absolutely no experience with Methadone. For him to speak about it and say that he can't imagine being depressed and on methadone is unwarranted and uneducated. I am now on methadone and never uttered a word (except questions) about methadone before I was on it myself. I don't think it's fair or accurate for anyone, including myself, to make blanket statements about drugs that we've never tried. I think this is a case of people valliantly trying to help, even though they know little or nothing of the circumstances. As nice as this may be, it is useless to the individual who was asking for help. He just needed to know the interaction of methadone with SSRI's. If I or anyone else doesn't know about that, maybe silence is golden. I know Thomas will take this personally, and I really hope he doesn't because the stuff he DOES know about is really helpful, it's just that some people are truly only looking for the exact answers to their questions here. Yeah, he was a little harsh to Thomas - but hey - we've all been there too. A little sympathy isn't only proper, but warranted.

by Wizard, May 23, 2001 12:00AM
To: Jimenez
You are truly right in the fact that we all have been there.But if you really read what Thomas said, you will see that he STARTED his post with " I'm afraid I have no medical info to help you" then he proceeds to refer to Doc Dan. That's pretty clear to me. He only then proceeded to state his opinion which did NOT warrant the sarcasm that was delivered to him. WE ALL have a story to tell here. We ALL pull from each others experience. I still say, "BAD ATTITUDE=NO SYMPATHY" I DO have COMPASSION and PITY for anyone in his situation. I DO still love him as a fellow human being suffering. I will STILL pray for his peace. And above all, I DON'T think Thomas will take it personally. He's got too much Class, Integrity and Life experience to waste time on negative force. I think Maximus should re-read Thomas' post again with a little love in his heart. For in his post, there were some leads to GOOD information! I applaud YOU Jimenez, for coming to Maximus' defense. You see, We all are family including you and Maximus, and protect our own. You are All in my prayers,

Power & Magick 2 U all,

Peace & Light on us all,

Wizard

by Thomas, May 23, 2001 12:00AM
I'll tell you what, gentleman, since I don't seem to have pleased anyone on the forum today, I've been thinking of retiring from participating on the forum anyway and maximus has given me all the motivation I need to bid you all farewell. Goodbye and good luck.

In the future, consider me gone.



Thomas

by Angelica, May 23, 2001 12:00AM
To: Maximus.............
Totally uncalled for!!!!  As I said once before, don't wear your feelings on your sleeve......I don't recall Thomas calling you any derogatory names.  You are "way to sensative!" Man, who needs to get a grip???????



Thomas: Don't you go and abandon me too.  This is getting to be, to much for me to handle.  You've seen people come and go, from this board, and you've been one of the mainstayers...here.  You have helped so many people, and you were the very first one to respond to me on this doggone board!!!! This is the last straw...people just drop by here, and say anything they dam well please (like someone else I know). This needs to stop.

....We are not doctors, nor do we claim to be......we are here to discuss our life experiences, concerning addiction...and everything that goes w/it, and  You've gone beyond the call of duty. Sometimes, I think people are looking for a fight.....they drop in here just to release some steam, and then POOF!...they're off.

  

Jiminez:  Where have you been lately??? Nice to see you resurface, still holding grudges??? (:

Angelica

by Wizard, May 23, 2001 12:00AM
To: Angelica
Nicely said....You Go Girl!....As I said above we ALL take care of our own. You keep your chin up, there will always be some of us here for you. As for the **** disturbers, **** THEM! oh geeze....I got carried away for a moment....I formally apologize to all of you for my lapse of good manners. I DO have to eat with this mouth...I'm sorry for saying F**K YOU..oops I did it again. The Wizard is going to wash his mouth out with soap. This is not following the way  of the Wiz......Forgive me. I think I'll go back over the rainbow and do some serious praying for us all.

Power & Magick 2 U,

Peace,

luv,

Wizard

by Deja, May 23, 2001 12:00AM
To: Maximus § All RE: Stopping SSRI's
I'm not going to get involved in the above squabble, however, I do have some information to relay in regard to stopping SSRI treatment.  



I can seriously sympathize with your circumstances and I do understand that depression often lives comorbidly with chronic pain.  In the past when you have stopped your SSRI treatment you state that you have gone off it for 2 weeks with no success.



If you think back to when you began treatment with your particular antidepressant it took up to 6 weeks to become fully effective.  Anyone discontinuing use of one of these medications has to be weaned off, that is, dropping the dose as per your doctor until you are able to stop totally.  



It takes the same 4 to 6 weeks to know if you can stay off the medication without relapse of depression.  It's not an easy thing stopping SSRI meds!  Sudden cessation can lead to many, many symptoms not limited to but including; anxiety, restlessness, neurological disturbances (twitching, head or eye