Combinations - Citalopram and Codeine - is there a way?

[racemethorphan]

SWIM takes Citalopram regularly (10mg/day), and recently consumed a horrible-tasting CWE based on ~230mg of codeine in the source tablets, and got virtually nothing out of it. SWIM drank grapefruit juice at the same time (about a glass worth). Nothing.

Absolutely nothing, save for a slight warmth.

Is there a way to get that pesky CYP2D6 enzyme working while on Citalopram? Or, alternatively, how safe is it to consume DXM and codeine at once? (DXM makes a nice single-night substitute for his antidepressants, so SWIM tells me.)

He doesn't want to go through moody ups and downs for days, for just a few hours of chill time.

[RoboCodeine7610]

Maybe SWIY should take promethazine with it...Swim has heard that it's an enzyme inducer.
About the DXM, according to William White they would cancel each other to some degree.

[Tortoise]

Promethazine is not an enzyme inducer.

[TheNewLeft]

SWIM is having the same problem with his cipralex (SSRI) completely diminishing the effects of codeine.

SWIM finds certain things help marginally....like taking sedating anti-histamines 10 minutes before ingesting or mixing the CWE product with Tonic Water for the Quinine content....

but these are only marginal, barely noticeable improvements. SWIM wants his old codeine back!

[jb2008]

SWIM is having a similar problem. His dog is on venlafaxine, and he can't stop taking it because of horrendous withdrawal symptoms, starting as early is a day after the previous dose, so how can he get the high back?

The best SWIMs dog can do is take venlafaxine as normal, but the next day delay the next dose of venlafaxine until after the codeine has been experienced. Venlafaxine has a very short half life and a lot will be out of his system by the day after, could this work at all?

Thanks

[vinylmesh]

This explains it;

http://en.wikipedia.org/wiki/Cyp2d6#CYP2D6_Ligands

[Solinari]

Just out of interest is this CYP2D6 enzyme responsible for converting codeine to morphine?

[vinylmesh]

yep!

[Xeon]

citalopram and most most other ssri drugs are cyp2d6 competitive inhibitors and so will reduce the speed at which cyp2d6 converts codeine to morphine. if possible reduce the level of ssri in swiys body and try again. if this medication is really neccessary swim would suggest stopping the codeine use as it will interfere with the effect of the ssri. i.e. neither codeine or ssri will work properly.