Sure SSRIs can inhibit the breakdown of opioids within the physique. Glasshouse Photos/The Picture Financial institution by way of Getty Photos
Taking oxycodone concurrently sure selective serotonin reuptake inhibitors (SSRIs), a generally prescribed class of antidepressant, can improve the chance of opioid overdose, in keeping with a examine my colleagues and I revealed.
Medical doctors prescribe the opioid oxycodone to deal with average to extreme ache after surgical procedures and accidents or sure circumstances like most cancers. Opioids are additionally a typical drug of abuse. Within the U.S., over 70% of drug overdose deaths in 2019 concerned an opioid.
As a result of many sufferers with melancholy additionally expertise persistent ache, opioids are sometimes coprescribed with antidepressants like SSRIs. Prior analysis has proven that sure SSRIs, particularly fluoxetine (Prozac or Sarafem) and paroxetine (Paxil, Pexeva or Brisdelle), can strongly inhibit a liver enzyme essential to the right breakdown of medication within the physique, together with oxycodone. The ensuing elevated focus of oxycodone within the blood might result in unintended overdose.
To see whether or not several types of SSRIs may have an effect on a affected person’s danger of overdosing on oxycodone, my colleagues and I examined knowledge from three massive U.S. medical health insurance claims databases. We included over 2 million adults who started taking oxycodone whereas utilizing SSRIs between 2000 and 2020. The typical age of the group was round 50, and slightly over 72% had been ladies. Just a little over 30% had been taking the SSRIs paroxetine and fluoxetine.
We discovered that sufferers taking paroxetine or fluoxetine had a 23% increased danger of overdosing on oxycodone than these utilizing different SSRIs.
About 30% of sufferers with persistent ache expertise hostile drug interactions whereas taking opioids. Different forms of medicine have been proven to extend the chance of overdose and different dangerous interactions. These embody some muscle relaxants generally used to deal with ache, benzodiazepines generally used to deal with nervousness or poor sleep and a few antipsychotics generally used to deal with schizophrenia or bipolar dysfunction. Equally, in 2019, the Meals and Drug Administration required drugmakers to incorporate new warnings on utilizing gabapentinoids, a category of medication generally used to deal with epilepsy and ache, concurrently with opioids and different medicine that suppress the central nervous system. This mandate was resulting from an elevated danger of dangerously decreased respiration charges that may end up in overdose and dying when these medicine are taken collectively.
The findings from our examine supply perception on which of essentially the most generally used antidepressants may probably result in opioid overdose. Additional investigation of how different medicine work together with opioids may assist docs and sufferers higher perceive which medicine are secure to take on the identical time.
Ismaeel Yunusa doesn’t work for, seek the advice of, personal shares in or obtain funding from any firm or group that may profit from this text, and has disclosed no related affiliations past their tutorial appointment.
