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Thread: Citalopram & Co-Codamol

  1. #1
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    Jul 2013
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    Citalopram & Co-Codamol

    Morning.

    Due to start 10mg of CIT today or tomorrow but been taking co-codamol for severe tension headaches. Are you supposed to avoid codeine due to potential serotonin syndrome? I cannot get a definitive answer on the web but some sites suggest you should avoid it. If so how long should I wait after last taking co-codamol before I bosh first CIT tablet?

    Thanks
    B

  2. #2
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    Nov 2018
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    Re: Citalopram & Co-Codamol

    I'm on 20mg citalopram and I take cocodamol for headaches/period pain. Pretty sure I cleared it with the pharmacist, too.

  3. #3
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    Re: Citalopram & Co-Codamol

    Quote Originally Posted by EnoughAlready View Post
    Due to start 10mg of CIT today or tomorrow but been taking co-codamol for severe tension headaches. Are you supposed to avoid codeine due to potential serotonin syndrome?
    Probably 99% of what you find about serotonin syndrome/toxicity (SS/ST) online is nonsense. But to be fair, a lot of what is written about it in medical journals and even by WHO, MHRA, FDA and other drug regulators is just as flawed. Not my opinion, but that of one of the two leading SS/ST experts, Dr Ken Gillman, who spends much of his semi retirement trying to correct the nonsense. You can read his frustration on his website.

    There is no risk of SS/ST with taking any AD, including the MAOIs (which are the riskiest ADs for SS/ST), and codeine, as Ken explicitly says here: Monoamine Oxidase Inhibitors, Opiate Analgesics and Serotonin Toxicity.

    The opiates that have been implicated are d-propoxyphene, dextromethorphan, fentanyl, meperidine aka pethidine, methadone, tapentadol and tramadol. Dextromethorphan is the one to be wary of as it is in many over-the-counter cough and cold medicines, though whether they contain enough to cause serious issues I can't say.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  4. #4
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    Re: Citalopram & Co-Codamol

    So I think you are telling me it's ok? That right? Thanks for responding both.

  5. #5
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    Re: Citalopram & Co-Codamol

    Yes, you can take it both as there is no risk of serotonin syndrome.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  6. #6
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    Re: Citalopram & Co-Codamol

    Thanks. Supposed to start today but I'm bricking it about side effects. Think I've read way to much about worse case scenario and assumed the worst.

    Thing is I'm not depressed as far as I'm aware, I can do most normal things in life but I have situational anxiety about certain things and avoid them. I also get bad HA. Other than that I'm fine, can work OK, interact with people etc etc. I've counselling starting tomorrow and now I'm thinking maybe I should just start counselling and see if that works first.

  7. #7
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    Re: Citalopram & Co-Codamol

    Quote Originally Posted by EnoughAlready View Post
    Supposed to start today but I'm bricking it about side effects. Think I've read way to much about worse case scenario and assumed the worst.
    Support groups like NMP give a very distorted picture of side-effects. Most have no to mild side-effects, but they don't usually post about it. Unfortunately, reading about them can often trigger them. An anxious mind is very capable of producing the whole catastrophe if given the chance.

    Thing is I'm not depressed as far as I'm aware, I can do most normal things in life but I have situational anxiety about certain things and avoid them. I also get bad HA. Other than that I'm fine, can work OK, interact with people etc etc.
    Both anxiety and depression are the emotional expression of the same brain problem, atrophy of part of the two hippocampal regions of the brain caused by high brain stress hormone levels killing brain cells and inhibiting the growth of new ones. Antidepressants work by stimulating the growth of replacement cells (neurogenesis). They and the interconnects they forge produce the therapeutic response, not the ADs directly. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

    SSRIs are actually more effective anti anxiety than anti depression meds.

    I've counselling starting tomorrow and now I'm thinking maybe I should just start counselling and see if that works first.
    Cool. The cognitive/behavioural/mindfulness therapies also work by neurogenesis.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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