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MAOI's and Suboxone

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Entheogenerator

Entheogenerator

Homo discens
I am well aware that there are significant risks associated with taking MAOI's and full agonist opiates, but I have not been able to find any information regarding ingestion of an MAOI in combination with a partial agonist opioid, such as buprenorphine. I have thus far chosen to err on the side of caution, assuming that it could cause a dangerous interaction. But I am curious as to whether or not the people of The Nexus could shed some light on the subject. I have been utilizing Suboxone treatment for about 6 months, and will likely continue the treatment for at least another 6 because it has been an enormous help and I have experienced very positive results from the treatment. Entheogens have played a major role in my treatment and I believe they have contributed largely to my progress. I am eager to experiment with pharmahuasca and harmala-containing changa, but obviously I cannot do that if there are serious health risks involved. Any information would be greatly appreciated!:thumb_up:
 
Hello, there has been some thread about that. I'm sure you can find some.
As for combining the two I think it's better to stay safe, you can always use tryptamines with NO MAOI/RIMA until you're clean off subuxone.
If you search the forum try to read corpus collapsum, he is one user who knows a bit in pharmacodynamics.
 
Buprenorphines plasma level can be increased by concomitant administration of inhibitors of CYP3A4, of which harmine is an example, so using this as (part of) your RIMAs to activate DMT orally can potentially be hazardous.I would avoid oral harmalas with buprenorphine on board.
 
Thanks everyone. I figured that this would be the case, but I thought I would ask anyways. I intend to wait on the aya/pharmahuasca until I finish buprenorphine treatment. I very much enjoy my tryptamines without MAOI's, so waiting won't be a problem. 😁
 
I actually heard about a study where they combined Suboxone with an MAOI medication in their subjects, and results were not bad. Please don't quote me on this though, because I never read the actual article. See if you can find it. Because I've actually heard from more sources than not that if you're on a low dose of Suboxone, it's okay to take the RIMA MAOIs. I've searched for this online many times and this is actually the only thread I've ever seen where people said it shouldn't be safe. I'm probably going to get flamed for saying that, so let me make it very clear that ***I am not telling you that it is safe or to go ahead and try***. I'm at the very least suggesting that you try to find some scientific information on the topic. :)
 
chaosbydesign said:
I actually heard about a study where they combined Suboxone with an MAOI medication in their subjects, and results were not bad. Please don't quote me on this though, because I never read the actual article. See if you can find it. Because I've actually heard from more sources than not that if you're on a low dose of Suboxone, it's okay to take the RIMA MAOIs. I've searched for this online many times and this is actually the only thread I've ever seen where people said it shouldn't be safe. I'm probably going to get flamed for saying that, so let me make it very clear that ***I am not telling you that it is safe or to go ahead and try***. I'm at the very least suggesting that you try to find some scientific information on the topic. :)
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Thank you, I will definitely look into it. I still plan to be cautious and wait until I finish the treatment, but I am interested and I look forward to reading the article. :thumb_up:
 
chaosbydesign said:
I actually heard about a study where they combined Suboxone with an MAOI medication in their subjects, and results were not bad. Please don't quote me on this though, because I never read the actual article. See if you can find it. Because I've actually heard from more sources than not that if you're on a low dose of Suboxone, it's okay to take the RIMA MAOIs. I've searched for this online many times and this is actually the only thread I've ever seen where people said it shouldn't be safe. I'm probably going to get flamed for saying that, so let me make it very clear that ***I am not telling you that it is safe or to go ahead and try***. I'm at the very least suggesting that you try to find some scientific information on the topic. :)
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Its important to recognise that all RIMAs are not the same.Apart from their MAO-A effects you have to consider how each agent is metabolised and whether or not this can have knock-on unintended effects.Harmine specifically inhibits the enzyme required to process buprenorphine which is clearly not ideal.

The datasheet on moclobemide, for example, mentions concomitant use with opioids has been shown to potentiate opioid effects in animals and , I quote, "dosage adjustment may be necessary".It would be unwise to ignore this.

Lastly, some opioids have serotonin-enhancing effects which make them particularly hazardous with MAOIs- these include pethidine, methadone and DXM; recently Jannsen Cilag, the makers of Durogesic (Fentanyl) patches issued an update to prescribers warning of hazards with this and other agents with serotoninergic effects such as SSRIs.Codeine, morphine, oxycodone and buprenorphine are not regarded as having significant serotonin-releasing effects so if a MAOI had to be used with opiates then these agents are safest, but not necessarily 100% safe.
 
I apologise for reviving this thread, but I've also been asked this question. I understand what has been said so far, but wonder whether buprenorphine potentiation would actually be such a dangerous thing. Hear me out. Classic opiates like morphine or heroin have straight-up agonist activity, right? So their dose-response curve just keeps going up and up, or to put it another way, as you increase the dose, you will just keep getting stronger and stronger effects until you reach the point where you die of respiratory depression. Now afaik this is NOT the case with buprenorphine. Bupe, being a partial agonist, binds to the opiate receptors without activating them fully. This means that above a certain level (usually somewhere around 30mg if the dosing guidelines are anything to go by), the opiate effects of this drug just won't get significantly stronger. So even if your effective dose of bupe is doubled by MAOIs, it will still be subject to this "ceiling effect".

Of course, this doesn't necessarily mean that this will absolutely be safe, there may be some active metabolite hiding in the woodwork, just waiting for monoamine oxidase or cyp3a4 to retreat...

But generally speaking, the partial-agonist effect is very important when comparing buprenorphine safety to that of classic opioids. Bupe is VERY difficult to overdose on.
 
Anodyne said:
I apologise for reviving this thread, but I've also been asked this question. I understand what has been said so far, but wonder whether buprenorphine potentiation would actually be such a dangerous thing. Hear me out. Classic opiates like morphine or heroin have straight-up agonist activity, right? So their dose-response curve just keeps going up and up, or to put it another way, as you increase the dose, you will just keep getting stronger and stronger effects until you reach the point where you die of respiratory depression. Now afaik this is NOT the case with buprenorphine. Bupe, being a partial agonist, binds to the opiate receptors without activating them fully. This means that above a certain level (usually somewhere around 30mg if the dosing guidelines are anything to go by), the opiate effects of this drug just won't get significantly stronger. So even if your effective dose of bupe is doubled by MAOIs, it will still be subject to this "ceiling effect".

Of course, this doesn't necessarily mean that this will absolutely be safe, there may be some active metabolite hiding in the woodwork, just waiting for monoamine oxidase or cyp3a4 to retreat...

But generally speaking, the partial-agonist effect is very important when comparing buprenorphine safety to that of classic opioids. Bupe is VERY difficult to overdose on.
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Yes, I am aware of the "ceiling effect" that you mention, and I appreciate you contributing that to the discussion. But at this point, I have decided to err on the side of caution and not take harmalas until I am buprenorphine-free. I would encourage you to do the same, but you are your own person and must make your own choices.

The last thing I need to be worrying about during an aya experience is whether or not I might be dying from respiratory depression. :?
 
Especially when you consider how higher doses of ayahuasca can feel that way anyway-- like a giant snake is constricting you or something really heavy is sitting on your chest. Used to freak me out at first.
 
Personally I would be more worried about the prospect of taking a journey without "putting my affairs in order first", so to speak The weight of that unfinished business just hangs over me whenever I've tried this. I don't think I took any psychoactive for years during my extended bupe taper (thankfully over now!). Of course, sometimes that business is the reason for taking the journey in the first place... I guess it all depends on the individual and their priorities - some people in this same position might be considering ibogaine, for instance, which I would rank as a whole lot more risky than any bupe/maoi combo. So a lot depends on how risky their other options are.

I still have some friends on bupe, and this topic comes up from time to time. I was just bumping the thread on the chance that there might have been some updates. I totally respect your decision Entheogenerator, and wish you all the best with it. It is such a great feeling to be free!
 
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