Comment · Sat, November 9, 2013 · Ceretropic
Piracetam modifying the effects of morphine/opoids?
Original post in this thread
MisterBearcat · 2 points
I just started taking piracetam recently. Earlier today, I got a pretty severe migraine, bad enough that the usual course of home treatment of Imitrex was not sufficient, and that I needed to visit the ER. At the ER I was given an antiemetic, then a shot of morphine. Normally (I have been given shots of opioids for severe migraines before) I would expect to feel extremely out of it and to not remember (or to remember in a very fuzzy way) the period after, and to just come home and sleep it off. However, that was not the case today. While I experienced significant analgesia that fixed my migraine and a heaviness that I associate with narcotics that I've previously been given in the ER, I did not seem to experience any cognitive deficits! I talked cogently to my significant other, the doctors, and the nurses at the hospital and afterwards at home, and remember the conversations almost verbatim (including new, technical vocabulary used by the medical personnel)! A quick search shows that is at least some research on an interaction between the two:
http://www.ncbi.nlm.nih.gov/pubmed/6650196
http://www.ncbi.nlm.nih.gov/pubmed/1973390
In my experience, at least, the difference was pr…
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Direct reply to the original post — see the thread post above.
u/MisterYouAreSoDumb · Ceretropic
I've taken many opioids with all manner of racetams, and I do not find much direct interaction. Even the studies you linked showed that the effects were indirectly mediated. There is no antagonism/agonism of the opioid effects.
However, I do find that memantine interacts positively with opioids. Transmission of calcium through the NMDA receptor mediates tolerance to opiates and stimulants. Therefore, NMDA receptor antagonists like memantine can help reduce tolerance. This is very noticeable with opioids, as well as things like amphetamine. Taking them concurrently allows for lowering of dosage while maintaining or improving effects.
On the opposite side of the spectrum, racetams positively modulate the AMPA/NMDA receptors. So there could be a mechanism there for accelerating tolerance buildup to stimulants and opiates. I have noticed that since starting racetams, my tolerance to stimulants has risen steadily, even though I do not use them that often. The only common factor is my racetam use. Since starting my memantine regimen, I have noticed that my tolerance to many things has fallen drastically. I've been on oxycodone from my should surgery a couple weeks ago. The memantine has allowed me to keep my dosages much lower than my last surgery, while maintaining the desired effects. I have also noticed that my caffeine tolerance has been reset. I have not tried a stronger stimulant like amphetamine since beginning memantine, but I have a feeling my tolerance there is much lower now as well.
So yes, racetams can help to alleviate the brainfog that some people get while on opioid agonists. However, I have a feeling that they accelerate tolerance buildup. So they might be counter-productive in the long run. If someone has chronic pain, the last thing they want is to have to increase their pain pill dosage. Again, this is just postulation at this point. However, my personal experience lines up with the mechanisms.
Has anybody else noticed racetams increasing their tolerance to stimulants and/or opioids?