Co-codamol and dysphoria?

[Kiltie]

I was taking prescribed co-codamol for a couple of weeks.

Much of this time I felt quite unhappy but put it down to feeling sorry for myself due to the underlying problems that the co-codamol was intended to help.

I ran out before the weekend and I've been taking the "over the counter" strength for a few days.

Yesterday, I was thinking that everything was rosy and really feeling great ... I also picked up my new prescription (15mg / 500mg).

Today, there's a big black cloud over me - not nice.

Has anyone else felt quite "down" when taking co-codamol?

Cheers,

Eric

[Rollcage]

Not down, no. Can give headaches with prolonged useage though, in my experience. You want 50/500 dyhydrocodeine for full effect. You won't feel a thing!

[BlackVanDyke]

It made me feel a bit dissociative, is that what you mean?

[Rollcage]

I think it's because it's an opiate based drug. The really powerful ones can completely space you out if you aren't used to them.

It's the feeling heroin addicts get - and also why the WW1 bred a legion of junkies, as they were given Opium for pain relief!

[dumfriesdave]

Definitely give a feeling of disinterest.

Felt similar when I first started them Kiltie so you are not alone.
As stated it has an opiate-type mellowing sensation - if my partner has trouble sleeping she gets back up out of bed, takes one and she's fast asleep in no time.

I take 30/500 and use 50-60 in a week.

[LordGrover]

Have a chat with pharmacist or prescribing GP.

[duncancallum]

I do after taking the 30mg for a few days I get really blue and listless.

[Kiltie]

anonymous said:

[redacted]

BlackVanDyke said:

... dissociative ...

dumfriesdave said:

... feeling of disinterest ...

duncancallum said:

... blue and listless ...

Yup, this is all very familiar. Thanks people.

I've taken none today. Thankfully, my pain isn't too bad and "parrots eat 'em all" is adequate.

I'm feeling much better in my head ... but look ... 03:23 and I have work in the morning.

Ho hum!

Eric

[scorp]

dumfriesdave said:

I take 30/500 and use 50-60 in a week.

500mg paracetamol x 60 = 30000mg per week, the daily safe limit is 2000mg? Doesn't sound good for your liver.

[dumfriesdave]

scorp said:

500mg paracetamol x 60 = 30000mg per week, the daily safe limit is 2000mg? Doesn't sound good for your liver.

I also take a drug called azathioprine (a tablet form of mild chemotherapy that can destroy bone marrow amongst other side effects) which can also affect liver and pancreas function, so as a result have regular blood tests which flag up any problems.

[BlackVanDyke]

scorp said:

dumfriesdave said:

I take 30/500 and use 50-60 in a week.

500mg paracetamol x 60 = 30000mg per week, the daily safe limit is 2000mg? Doesn't sound good for your liver.

You've got your (normal) daily safe limit wrong - it's 4g/4000mg. One tablet is 500mg, it's 4 lots of 2 tablets a day. So the OP shouldn't be getting through more than 56, which is bang on what he said!

I found that a decently strong coffee helped with some of the side effects.

[mph1977]

scorp said:

dumfriesdave said:

I take 30/500 and use 50-60 in a week.

500mg paracetamol x 60 = 30000mg per week, the daily safe limit is 2000mg? Doesn't sound good for your liver.

daily dose for paracetamol if you have normal liver function is 4g

4g *7 = 28g

[honest_delboy]

I felt like I was on the outside looking in. Watching a movie about myself where is was played by a slightly overweight version of me.

It does help me get to sleep though.

As an opiate it slows down your peristalsis(sp?) too, and when you stop taking them..... oh boy.

[BlackVanDyke]

honest_delboy said:

I felt like I was on the outside looking in. Watching a movie about myself where is was played by a slightly overweight version of me.

It does help me get to sleep though.

As an opiate it slows down your peristalsis(sp?) too, and when you stop taking them..... oh boy.

I still reckon they ought to put people on Lactulose when they start them on any opiate or opioid as standard.

[mph1977]

BlackVanDyke said:

I still reckon they ought to put people on Lactulose when they start them on any opiate or opioid as standard.

or movicol

the solution to opiate related constipation is prevention

[BlackVanDyke]

mph1977 said:

BlackVanDyke said:

I still reckon they ought to put people on Lactulose when they start them on any opiate or opioid as standard.

or movicol

the solution to opiate related constipation is prevention

Eeexactly. It's just unkind for them to wait until the patient is in enough pain to ask for help a week later...

(ps hate movicol. Gives me worse gutache than a dose of e. coli did!)

[Prof Prolapse]

I'd be surprised if you're experiencing problems at such a low dose.

There's a school of thought however that 15/500 formulations should be banned as it doesn't have any beneficial analgesic effect but potentially still retains the addictive properties.

I've never derived any benefit from anything below 30/500 (x2) and even that is negligible between that and a gram of Paracetamol alone.

[mph1977]

Prof Prolapse said:

I'd be surprised if you're experiencing problems at such a low dose.

There's a school of thought however that 15/500 formulations should be banned as it doesn't have any beneficial analgesic effect but potentially still retains the addictive properties.

I've never derived any benefit from anything below 30/500 (x2) and even that is negligible between that and a gram of Paracetamol alone.

conversely there is supposedly a ceiling effect on codeine doses which means that 15 / 500 should be the normal choice ...

[Prof Prolapse]

Whilst it's been a few years since I studied it my understanding is that's old school thinking. Only about 5% of Codeine is metabolised by CYP2D6 to morphine(a rate limiting step). The majority of the analgesic effect comes from the metabolism to Codeine-6-glucoronide by the phase II enzyme UGT2B7. I think this is about 70%, and it isn't limited to the same extent. So higher doses will yield a higher analgesic effect.

[Silent1]

mph1977 said:

Prof Prolapse said:

I'd be surprised if you're experiencing problems at such a low dose.

There's a school of thought however that 15/500 formulations should be banned as it doesn't have any beneficial analgesic effect but potentially still retains the addictive properties.

I've never derived any benefit from anything below 30/500 (x2) and even that is negligible between that and a gram of Paracetamol alone.

conversely there is supposedly a ceiling effect on codeine doses which means that 15 / 500 should be the normal choice ...

600mg is the ceiling dose for codeine, well past the sensible therapeutic dose