Mixing Codeine (lean) and SSRIs (antidepressants)
Caution
Some SSRIs stop codeine working, which tempts redosing, and if the SSRI changes, the same dose can hit far harder. Do not redose to chase the effect.
Fluoxetine and paroxetine strongly inhibit CYP2D6, the enzyme that turns codeine into morphine. The usual result is that codeine stops working, which invites redosing — and if the SSRI is stopped or changed, the same dose can convert normally again and hit far harder than expected.
The risk here is to the body — breathing, heart, temperature or organs. Set limits before you start, because this kind of harm does not announce itself in time to react.
Headspace vs physical riskCan you mix Codeine (lean) and SSRIs (antidepressants)?
MixSafe rates mixing Codeine and SSRIs as "Caution" — carries risk that is worth understanding before combining. Reduce doses and do not use alone. Source: MixSafe research. Educational information, not medical advice.
- Codeine
- Weak, but metabolised unpredictably between people
- Codeine also called
- lean, purple drank, co-codamol, dihydrocodeine
- SSRIs also called
- ssri, zoloft, sertraline, lexapro, escitalopram, prozac
- Codeine Intoxication Associated with Ultrarapid CYP2D6 Metabolism. NEJM. https://www.nejm.org/doi/full/10.1056/NEJMoa041888
- Codeine Therapy and CYP2D6 Genotype. Medical Genetics Summaries, NCBI. https://www.ncbi.nlm.nih.gov/books/NBK100662/
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Checking more than two?
Combinations of three or more carry risks that no pair-by-pair chart can show. The checker rates every pair at once and flags the whole-mix ones on top.
Open this in the checkerRelated combinations
All combinations →Rated caution. Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety.