Mixing Opioids and SSRIs

Mixing Opioids and SSRIs is relatively low-risk, with roughly additive effects — TripSit rates this combination “Low Risk & No Synergy.” Low risk never means safe.

There have been some case reports of serotonin syndrome in individuals who were given a combination of opioids and SSRIs. Other research has indicated a small increase in overdose risk for people who are prescribed CYP2D6-inhibiting SSRIs (e.g. fluoxetine and paroxetine) with oxycodone. Overall, risk is low with this combination but, as always, be mindful of your consumption.

Opioids (also known as heroin, fentanyl, oxycodone, morphine, methadone) and SSRIs (also known as most antidepressants).

What to do

• Even for lower-risk pairs, the safest choice is not to mix — and never to use alone.
• Keep naloxone (Narcan) within reach. It reverses opioid overdose and is safe to give if you are unsure.
• Start with much less than usual and go slow — you can always take more, never less.
• Never use alone. If you do, call 1-800-484-3731 (Never Use Alone) so someone can send help if you stop responding.

Open the interactive combination checker

Related combinations

• Mixing Opioids and Benzodiazepines
• Mixing Opioids and Alcohol
• Mixing Opioids and Cocaine
• Mixing Opioids and Amphetamines
• Mixing Opioids and MDMA
• Mixing Opioids and Cannabis
• Mixing Opioids and Ketamine
• Mixing Opioids and GHB / GBL

This is educational information, not medical advice. "Low risk" never means "safe", and the potency of an unregulated supply is unknown.