I am doing some research, and need someone that has a good understanding of neurotransmitters. The topic I am looking into is a bit more than my neurobiochemistry background.
Anyone have a good handle on dopamine receptors and how they interact with chronic pain, oxycodone, and the body’s natural release of dopamine in response to pain?"
I have stumbled across a possible drug interaction that may limit the effectiveness of opioids.
I have moved beyond my basic understanding of neurobiochemistry. I have a suspicion that a particular medication I am taking may be increasing my pain perception and lowering the effectiveness of opioids. I am not going to name the suspect drug because I don’t want to start a rumor that cannot be confirmed.
I posed the question to my PCP. The response was more or less “WTF! I hope you are wrong!” He is asking people that know more.
Not it either
It was worth a try. I did access one of the ChatGPT’s and found some good information.
Interesting I would love to know more. I don’t know enough about the subject matter re pain perception to help you but I certainly think more meds interact for certain people rather than generically than credit is given. Twice now I’ve had a reaction which is classed as known but very very rare. So therefore initially missed etc etc.
That made me splutter my coffee! 
“…need someone that has a good understanding of neurotransmitters.”
I have ‘some’ understanding, calling it a ‘good understanding’ might/would be stretching it. I’ve completed a few courses in pain management and pain modulation previously (prior to my own journey.) We had a day on neurotransmitters and their interactions. I’ve also attended sessions at a pain clinic as a patient, that was more a talk fest. But by no means would I say I have a complete knowledge.
Now I have been given links to pain management sites and found this which I thought may be relevant
Dopamine’s Crucial Role in “Priming” Chronic Pain (practicalpainmanagement.com)
P.S. I cant say I’m up with ChatGPT, but it will be interesting to see the info provided.
Hope it helps
Merl from the Modsupport Team
I am still researching it, but I am trying to figure out dopamine receptors as they apply to pain perception. I am taking Semaglitude and have found that it affects dopamine receptors in order to help satiation for appetite. The research indicates that reducing dopamine uptake can also increase the perception and feeling so pain. They just don’t know by how much.
Semegalite research also shows that it will reduce the effectiveness of opioids, they just do know how much. There is an indication that it will also help enthesitis, but only in studies with people with Type 2 diabetes.
I have been reading research papers for two weeks, See if you can make heads or tells out of it.
I have read the paper you linked to several times already.
Part of the problem with the question ‘How much…?’ is that it can be very subjective. For example, I’ve been taking opiates for years, so the ‘Therapeutic Dose’ I require vs the dose my wife can handle is much higher. I have a level of tolerance to the drug and I know, for me, if I keep increasing the dose my tolerance also increases, needing more and more to get the same relief. Due to my body building that tolerance and the way the medication affects my insides, I ‘try’ (not always successfully) to keep my opiate intake as low as possible. So using something that reduces the effectiveness of my primary pain med, would negate the benefit for me. Because of all of this that ‘How much?’ question would be variable for THAT individual patient.
I also have some odd drug interactions. My chemist gave me a generic version of a medication and although the active ingredient was the same, the filler caused a reaction in me. I have since spoken to my chemist and it has been agreed, if the prescription says ‘X’, you give me ‘X’. It does cost more, admittedly, but I see no sense in using a cheaper medication if it doesn’t do the job or the side effects outweigh the benefit.
I think you hit the nail on the head when you say
So, it may help for a specific condition for people with a specific condition. Both of those specifics limit the control group. Then of that group you remove users of opiates and you start getting a refined experience, rather than a broad overview of a population. This is why I’m a little reserved with some of these studies, how complete is the data they start with? If you survey the right group of people, you can get the figures to equate to any proposal.
I’m in Australia and Semaglitude has become the new weight loss magic potion. There has been a bit of a scare campaign where people who NEED it for diabetes are having difficulties obtaining it because the weight loss community are buying it all up. There was talk of it being restricted solely for diabetics. It was a big issue during COVID with the shortages in drug supply and I haven’t heard if those shortages have been overcome or not.
Merl from the Modsupport Team
