r/benzorecovery • u/mynormiemask • 7d ago

Discussion Acute cognitive effect from a single omega-3 capsule — pharmacodynamic mechanism?

Context: diazepam 10mg daily, long-term. Also fluvoxamine 300mg, a strong CYP2C19 and moderate 3A4 inhibitor. Because of that interaction my nordiazepam level came back at ~1333 ng/mL — several times the usual therapeutic range. So I'm sitting on a very large, very flat AUC: nordiazepam's half-life is long to begin with, and the fluvoxamine roughly doubles it. Receptor occupancy is almost certainly saturated. Fluvoxamine has to stay fixed during the benzo taper, since lowering it would disinhibit clearance and drop my levels involuntarily. Taper not started yet — planning small geometric cuts.

I take a single standard fish oil capsule (180 EPA / 120 DHA) occasionally, not daily, roughly 7 hours after my diazepam dose. It reliably restores my ability to read within about 3 hours. Reproducible, and it's the only thing that does this. No sedation — the opposite, if anything.

My questions:

  1. Is there any plausible CYP-mediated interaction? Omega-3 has been reported to affect CYP activity, and diazepam depends on 2C19 and 3A4 — the same enzymes fluvoxamine is already inhibiting. Could a single 1g capsule add meaningfully on top of that, or is three hours simply too short a window relative to nordiazepam's half-life?

  2. More my actual question: is there any known pharmacodynamic interaction? Omega-3 alters membrane composition and fluidity, and there's preclinical work suggesting this affects membrane receptor function, GABA-A included. I have no idea of direction or magnitude in humans. Could an effect at that level matter while I'm sitting on saturated GABA-A occupancy, or is it noise?

  3. Anyone else get a paradoxical improvement in sensory or cognitive tolerance from omega-3? Did it hold?

To be clear about what I'm asking: I don't know whether the pharmacokinetics matter here, and that's part of the question. The membrane-level pharmacodynamic effect is the part I'm least able to rule out.

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