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Tramadol - The Insideous Daemon


Shattered

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Tramadol, aka Ultram is a Schedule IV federally controlled substance that is widely prescribed for moderate pain, as well as for chronic pain disorders such as fibromyalgia.  Its exact mechanism of action is the subject of several scientific studies and is rather complicated.  For now, let’s just say that it wreaks havoc on the brain.  There are so many ways in which it works, that it is the subject of debate and intricate testing within the pharmaceutical industry.  To make matters worse, more uses and applications for the drug are also under investigation.  The most widely reported severe adverse effect of the drug is death by seizure.  It is psychologically and physically addictive, and can be taken for legitimate medical purposes or recreational use.

 

I have heard several horror stories associated with the use of this drug.  These range from tales of withdrawal symptoms that can last for up to two weeks, to seizure survivors who have lost a degree of mental functioning due to the rather frightening neurological event. 

 

I have my own horror stories associated with the use of the drug as well, but I was stupid enough to use the drug in conjunction with SSRI antidepressants.  The first event landed me in a psychiatric hospital for two weeks.  The second event lead to an attempted overdose on Tylenol that was prompted by the delirium and frustration that comes with sleep deprivation.  This landed me in the hospital for two weeks on the brink of liver failure, and upon my recovery, a stay in a psychiatric hospital for a period of two weeks.  The worst part about it was, that even after going an entire month with no sleep before making the decision to overdose, I was awake for my entire hospital stay, my little stint in the psych ward, and for another three weeks when I returned home.

 

Plan B had to be put into effect and a bulk order of purple footballs from a currently blacklisted pharmacy was placed in an attempt to finish the job.  Luckily, good old Shattered likes to test his pills before ingesting a rather large amount of them in order to achieve the lethal dose.  I made the very wise decision to ingest ten of them in order to see if they were bunk.  They most certainly were not.  I fell asleep within an hour, and slept normally from there on.  Why this worked is a mystery to me.  Please, by all means, do not even think about using this reckless method of testing in order to fall asleep or any other reason!

 

For all of the more medically inclined readers out there, here are some of the main ways in which Tramadol alleviates pain:

 

It binds to the mu-opioid receptor simulating the action of opiates, the strength in which it does this can be compared to codeine.

 

It is a u-opioid agonist.  Agonists sensitize brain receptors in such a manner that the natural opioids in the brain are felt more intensely by the individual taking the medication.

 

It is a potent serotonin releasing agent.  Serotonin is the "feel good" chemical that is attributed to feelings of wellbeing among other things.

 

It is a norepinephrine reuptake inhibitor.  This means that it does not allow the "fight or flight" chemical to recycle itself within the brain so that it can build up within the synapses.

 

Worst of all, it is a 5-HT2c receptor antagonist.  This merely means that it blocks this particular serotonin receptor.  This is quite dangerous because it makes the possibility of seizures more likely.  Seizures of this nature commonly result in instant death.  Factors such as abrupt withdrawal from benzodiazepines or taking certain medications such as Wellbutrin or other SNRI's can increase the likelihood of seizures.  If you are taking Tramadol in conjunction with sedative/hypnotics, it is advised that you do not stop taking them under any circumstances.  This will lower the seizure threshold to dangerous levels.  One little blip on the TV could have you shuckin' and jivin' on the living room floor!  Not to mention the flickering blue light that you do not see when looking at a computer screen or a cell phone.  Not only does this light decrease levels of melatonin in the brain, but also may pose a seizure risk as well.

 

Taking Tramadol in conjunction with antidepressants of any kind can induce psychotic episodes that are quite similar to bipolar mania, but especially those that fall within the SSRI class.

 

If you are currently taking Tramadol, please do not let this information frighten you!  Abrupt discontinuation is NOT advised.  Withdrawal symptoms vary from person to person but most commonly involve a disturbing amount of insomnia. 

 

The best way to taper is over a period of months.  Cutting back the dosage by ¾ every month is the best idea.  No, this does not mean going from 100mg to 75mg to 50mg to 25mg to 0.  While this can be done, discontinuation effects may hinder your life to a certain degree.

 

The correct way to taper from a medication is to go from 100mg to 75mg to ¾ of 75mg which would be 56mg, to 42mg, to 31mg, to.23mg to 18mg per day each month.  While this may appear to be a daunting task for those who do not own a milligram scale, it is indeed the best way to taper from addictive drugs of any kind.

 

A healthy regimen of low dose benzodiazepines will most certainly ease the withdrawal symptoms or, if you continue to take the medication, cut the seizure risk down a bit.  Given the addictive nature of benzos, they should not be taken for any longer than four to six weeks. 

 

The best advice I could possibly give is to have a proper diet and exercise regimen during your withdrawal period.  I personally recommend outdoor activities.  It is amazing what some vital nutrients, extra endorphins, and the antidepressant power of sunlight can do for anyone.

 

That’s all I have for now, I have some much deserved Horned White Vein to burn, some melatonin to take from staring at this computer screen for so long, and maybe a little nap to take when I crash since I have been awake all night.

 

I guess the floor is open for questions!

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Love the Olde English spelling of "Daemon"!

That story of you finally getting sleep after taking the footballs is the one I remember reading years ago. Jesus. I have been awake for five and six days, with one night of sleep between the two....i cannot imagine what you went through after weeks of no sleep. My God. I have never been suicidal in my life. I was once while going through tramdrawals. It was awful.

People, you CAN get off of this drug. It is possible. We are living proof. Talk to us! We have lots of things that can help you! I am so lucky to be alive! Any one else's experience is welcome here! There are also two other threads about this drug.

I certainly second the exercise! You have to force yourself at first,but it will do AMAZING things for your mood. Hard hard exercise! Aerobic and weights! The more the better. Plus, having a BANGIN' body never did anything bad for someone's mood..thats for sure! It also helps with all of the muscle spasms so so much!

Thank you for posting this Shattered.

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Hey Shattered, welcome back!

 

I take zoloft and my primary prescribed tramps for neck pain. Well I got a call from the Pharmacy saying there is a slight risk of a serious reaction. They called my doc back who switched it to Vicodin.

I'm glad the Pharmacist was on the ball. Sounds like that warning about a reaction between SSRI's and Tramps is no joke. Glad you made it.

 

Then my docs practice changed the policy about prescribing narcotics and said the people in pain would have to go else where from now on, like a pain clinic. These doctors have become so paranoid about prescribing pain meds that is really does affect those in need. And now it seems some of our good alternatives are slowly disappearing but not without causing even more pain before they're completely gone.

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Ya know pharmacist don't get enough credit. They actually know more about how a drug affects a person than a doctor. I'm not slamming doctors cause they are doing their job but they are trained to prescribe according to a patients symptoms. And I'm sure doctors are required to continuous education to stay current. But Pharmacist deal with meds 24/7.

 

And even the endless parade of drug company sales people in and out of the office probably isn't enough to keep the doctors informed. Those sales snakes are just pushing their high priced brand name meds.

 

Sorry, I'm straying again from the real topic.

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Hey Shattered, welcome back!

 

I take zoloft and my primary prescribed tramps for neck pain. Well I got a call from the Pharmacy saying there is a slight risk of a serious reaction. They called my doc back who switched it to Vicodin.

I'm glad the Pharmacist was on the ball. Sounds like that warning about a reaction between SSRI's and Tramps is no joke. Glad you made it.

 

Then my docs practice changed the policy about prescribing narcotics and said the people in pain would have to go else where from now on, like a pain clinic. These doctors have become so paranoid about prescribing pain meds that is really does affect those in need. And now it seems some of our good alternatives are slowly disappearing but not without causing even more pain before they're completely gone.

 

Hey HB, thank you for the welcome, it feels really good to be back at my true home.  Being given a second chance like this is downright amazing. 

 

Due to the fact that Tramadol causes the brain to release rather large amounts of serotonin, and the fact that Zoloft keeps serotonin from breaking down, it puts a person at risk for a very dangerous condition known as "Serotonin Syndrome".  I know that the first signs are nausea and diarrhea, but would have to look up a few things on the subject for more information.  Let's just say that "Serotonin Syndrome" warrants a trip to the ER where a serotonin blocking agent is given to the patient in order to reverse the potentially deadly effects of the condition.  I can imagine a person losing their mind a bit in the process as well.   So yeah, the pharmacist may very well have saved your life!  Write on your calendar to send him or her a Christmas card next year :D.

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Having been on 150 mg of effexor and up to 2000 mg a day of tramadol for two years, can I just say Amen? I am very lucky to be here.

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2000 holy shit. I can't even fathom what a taper off that would be.

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Yeah what headbanger said is kind of true, sometimes the pharmacist knows more about drug interactions than the Doctor. I was prescribed Tramadol and Celexa at the same time a couple of months ago. When I went to Wallgreens to fill them, they said I couldn't fill the Celexa because there was a drug interaction with the Tramadol. But then they said I could come back in a couple days and fill the Celexa. So I don't know what the point of not filling the Celexa for only two days with if I was going to be taking both anyway after those two days past. They called my doctor but couldn't get through to him. The next time I went to the Doctor to get my refills I asked him if he can up my Tramadols from 90 to 120. He said he can't unless I stop taking the Celexa (but he would still give me 90 with the Celexa, go figure). I was about to tell him to up the Tramadol and I'll stop taking Celexa, but instead he switched me to Lexapro because I requested that change, but he still gives me the 90 trams on top of that. I'm not sure if this doctor knows about the danger of combining Tramadol with an SSRI, like you guys have been talking about, but i have been taking both meds as prescribed and haven't had any issues with that. I wonder if I can ask the Doc to give me a different pk than Tramadol but he already gives me T4's so I'm not sure if he would be willing to do it. Also I would have to explain why Tramadols don't interact well with an SSRI and I don't know if he would be willing to listen to that. 

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Yeah what headbanger said is kind of true, sometimes the pharmacist knows more about drug interactions than the Doctor. I was prescribed Tramadol and Celexa at the same time a couple of months ago. When I went to Wallgreens to fill them, they said I couldn't fill the Celexa because there was a drug interaction with the Tramadol. But then they said I could come back in a couple days and fill the Celexa. So I don't know what the point of not filling the Celexa for only two days with if I was going to be taking both anyway after those two days past. They called my doctor but couldn't get through to him. The next time I went to the Doctor to get my refills I asked him if he can up my Tramadols from 90 to 120. He said he can't unless I stop taking the Celexa (but he would still give me 90 with the Celexa, go figure). I was about to tell him to up the Tramadol and I'll stop taking Celexa, but instead he switched me to Lexapro because I requested that change, but he still gives me the 90 trams on top of that. I'm not sure if this doctor knows about the danger of combining Tramadol with an SSRI, like you guys have been talking about, but i have been taking both meds as prescribed and haven't had any issues with that. I wonder if I can ask the Doc to give me a different pk than Tramadol but he already gives me T4's so I'm not sure if he would be willing to do it. Also I would have to explain why Tramadols don't interact well with an SSRI and I don't know if he would be willing to listen to that. 

Who else know all that about interactions (or diferential diagnostic) if not the pharmacist. Most doctors don't inverst their time and IP to think about
interactions if not stated big and fat in the leaflet.

Just my 0.02

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A good GP will have at least the current issue of all meds currently in use. In the UK it's called the British National Formulary and is updated twice a year, I have  a very recent one myself as it happens. Whether they consult this book regularly or not is another matter of course! 

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A good GP will have at least the current issue of all meds currently in use. In the UK it's called the British National Formulary and is updated twice a year, I have  a very recent one myself as it happens. Whether they consult this book regularly or not is another matter of course! 

Got 2014 copy for £8! Your knowledge scares me sometimes haha. What a guy.

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Glad I could help snoop! 

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