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  #1  
Old 10-09-2013, 03:30 PM
RedBloom RedBloom is offline
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Tramadol withdrawal... SUCKS

I was put on this drug that basically saved my life in so many ways... 6 years ago. Pain/depression/anxiety - GONE. Doc decided that 6 years has been long enough now, it's lost it's efficacy and she refused to up the dose or switch me to something else. BAM. I weaned off for a couple of days and now I feel like death - day 2 into really nasty withdrawals I had no idea would happen. Not much is helping, and being that Tramadol is not even a narcotic, I'm surprised I feel this ROTTEN. I hate my doctor. HATE her. Please tell me this gets better... pleeeaaase.

This sucks.
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  #2  
Old 10-09-2013, 03:32 PM
Chimera Chimera is offline
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Most withdrawal sucks.

It will get better. It will just take time.
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  #3  
Old 10-09-2013, 03:36 PM
RedBloom RedBloom is offline
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I wonder how *much* time. Any more than a week and I might dig my own grave.
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  #4  
Old 10-09-2013, 03:53 PM
hotflungwok hotflungwok is offline
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What dose were you taking? Did you dr wean you off or just tell you stop taking it?

I take Tramadol for pain (I am clinically depressed and have noticed it's effect), I think I take 100mg pills. They used to have a significant effect on me, but lately I have to take at least 2 to feel anything different. I dont take it regularly, just as I need it.

It's sold as a painkiller OTC in England (IIRC).
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  #5  
Old 10-09-2013, 03:54 PM
Thrasymachus Thrasymachus is offline
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{{RedBloom}}

As a fellow anxiety/depression sufferer (although I never tried Tramadol), your body will adjust. Shame on your doc for not putting you on a graduated withdrawal, you may want to push on her about that.

The wikipedia article on Tramadol says 7 days or so for withdrawal, and it is severe...

http://en.wikipedia.org/wiki/Tramadol

Best thing to do is try to find something immersive to take your mind off the withdrawal symptoms, e.g.:
  • Something you enjoy and can lose yourself in (like maybe sculpture, video games, hanging out with friends) = good

  • Lying in bed staring at the clock and being hyper-aware of every bad sensation = bad
Good luck!
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  #6  
Old 10-09-2013, 03:55 PM
RedBloom RedBloom is offline
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I took 50mg 3X daily for 6 years. She abruptly stopped me. I asked what to do about withdrawals (as I've stopped taking them before and knew it may happen). Her suggestion? "Go to the Rehab Clinic".

Yeah, you do build up a tolerance quickly, but I never felt the need to ask for more. Well, when I did recently, she took me off of it. Grrr.
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  #7  
Old 10-09-2013, 03:55 PM
Chimera Chimera is offline
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I had been on a minimal dose of an anti-depressant during my brief marriage - at my wife's insistence (she was on SSDI for Mental Illness). When we separated, I went to my doctor and asked to come off it. He refused. So I stopped seeing him and stopped taking it cold turkey. Was pretty bad for about a week. The expression in Lord of the Rings where Bilbo says "Like butter scraped over too much bread" was one possible description. Having your mind randomly stretched like taffy was another.

But it passed.
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  #8  
Old 10-09-2013, 04:07 PM
2gigch1 2gigch1 is offline
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I'm very sorry to read this.

With absolutely no snark intended I suggest this may be a good time to find a new doctor. The lack of compassion shown by your doctor here is saddening, and you don't deserve it.

A new doctor may not help you in this situation, but I sure as hell wouldn't want to have to deal with the same doctor in a future situation. Sounds like a deal breaker.

Good luck in your recovery.
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  #9  
Old 10-09-2013, 05:56 PM
Merneith Merneith is offline
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Originally Posted by RedBloom View Post
I was put on this drug that basically saved my life in so many ways... 6 years ago. Pain/depression/anxiety - GONE. Doc decided that 6 years has been long enough now, it's lost it's efficacy and she refused to up the dose or switch me to something else. BAM. I weaned off for a couple of days and now I feel like death - day 2 into really nasty withdrawals I had no idea would happen. Not much is helping, and being that Tramadol is not even a narcotic, I'm surprised I feel this ROTTEN. I hate my doctor. HATE her. Please tell me this gets better... pleeeaaase.

This sucks.
Tramadol is an opioid, like codeine. That makes it a narcotic, even though the laws regarding it aren't as stiff as other opioid. It varies by state. It does affect serotonin and dopamine but it's mostly a painkiller. I'm not surprised that your doctor wanted to take you off it rather than up your dose. She probably won't put you back on it but you might talk to her or a therapist about going on a more typical antidepressant.

Tramadol's got a nasty withdrawal window, which lasts about a week. If it gets really bad don't hesitate to go to your doctor or even your ER to help you through it.
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  #10  
Old 10-09-2013, 09:11 PM
curlcoat curlcoat is offline
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Originally Posted by 2gigch1 View Post
I'm very sorry to read this.

With absolutely no snark intended I suggest this may be a good time to find a new doctor. The lack of compassion shown by your doctor here is saddening, and you don't deserve it.

A new doctor may not help you in this situation, but I sure as hell wouldn't want to have to deal with the same doctor in a future situation. Sounds like a deal breaker.

Good luck in your recovery.
Another vote for a new doctor. That response is not only unfeeling, it could end up being medically dangerous! If any of my doctors did that to me, I'd camp out in their office during the worst of the symptoms. Go to the Rehab Clinic indeed ...
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  #11  
Old 10-09-2013, 09:16 PM
Chimera Chimera is offline
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As I always say;

Professionals work for you.
If they don't work for you,
find another.
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  #12  
Old 10-09-2013, 10:14 PM
nearwildheaven nearwildheaven is offline
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Tramadol is one of the most addictive legal substances out there. I would personally have to be VERY desperate before I took it; it also has some very common and unpleasant side effects.
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  #13  
Old 10-10-2013, 07:48 AM
RedBloom RedBloom is offline
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Originally Posted by nearwildheaven View Post
Tramadol is one of the most addictive legal substances out there. I would personally have to be VERY desperate before I took it; it also has some very common and unpleasant side effects.
After reading up on it a bit more - I've discovered this as well. I really had no idea it was as potent as it was... hence the horrific withdrawals I imagine.
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  #14  
Old 10-10-2013, 07:51 AM
RedBloom RedBloom is offline
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I will most definitely be getting a new doctor.

My problem is that I'm already on antidepressants, I have been for 11 years. They started pooping out, hence the Tramadol for depression/pain relief. Now I'm left on this antidepressant and anti-anxiety meds that make me a ZOMBIE. At least the Tramadol gave me some life and energy. I was functioning very high level. Now I feel dead.

Even stranger tidbit yet? My doctor referred me to a Neurologist.
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  #15  
Old 10-10-2013, 07:57 AM
Merneith Merneith is offline
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I don't know what's up with the neurologist but it might be time to try a different antidepressant and different combos. It might be time to start fresh. But one withdrawal at a time. It's something to discuss with your new doctor. Maybe it's time to talk to a psychologist, too. I don't know of course, but they have more experiences with these meds than regular doctors do.
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  #16  
Old 10-10-2013, 08:01 AM
Sateryn76 Sateryn76 is online now
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Are you doing any kind of CBT or other talk therapy?
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  #17  
Old 10-10-2013, 08:13 AM
Truman Burbank Truman Burbank is offline
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Originally Posted by Merneith View Post
I don't know what's up with the neurologist but it might be time to try a different antidepressant and different combos. It might be time to start fresh. But one withdrawal at a time. It's something to discuss with your new doctor. Maybe it's time to talk to a psychologist, too. I don't know of course, but they have more experiences with these meds than regular doctors do.
Nitpick: "Psychiatrist", not psychologist. Actually, the suggestion about the chemical dependency (Rehab clinic) followup wasn't a bad one. This is a big part of what they do. If I was you, that's where I'd go now, rather than white-knuckling it or looking for help from an ER doc.

Last edited by Truman Burbank; 10-10-2013 at 08:15 AM..
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  #18  
Old 10-10-2013, 08:36 AM
RedBloom RedBloom is offline
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I see a talk therapist.

I see a psychiatrist (his comment about coming off Tramadol was "I'm sorry - withdrawal is out of my scope. You'll need to see your doctor".

NO doctors want to deal with painkillers or withdrawals. NONE. It must look bad to be associated with people who have had dependancies or addictions and there is too much liability.

I am going to work every day and taking care of my 2 kids through this personal hell. I have to. I can't stop my life to be depressed or sleep. My pity party is getting noisier, isn't it.
I'm completely disheartened by everything and everyone. The help that is extended is in vain - the doctors see me drowning and they throw me a line of dental floss. That's what this struggle feels like.
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  #19  
Old 10-10-2013, 08:48 AM
Chimera Chimera is offline
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Bear in mind that it seems worse because of the psychological effects of the withdrawal. Knowing that this is not necessarily real, that it is how it is making you feel and it is only temporary, may help you struggle through it.
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  #20  
Old 10-10-2013, 09:28 AM
Truman Burbank Truman Burbank is offline
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Originally Posted by RedBloom View Post
I see a talk therapist.

I see a psychiatrist (his comment about coming off Tramadol was "I'm sorry - withdrawal is out of my scope. You'll need to see your doctor".

NO doctors want to deal with painkillers or withdrawals. NONE. It must look bad to be associated with people who have had dependancies or addictions and there is too much liability.

I am going to work every day and taking care of my 2 kids through this personal hell. I have to. I can't stop my life to be depressed or sleep. My pity party is getting noisier, isn't it.
I'm completely disheartened by everything and everyone. The help that is extended is in vain - the doctors see me drowning and they throw me a line of dental floss. That's what this struggle feels like.
Well, again, the MDs in Rehab aren't scared. Is there a reason you don't want to try that option? It's not a moral/ethical issue, you're (medically) addicted, and that's their scope of practice specifically.
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  #21  
Old 10-10-2013, 09:39 AM
RedBloom RedBloom is offline
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Well, again, the MDs in Rehab aren't scared. Is there a reason you don't want to try that option? It's not a moral/ethical issue, you're (medically) addicted, and that's their scope of practice specifically.
I.... am saving that for a last ditch effort. As many people have stated, "you were ONLY on 50mg 3 times per day? Shit, that's nothing".

Not true for me.

But, I will seek help... if I get to the edge of the cliff.
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  #22  
Old 10-10-2013, 11:14 AM
Qadgop the Mercotan Qadgop the Mercotan is offline
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If your doc has tapered you down over a week or three to about 50 mg a day, then cut you off, that's not bad care. That's a tapering dose.

I'll offer my patients a little clonidine at that point, if they're really jonesing, but there's nothing life or health-threatening about opioid withdrawal in and of itself.

I hate tramadol. If a patient needs an opioid for chronic pain (a few do), then I personally think one's better taking long-acting morphine. Less of a buzz, smoother detoxes, fewer problems if doses are missed. Not that I'm big on prescribing morphine either, but it's better than tramadol for chronic pain.
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  #23  
Old 10-10-2013, 12:00 PM
Silver Fire Silver Fire is offline
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Wow, this thread is completely insane to me. I've been taking 50-100mg tramadol PRN for pain (love the antidepressant effects) for three years. My doctor switched me to oxycodone when I became too pregnant to do the stretches that sometimes help, but I quit taking tramadol on my own the moment I started trying to get pregnant and had no effects at all. I also never experienced any terrible side effects. It makes me more affectionate (and almost insatiably horny sometimes) and occasionally I couldn't sleep but I always attributed that to "Hey, I'm not in pain and that's really pleasant. I don't want to waste it." Neither of those effects, for me, are bad.

To be fair re: lack of withdrawal symptoms, I only took it very occasionally, same with the Percocet now. A 30 pill bottle could last anywhere from a couple weeks to well over a month. Plus, I've quit illegal street drugs (meth is probably the "hardest" one) cold turkey with absolutely no symptoms too so I think I'm just lucky.

Sorry you're having a hard time. :/
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  #24  
Old 10-10-2013, 12:23 PM
RedBloom RedBloom is offline
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Wow, this thread is completely insane to me. I've been taking 50-100mg tramadol PRN for pain (love the antidepressant effects) for three years. My doctor switched me to oxycodone when I became too pregnant to do the stretches that sometimes help, but I quit taking tramadol on my own the moment I started trying to get pregnant and had no effects at all. I also never experienced any terrible side effects. It makes me more affectionate (and almost insatiably horny sometimes) and occasionally I couldn't sleep but I always attributed that to "Hey, I'm not in pain and that's really pleasant. I don't want to waste it." Neither of those effects, for me, are bad.

To be fair re: lack of withdrawal symptoms, I only took it very occasionally, same with the Percocet now. A 30 pill bottle could last anywhere from a couple weeks to well over a month. Plus, I've quit illegal street drugs (meth is probably the "hardest" one) cold turkey with absolutely no symptoms too so I think I'm just lucky.

Sorry you're having a hard time. :/
I'm curious - why did the doctor put you on Tramadol? Back pain? People think I'm too young to be on pain medicine... but I always hurt and ache all over, from my neck to my shoulders to my head to my lower back. My doc thinks I have a "pain perception" problem Regardless, my pain is very real, and doctors don't take it seriously unless someone is screaming or crying. This may be why I'm headed to a neurologist. I suspect my doctor has had it with my bitching and is moving me to the next specialist.
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  #25  
Old 10-10-2013, 01:19 PM
MOIDALIZE MOIDALIZE is offline
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I hate when doctors sling medication like they're corner drug pushers, then suddenly get a conscience about it later.

My stepdad is 64. He works 2nd shift maintenance at a hospital. He herniated a disc in his back years ago, which still gives him pain, and he's had three knee replacement surgeries performed on the same knee, which he can only bend about 30% of a normal range of motion. But his job requires him to be on ladders and walking all over the hospital. Thus, he's often dealing with pain, and a regular sleep schedule is difficult for him to maintain. So his doctor put him on Oxy and Ambien. Is he too reliant on those medications? Possibly. Do they help him endure life? Undoubtedly.

Now, apparently, his doctor is giving him a hard time about getting more prescriptions. He's the one who got him hooked to begin with! And honestly, is it really a mortal sin if this older man can get medicated so he can keep trudging off to his job? He'll be retiring soon anyway, he doesn't need the gratuitous pain to push him out the door.
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  #26  
Old 10-10-2013, 01:33 PM
carnivorousplant carnivorousplant is offline
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I've taken 50 mg Tramadol for a couple of years and never noticed anything except reduction in pain.
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  #27  
Old 10-10-2013, 02:32 PM
Silver Fire Silver Fire is offline
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Originally Posted by RedBloom View Post
I'm curious - why did the doctor put you on Tramadol? Back pain?
Back pain, yes. To my knowledge, there isn't actually anything wrong with my back. The problem is my hips which were somehow messed up during my last pregnancy. The stretch I learned was incredibly helpful* until about 6-7 months into my current pregnancy when my belly became just too big to do it anymore. That's why I typically can get by with so few pills.

* Lie flat on your back with knees bent and cross legs man-style with the ankle on the knee. Lift and move legs toward chest. I have my husband push slowly until I can really feel it and then hold for like 20 seconds. Alternate legs and repeat. Then I do bicycle kicks for like a minute and sometimes I'll touch the bottoms of my feet together, move them up to my ass, and spread my legs as far as I can and hold. Helps my back pain tremendously.

Last edited by Silver Fire; 10-10-2013 at 02:34 PM..
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  #28  
Old 10-10-2013, 03:26 PM
Uber_the_Goober Uber_the_Goober is offline
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Originally Posted by RedBloom View Post
I.... am saving that for a last ditch effort. As many people have stated, "you were ONLY on 50mg 3 times per day? Shit, that's nothing".

Not true for me.

But, I will seek help... if I get to the edge of the cliff.
Hey no joke, don't wait that long. You may fall off the edge before stepping back. Don't wait until you're too miserable to even care.

Take advantage of the presence of mind you have right now and get in touch with another doctor, so they can evaluate your situation from another perspective!
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  #29  
Old 10-10-2013, 05:09 PM
Soul Brother Number Two Soul Brother Number Two is offline
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If the OP is telling the truth, and the doctor did not taper the dose but abruptly stopped the meds, I would file a complaint.
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  #30  
Old 10-10-2013, 05:16 PM
SerafinaPekala SerafinaPekala is offline
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Have you tried Darvocet? That seems to give me the "buzzed&warm all over" feeling some describe on Tramadol (bad bad drug) without the bad withdrawal potential.

Combining Tramadol with SSRI can cause seizures, as Im sure you know:

"Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects."
http://arthritis.about.com/od/ultram/a/tramadol.htm

Tapering would def be the way to go to avoid seizures.
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  #31  
Old 10-10-2013, 06:05 PM
Truman Burbank Truman Burbank is offline
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Originally Posted by SerafinaPekala View Post
Have you tried Darvocet? That seems to give me the "buzzed&warm all over" feeling some describe on Tramadol (bad bad drug) without the bad withdrawal potential.

Combining Tramadol with SSRI can cause seizures, as Im sure you know:

"Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects."
http://arthritis.about.com/od/ultram/a/tramadol.htm

Tapering would def be the way to go to avoid seizures.
Probably not the best advice I've seen given today.
1) requires prescription, and may not even be available in the US any more. Googling quickly brings us to a site which informs us:
Darvocet-N (propoxyphene napsylate and acetaminophen) is a Schedule IV narcotic under the U.S. Controlled Substances Act. Darvocet-N (propoxyphene napsylate and acetaminophen) can produce drug dependence of the morphine type, and therefore, has the potential for being abused.
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  #32  
Old 10-10-2013, 06:07 PM
SerafinaPekala SerafinaPekala is offline
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Well, of COURSE it requires Rx but its a step-down drug from Tramadol! Just trying to suggest ways to cope with the withdrawals which is what the thread is about, no?
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  #33  
Old 10-10-2013, 07:28 PM
Silver Fire Silver Fire is offline
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Meds containing propoxyphene have been off the market for years. Darvocet was an absolute shit pain killer anyway but, IIRC, the company pulled it due to ease of overdose and potentially fatal side effects even at recommended dosages.
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  #34  
Old 10-10-2013, 07:30 PM
Qadgop the Mercotan Qadgop the Mercotan is offline
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Well, of COURSE it requires Rx but its a step-down drug from Tramadol! Just trying to suggest ways to cope with the withdrawals which is what the thread is about, no?
Propoxyphene (darvon, darvocet, etc.) is no longer available in the US, and I'd not consider it a step down from tramadol anyway. If one is physically dependent on tramadol, just taper tramadol, don't substitute another opioid.
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  #35  
Old 10-10-2013, 07:33 PM
Mama Zappa Mama Zappa is offline
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I took 50mg 3X daily for 6 years. She abruptly stopped me. I asked what to do about withdrawals (as I've stopped taking them before and knew it may happen). Her suggestion? "Go to the Rehab Clinic".

Yeah, you do build up a tolerance quickly, but I never felt the need to ask for more. Well, when I did recently, she took me off of it. Grrr.
Wowsers.

I would suggest this is a sign - a great big blinking Times Square on 12/31 sign - that you need to find a new doctor.

Now, I'm not saying that "stop the Tramadol" is the wrong decision. But making you go cold turkey, and tossing off a flippant "go to the rehab clinic" is amazingly callous doctoring. I'm stunned that you got that reaction from her, versus a discussion of weaning off the stuff or alternate approaches to managing your health issues.

I have never taken the stuff. But as an RLS patient, I know people who have tried it (narcotics are effective for RLS so many people are offered this "non-narcotic" as an alternative), and the scuttlebutt is that yeah, it's not as addictive as the true opiates - but it IS more addictive than early publicity said it would be.

Here's hoping you get past the hump quickly.
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  #36  
Old 10-10-2013, 07:35 PM
Schism Schism is offline
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I second the Mercotans advice on trying to get some clonodine. A lot of withdrawal symptoms can be alleviated by lowering your blood pressure and clonodine will do that. It works by simply expanding your blood vessels IIRC. Helps you feel more calm and you might even catch some sleep.

Good luck and hang in there.
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  #37  
Old 10-10-2013, 07:45 PM
SerafinaPekala SerafinaPekala is offline
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Originally Posted by Qadgop the Mercotan View Post
Propoxyphene (darvon, darvocet, etc.) is no longer available in the US, and I'd not consider it a step down from tramadol anyway. If one is physically dependent on tramadol, just taper tramadol, don't substitute another opioid.
I stand corrected then. Its been a while since Ive seen anyone use it.
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  #38  
Old 10-10-2013, 10:01 PM
carnivorousplant carnivorousplant is offline
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Originally Posted by Qadgop the Mercotan View Post
Propoxyphene (darvon, darvocet, etc.) is no longer available in the US, and I'd not consider it a step down from tramadol anyway. If one is physically dependent on tramadol, just taper tramadol, don't substitute another opioid.
As I posted earlier, I take tramadol, 50 mg, three times a day with acetaminophen for the pain associated with ankylosing spondilitis. I have noticed no "buzz", euphoria or dependency.
I believed it was much better than taking a narcotic. Although the container is often labeled "no refills", the pharmacist FAXes my physician and it is refilled.
Is it truly as bad as described in the above posts?
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  #39  
Old 10-10-2013, 10:30 PM
JayRx1981 JayRx1981 is offline
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Originally Posted by RedBloom View Post
I was put on this drug that basically saved my life in so many ways... 6 years ago. Pain/depression/anxiety - GONE. Doc decided that 6 years has been long enough now, it's lost it's efficacy and she refused to up the dose or switch me to something else. BAM. I weaned off for a couple of days and now I feel like death - day 2 into really nasty withdrawals I had no idea would happen. Not much is helping, and being that Tramadol is not even a narcotic, I'm surprised I feel this ROTTEN. I hate my doctor. HATE her. Please tell me this gets better... pleeeaaase.
As others have stated, it does get better. Unfortunately, due to it's multiple mechanisms of action, half-life, and the half-life of one particular major metabolite, withdrawal from long term tramadol therapy sometimes results in a longer lasting acute withdrawal effect combining features of opioid and antidepressant withdrawal. I would echo the recommendations of several other posters and encourage you to seek help from another physician, even if the only thing said physician will do for you is supportive medication like clonidine.

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Originally Posted by RedBloom View Post
I took 50mg 3X daily for 6 years. She abruptly stopped me. I asked what to do about withdrawals (as I've stopped taking them before and knew it may happen). Her suggestion? "Go to the Rehab Clinic".

Yeah, you do build up a tolerance quickly, but I never felt the need to ask for more. Well, when I did recently, she took me off of it. Grrr.
I'm a little confused. In your first post you stated that you were on day 2 of severe withdrawals you didn't know would happen, yet here you asked her what to do about withdrawals which you knew might occur because you've stopped before. It is possible I'm misreading here, of course, but the two statements don't seem to mesh.

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Originally Posted by Merneith View Post
Tramadol is an opioid, like codeine. That makes it a narcotic, even though the laws regarding it aren't as stiff as other opioid. It varies by state. It does affect serotonin and dopamine but it's mostly a painkiller.
Strictly speaking, while it does have very mild uptake inhibition of dopamine, this study found a much greater (~2 orders of magnitude) selectivity for uptake inhibition of noradrenaline over dopamine and this uptake inhibition likely directly contributes to it's painkilling properties via spinal descending noradrenergic pathways.

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Originally Posted by nearwildheaven View Post
Tramadol is one of the most addictive legal substances out there. I would personally have to be VERY desperate before I took it; it also has some very common and unpleasant side effects.
I wouldn't say it's one of the most addictive, given its non-scheduled status in most US states, though at least in my state, it does show up on the state prescription monitoring program similar to scheduled medications. I would say that some physicians, pharmacists, and patients seem to under-appreciate the very real risks of dependence associated with this drug, at least in my anecdotal experience, but disagree that it is anywhere near "most addictive legal substances out there".

Quote:
Originally Posted by RedBloom View Post
My problem is that I'm already on antidepressants, I have been for 11 years. They started pooping out, hence the Tramadol for depression/pain relief. Now I'm left on this antidepressant and anti-anxiety meds that make me a ZOMBIE. At least the Tramadol gave me some life and energy. I was functioning very high level. Now I feel dead.

Even stranger tidbit yet? My doctor referred me to a Neurologist.
Given the picture you are presenting here, I don't think it unusual that your doctor is referring you to a specialist. I'm assuming the doctor who stopped prescribing the tramadol is a general or family practice physician. If so, she may simply feel like she is reaching the limits of what she knows to do to help your situation, which isn't all that unusual (IME) when dealing with comorbid pain, depression, and anxiety in a patient.

Quote:
Originally Posted by RedBloom View Post
I see a psychiatrist (his comment about coming off Tramadol was "I'm sorry - withdrawal is out of my scope. You'll need to see your doctor".
This response is not all that unusual, in my experience (both as a patient and as a professional), since most providers don't want to interfere with another provider and their treatment choices unless a patient is being specifically referred to them for that purpose, or in the case of an emergency.

Also, given your description of how you are responding to your antidepressants and anti-anxiety meds, have you informed your psychiatrist that they leave you feeling like a zombie?

Quote:
Originally Posted by Truman Burbank View Post
Well, again, the MDs in Rehab aren't scared. Is there a reason you don't want to try that option? It's not a moral/ethical issue, you're (medically) addicted, and that's their scope of practice specifically.
If RedBloom is looking to get off the pain meds altogether, yes, providers trained to deal with addiction and dependence would be a good choice due to their familiarity with the risks of withdrawal and evidenced based procedures for minimizing the more severe aspects of withdrawal. However, if RedBloom is more interested in pain relief, then the referral to a neurologist or a pain care specialist might be the better choice in the long run.

Quote:
Originally Posted by RedBloom View Post
I.... am saving that for a last ditch effort. As many people have stated, "you were ONLY on 50mg 3 times per day? Shit, that's nothing".
Assuming you aren't either a rapid metabolizer or slow metabolizer, 150mg of tramadol daily is considered to be approximately the equivalent of 15mg of morphine daily. I would actually be a little bit shocked if after 6 years of use there weren't signs of withdrawal.

One study, linked here, found some degree of dependence at a daily dose of 200mg (50mg four times daily) for up to 4 weeks. Granted, the study in question demonstrated dependence via challenge with an increasing dose of naloxone, an opioid blocker (separated by 48 hour intervals) while participants were kept on a regular scheduled tramadol dose, versus stopping the tramadol altogether and observing for withdrawal.

Quote:
Originally Posted by Qadgop the Mercotan View Post
I hate tramadol. If a patient needs an opioid for chronic pain (a few do), then I personally think one's better taking long-acting morphine. Less of a buzz, smoother detoxes, fewer problems if doses are missed. Not that I'm big on prescribing morphine either, but it's better than tramadol for chronic pain.
Oh, if only I could unleash you upon some of the providers in my area.

Quote:
Originally Posted by RedBloom View Post
People think I'm too young to be on pain medicine... but I always hurt and ache all over, from my neck to my shoulders to my head to my lower back. My doc thinks I have a "pain perception" problem Regardless, my pain is very real, and doctors don't take it seriously unless someone is screaming or crying. This may be why I'm headed to a neurologist. I suspect my doctor has had it with my bitching and is moving me to the next specialist.
While I don't doubt that there are some healthcare practitioners who too quickly write off a patient's complaints of pain, many of us have been trained under the philosophy that if a patient says they are in pain, treat them as if they really are in pain. If you say you are in pain, I'm going to treat you as if your pain is real (well, within the limits of my scope of practice, as I'm a pharmacist, not a physician/PA/NP). However, the treatment of chronic pain, particularly non-cancer pain, can be challenging, even to those who really know their stuff. Sometimes, in my experience, the solution the patient often wants (increased frequency/dose of their current pain medications) can actually end up making things worse, directly or indirectly, while the option(s) the practitioner feels has the best chance of helping the patient might require time to start working or may actually make the patient feel worse for a short period of time.

Quote:
Originally Posted by MOIDALIZE View Post
I hate when doctors sling medication like they're corner drug pushers, then suddenly get a conscience about it later.

My stepdad is 64. He works 2nd shift maintenance at a hospital. He herniated a disc in his back years ago, which still gives him pain, and he's had three knee replacement surgeries performed on the same knee, which he can only bend about 30% of a normal range of motion. But his job requires him to be on ladders and walking all over the hospital. Thus, he's often dealing with pain, and a regular sleep schedule is difficult for him to maintain. So his doctor put him on Oxy and Ambien. Is he too reliant on those medications? Possibly. Do they help him endure life? Undoubtedly.

Now, apparently, his doctor is giving him a hard time about getting more prescriptions. He's the one who got him hooked to begin with! And honestly, is it really a mortal sin if this older man can get medicated so he can keep trudging off to his job? He'll be retiring soon anyway, he doesn't need the gratuitous pain to push him out the door.
Oh joy--combination opiates and benzodiazepine(-like) drugs in elderly patients.

Please don't misunderstand, there are times when they are appropriate together, as may or may not be the case with your stepfather. The combination, particularly in elderly patients, can however pose significant risks beyond even simple dependence/addiction, so the general rule of thumb is to limit the use to the lowest effective dose for the shortest possible duration.
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  #40  
Old 10-11-2013, 09:38 AM
RedBloom RedBloom is offline
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Day 4. COMPLETE AND UTTER RESTLESS BODY SYNDROME that is making me feel like I am completely and utterly losing my mind. Pacing, walking, no sleeping, ANGRY AS HELL, still chilled and aching to the bone, pounding heart...

I can see why people stay addicted. I really can. And this is Tramadol, for fuck's sake. No amount of Ativan and Advil will help this. I hope my doctor burns in hell.
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  #41  
Old 10-11-2013, 11:48 AM
Qadgop the Mercotan Qadgop the Mercotan is offline
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Heh. I hate opioid withdrawal. Max suckage. Last time I did it back in 1990 I did it without the benefit of anything except tylenol. Such misery.

Keep talking, get exercise, push fluids, do slow deep breathing exercises, repeat as necessary.

I do feel your pain. It won't last forever, but it sure feels like it.
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  #42  
Old 10-11-2013, 01:35 PM
Mama Zappa Mama Zappa is offline
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Quote:
Originally Posted by RedBloom View Post
Day 4. COMPLETE AND UTTER RESTLESS BODY SYNDROME that is making me feel like I am completely and utterly losing my mind. Pacing, walking, no sleeping, ANGRY AS HELL, still chilled and aching to the bone, pounding heart...

I can see why people stay addicted. I really can. And this is Tramadol, for fuck's sake. No amount of Ativan and Advil will help this. I hope my doctor burns in hell.
I wonder if a massage would feel good.

I mean, it's relaxing and sends lots of endorphins. On the other hand, if you've got crazy restless body syndrome, it may be tough to let yourself relax, and your brain may go into full-on fight-or-flight, screaming DON'TTOUCHME mode; I have no idea. Certainly there've been times where my legs have started trying to twitch during a massage (because I get relaxed and drowsy and that's a huge trigger for RLS).

Similarly, hot bath (or maybe cold bath). Or heavy, vigorous exercise (if you can).

Basically anything that distracts/disrupts/confuses the sensory symptoms for a bit.

If there's anyone who can give you a quick trial back/shoulder rub and you don't want to run screaming, maybe schedule a real massage somewhere.

Note: I have no experience with any such withdrawal symptoms, just making wild-assed guesses based on screwed-up brain chemistry (and what works for my own variant of that).
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  #43  
Old 10-11-2013, 02:29 PM
RedBloom RedBloom is offline
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Quote:
Originally Posted by Mama Zappa View Post
I wonder if a massage would feel good.

I mean, it's relaxing and sends lots of endorphins. On the other hand, if you've got crazy restless body syndrome, it may be tough to let yourself relax, and your brain may go into full-on fight-or-flight, screaming DON'TTOUCHME mode; I have no idea. Certainly there've been times where my legs have started trying to twitch during a massage (because I get relaxed and drowsy and that's a huge trigger for RLS).

Similarly, hot bath (or maybe cold bath). Or heavy, vigorous exercise (if you can).

Basically anything that distracts/disrupts/confuses the sensory symptoms for a bit.

If there's anyone who can give you a quick trial back/shoulder rub and you don't want to run screaming, maybe schedule a real massage somewhere.

Note: I have no experience with any such withdrawal symptoms, just making wild-assed guesses based on screwed-up brain chemistry (and what works for my own variant of that).
Good call. I had called this morning to schedule a massage for tomorrow morning. I've been noticing that distraction = VERY GOOD THING. So, provided this doesn't last for the rest of my God-given life, I can possibly pull through this with white knuckles. I'm hyper-sensitive to every little nuance, so these feelings to me are like sensory overload. I'd go through labor 10 times over before doing this again.
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