I've taken both Ultram and Ultracet and I think I remember reading somewhere that Ultracet had been found by patients to be more effective than even a larger dose of Ultram alone and more effective than if the patient took a separate Ultram tab and a separate acetominophen tab at the same time- don't ask me why though....I'm sure there's a good scientific reason for it- not that I would understand it it they tried to explain it to me. Good luck with it though, Victoria- I've found that it helps me about as much or more than the Vicodin I've been given before, as far as helping the pain, and it doesn't give me a "spacey" feeling.