I've been taking 30-40mg of Nortriptyline daily, and have been using a Capsaicin pepper cream behind my toes and on the balls of my feet. Both seem to have "crapped out" on relieving this type of pain, but do still work on the burning, pins and needles, etc. My Dr just prescribed me 50 mg of Tramadol 3x daily for the pain I described. I took one this AM & seems to deaden the "folded sock" pain. Is anyone taking Tramadol JUST for the burning, pins and needles etc, and not much else? If the Tramadol helps with the other types of pain, I'd like to do just one Med, if possible, but I know it's unlikely.

Groucho,

I have a script for tramadol and while it is written for daily use it is my "bad day/lyrica isn't cutting it/I've got too much to get done basket". I've not read much information on it as a stand alone, though if it works for you that certainly seems like something to bring up to your physician.

It must be nice to find relief. Here is to zero diminishing returns.

I think Tramadol is useful for some. I use 1/2 tablet (25mg) only at night for tough days. (this is to avoid tolerance).

I also get nausea sometimes with it...so I use it carefully.

You cannot really use it with SSRIs or SNRIs safely, as the risk of seizures increases and also serotonin syndrome.

Tramadol needs to be activated by the liver to its active metabolites, so there is a delay in onset from when you swallow your dose. Some people mistake this delay for it not working and up doses when that is not necessary. And some people lack the liver enzyme to activate it at all ...so it won't work well for them.

I personally like it because the next day, I am virtually pain free..so a very little goes a LONG WAY for me.

But response is all very personal depending on your genetics and particulars.

Thanks, mrsD,

I have read similar things about combining TCA's (Nortriptyline) and Tramadol. I have also read that the combination is used often, though, and without incident, according to patient reviews. Maybe I live dangerously? LOL. I took half a tablet this AM & after more than an hour, I felt only a small improvement. I took the other half, 2 hours after the 1st, and noticed a bit more.

Although relief was better for me, initially with Nortriptyline, and before that, Gabapentin, my feet felt reasonably good the rest of the day on the Tramadol, into the afternoon. I've been prescribed 3 daily, & probably won't take more than one daily, and 2 on my "rough" days, when I really don't feel like dealing with it. The only side effect I may have had was a bit of gurgling in my stomach from my breakfast. Maybe not.

mrsD,

What is your personal take on the use of Tramadol with a Tricyclic antidepressant? There are warnings on the Drug Interaction Checkers online, but, as I've noted, they are often prescribed together. My Pharmacist, here in a small town, knows me by name, but made no comments on it.

When the TCA is a very low dose, the interaction potential is low.

This warning rises, as the TCA dose (and or Tramadol dose) increases.

People with high serotonin levels to begin with...would be more at risk. You can gauge this by the side effects from Tramadol occurring at the lower dose levels... like nausea, dizziness etc.

Because people vary so much, there is really no one rule to fit everyone equally.