Effectivness of long term tramadol use?
 

I have been taking tramadol for years now but sparingly. Sometimes I can go weeks until the pain is to much. But other times like vacations I use it much. 100mg twice a day even. I don't wont to spoil the day for others so I have done this to get through the day.

My question is, if one uses a drug like tramadol and the body gets accustom to it and needs more and more can that be reversed? Or in other words if I don’t take it for some time will it go back to being as effective? If so does anyone have any idea on how long a time it takes? I worry because it does do the job and I don't wont this to happen.

I believe Tramadol has addictive potential. I used to see patients forge Rxs for it, and consume huge amounts. But it is not a controlled substance by the FDA.

It IS difficult to come off, esp high doses, for long periods of time.
One should taper down when this happens, when you need to discontinue.

We are finding that all drugs that sit on neurotransmitter receptors do this. The body notices that the sites are filled and makes more receptors so pain can be felt again. This is some survival mechanism. Opiates do this, and since tramadol sits on mu receptors it does too. Tramadol also affects serotonin receptors to some extent too. SSRI drugs also do this to receptors, and require tapers. Even things like Neurontin/Lyrica an require tapers. The age of neurotransmitter manipulation is still new with Big Pharma...and unfortunately many patients have suffered because of this factor.

This is why I reserve it for occasional use for myself. I've seen the the Good, Bad and the Ugly of this drug. But for nerve pain, I think it is better than opiates overall.

I use topical agents, Lidoderm, or Salonpas, magnets, for much of my foot pain, and only use the Tramadol when more than my feet are awful (severe weather changes, and overuse issues, mostly).

It is each person's decision on how to deal with this factor. Some use it well, for long periods, and others may become habituated to it or need ever increasing doses.

My DH used it within rx limits for many years. He said recently it didn't kill the pain anymore, and stopped using it. I took one of his once. In about 20 minutes, geez, I felt good! I also didn't get any sleep that night. No more for me either.

Hi, I used Tramadol [ER] 300 mg x twice a day for a number of years, it did work well for me, at times I did think it was loosing its effectiveness so I would just drop down to 200 mg x 2 times a day for a short term then back up to the original dose and it worked fine again.

I just posted about this on the other thread. This was the reason why my pain doctor long term did not like this med because he said I would end up needing more of it. Also I think my brain would become more sensitive to pain. I am not sure if it was this med or vicodin or both.

Thanks for the information everyone!

Sometimes I go months without taking it. But then I do take it twice daily at 100mg a dose for 2 weeks or so. I believe I'm building up a tolerance to it's effectiveness. Honestly it works much better than anything else including Lyrica, Cymbalta and Neurontin. I would just take it daily if I could but it does loose its effectiveness and then what would I do? :eek: Nothing else works and I’ve tried many of the opiates as well.

If I stop for a month or so will it once again work as well as it did. Any thoughts or experiences with doing this?

I don't know if two weeks is enough to set up a tolerance or not.

I do know that when I took my first tablet, of 50mg, I hallucinated all night, and didn't sleep at all.

Then I used 25mg a night here and there, for about 7 doses. I then bumped up to 50mg and no more weird mental effects. But sometimes it does interfere with my sleep. But the next day I feel so much better...it is like it lasts the whole next day for me too. I don't even take it once a week. But I have found bursts of 3 days in a row very good for major pain issues. (mostly arthritis, and some foot burning). It works really well for the burning. Less well for deep intense pain. And it worked pretty well when I had my root canal last year.

Thanks mrsD. Pretty much the same with it's effectiveness for me too. It’s the only drug I’ve found to help with the burning. But I’m really careful with it because it makes me feel so good I want to take it every day. Much more energy, better mood, more talkative and less sleep is needed. I don’t remember it working so well while one Cymbalta or Gabapentin so I think it works better in conjunction with Lyrica. I wish I didn’t need such a large dose though. What’s the prescribed limit for Tramadol?

Tramadol's suggested Rx limit is 400mg/day.
I was taking that amount for about 6-7 years,
but tapered off 25% and now only take it 3x day
(100mg) with my Lyrica (200mg- 3x/day).
It has worked for me, for years.

I just bought some ULTRACET for break through pain. In asia i have to self med although Im very responsible and titrate responsibly usually low dose to medium dose any way i hate meds :mad: but hate pain more ;)

its 37.5mg tramadol (HCI) and 325mg paracetamol

any thoughts on the mix appreciated

I think you should use the plain Ultram. Using too much
paracetamol (tylenol) is problematic these days.

To get adequate amounts of the tramadol, you'll be taking alot of the tylenol.

They only made that product to extend the patent on the Tramadol longer. The paracetamol is not really needed.

Tramadol starts at 50mg... your Ultracet is below that amount, forcing you to take 2.

thanks mrs D :)

Bob, Your on quite a bit more Lyrica then me. What your side effects like? I'm really tired at 150mg 2Xdaily.

Well me feet were really burning again so I took 2 tablets (75mg)
knocked the burning out straight away. wow its extremely effective, still going nearly 12 hours later.
Also noticed decreased appetite

Yes, I agree, tramadol is very good for burning type pain.

I am glad it is working for you.

No side effects that I'm aware of.
I'm up at 7:15 a.m. and work til 5:30, 6 days a week.
Neither tramadol or Lyrica give me any s/e except for weight gain from Lyrica and also stopping smoking last summer.
No fuzziness or lethargy and good pain control from burning. I also use 'Icy Hot' or 'Biofreeze' in the a.m. before going to work and sometimes before bed.

the tramadol made me feel a tad nauseous. Especially now that its waring off probably because was first dose. There is one drawback the heat has been replaced with cold and numbness where the burning was the worst.
still prefer icy feeling any day.
Bob did you add tramadol after the Lyrica? have you tried just tramadol ?
it may be all you need

I had nausea the first two doses of Tramadol.

That went away, quickly.

Thanks Mrs D . was a tad worried. Do you know how it interacts with elavil?
are they an okay combo?

should be okay with Elavil, as long as Elavil is low dose.

Raise the Elavil dose and you would get more serotonin issues, which "may" interact with tramadol. Most of this interaction is dose dependent. But I used to see people take both all the time with no problems (with Elavil in low dose.).

http://www.drugs.com/interactions-ch...=2221-0,168-74

Bob,
I don't remember how bad off you use to be Bob but can you wear shoes all day at work with no problem? If so was there a time when wearing shoes was practically impossible for you at work?

Wearing shoes all day is a must as a working locksmith, and hardware installer. Finding the right work shoes was the challenge, and still is. It seems that when I find a shoe that feels right, they discontinue the model and replace it with something created on another last. When I find a shoe that is right, I will buy 2 or 3 pairs, so that they will last for a while. Usually by the time I go thru the 3 pair (about a pair a year), I can't find the same model and have to go thru the hunting all over again.
I save the older shoes for rainy/snowy days and try to make the others
last a bit longer that way.
I've been fairly lucky with New Balance Velcro Walkers and Dr Scholl's walkers (velcro & laced) for work shoes. I am a born flat-foot. Cannot stand arches built into the shoe. I take out the factory innersoles with the arches and replace them with full gel innersoles and foam cushion pads on top of that. When I go to buy shoes, if the innersole won't come out, or the arch is built into the base of the shoe - its not for me. I take gels and foam with me to put into the new shoes in the store, to try on new pairs.
I only am successful about 20% of the time (maybe less- I've tried on 6-8 pair of shoes at a single store and come away zero).

Pretty much the same here for me as well. I've been using NB926's. I get them in a 5xwide and a size longer then I wear and mainly use them as slippers. It's mandatory where I work that my shoes be all leather so this has complicated it. But I now have a desk job and when I'm sitting at my desk which is 90% of the time off goes the shoes as fast as I can. When I drive or really anytime I sit down off comes the shoes. Even at church where I'm in a pretty seen position. Everyone knows my problem but it was really hard for me to swallow my pride. It's just that most ppl I've ran into with PN wear shoes so I wonder if I'm worse off then most, that's why I asked. If I had to wear shoes and stand all day at work I would maybe last a month before the pain would break me down to a non functioning employee. Thanks for sharing.

You're not alone, Marty. I've only found shoes that hurt vs. shoes that are torture. Even loose socks hurt. But I've figured out this week how to (somewhat comfortably) rest the back of my legs on a seat cushion placed atop an overturned wastebasket under my desk at work. The point for me is to have nothing touch them. So I've been wearing sandals, then taking them off so I'm, yes, barefoot. Nobody can see. During the day having them not touch anything is enough. Nightime is another story.

Tramadol: worked very well for a short period of time and then not at all. Vicodin has no effect either. But I seem to be the exception, so don't anyone go by my experience.

Hi JoanB
may ask what dose of Tramadol you were taking? Im on ultracet which is a combo of Tylenol and Tramadol but Now basically take 75 mg a day along with 100mg lyrica and 10 mg elavil, But its the Tramadol that cuts out 80% of the burn a and I lurrrve it ,makes you feel good is a bonus :D

I beleive 400mg is the max, this is one that could be fun to max out :cool:

Tramadol woes!
 

I am currently taking 50mg BD of Tramadol (1x 50mg of regular Tramadol and 1 x 50mg of slow release) with minimal side effects….however until a few months ago I had a foray into Tramadol 100mgs BD and developed significant Myoclonic Jerks almost from the first dose.

As a result of the jerks I had to reduce the Tramadol by half but commensurately increased my Paracetamol intake to the maximum amount per day, unfortunately!

One of my concerns is what I will do if I require more analgesia in the future as it is obvious I will not be able to increase my Tramadol dosage beyond 100mgs per day.

I am additionally on 300mg of Lyrica daily which I take before bed due to feeling like a zombie otherwise.

Tramadol is a controlled substance in Australia which means that no repeat prescriptions are issued, so a revisit to the doctor for each new script is required, which can be a real pain! :D

Megan, Hi Im an aussie living in Thailand. That would be a pain! have you tried slowly tit-rating up to 100mg?
Most chemists in Asia will sell it across the counter here

So were in the same boat. We work and can't wear sock or shoes. I too have used a wastebasket and cushion. Now I use an old chair that I took the back off of. I can't wear sandals of any kind. Interesting life isn't it working a full time job and not being able to wear shoes. :eek:

Sorry I started the thread about Tramadol and I'm now talking shoe's. Sham on me.

Im coming out of the closet. I too cannot wear shoes , I can wear very open 2 strap sandals but I dont work and live in a warm climate. I stopped working because mine was a very high profile (running large seminars)job I had to be in a suit and biz shoes and on my feet running around for 12 hours. Damn shame really, It paid embarrassingly large amounts of money, oh well thats life..

A question about Tramadol

does anyone else get Tinitus with this one? I have it naturally and it amplified on lyrica but went away over time. tramadol is a louder ringing though

Hiya zorro,

I was taking 50 mg, up to 600 mg/day at one point. I had no problem stopping them, i.e., I had no withdrawal, and since they weren't helping with pain (or even gave me the slightest buzz for that matter), I didn't miss them at all. But I'm glad that they work for you.:cool:

At the risk of being a broken record here, the only rx that has ever consistently relieved the foot burn for me is Ambien, but that has an obvious major drawback. zzzzzzzz

Ambien hah? Hmmmm never heard of that being used. Are you saying that it works because your asleep or does it really work?

It works even if I'm awake. I don't know if I'm the only one it has that effect on or not--I discovered it by accident. I keep telling doctors about this, but so far I haven't found one who is the least bit interested-you'd think maybe they'd want to know for their other patients to try. But you'd be wrong if you thought that.:rolleyes:

Tinnitus
 

Tramadol contains serotonin which is why it can help with burning pain, FWIW.

EEO3,
What other drugs contain serotonin?

Also Im getting very mild double vision which is new and about the same time I started on tramadol even though Im only on one tablet, I had reduce back from two as I was la la land ( im am very sensative to meds)
some brain fog.

My pn cocktail

150 lyrica (cutting back to 100)
10 elavil
50 tramadol

they all work in diff areas of brain and so far they work pretty good. the tramadol can be adjusted on demand for any breakthrough

I don't know all of them as I'm not a chemist/pharmacist. I just have experience with tramadol as I'm a long time user of it as I can't tolerate a lot of other meds. I also know that I can't take other meds with serotonin as it can lead to serotonin syndrome which can be dangerous. To my knowledge, antideprressants and the muscle relaxer flexeril are all off limits. Hopefully Mrs. D. will see your post and offer a thorough answer to your question.

Tramadol does not contain serotonin per se.

But it does act on serotonin receptors. This may be a function of the action it has on mu receptors (pain area) and other receptors like the kappa one.

Some opiates also do this. Oxycodone has quite a serotonin connection in some people.

Some neurotransmitter actions are cascades...initiated by one system and then a second one becomes active. Histamine in the brain is like this, initiating other systems.

The bottom line is that many drugs overlap onto other systems and have actions that complicate things for people.
Some of these are discovered during trials, but many take years and years to come forward, during post marketing.

Yes I get tinnitus. Lyrica does it, tramadol does it, neurontin does. LOL

Its starting to settle now that I have adjusted and yes agree with your post. That usually means time for a higher dose