Help! The Switch from Tramadol to Oxycodone IR (Withdrawals)

[Conainaily]

Hello!

I've been searching Google trying to get answers regarding this for hours, and even this forum (via Google's website search function), but I can't seem to find the answer to my specific problem, and could use some advice.

I've been prescribed Tramadol now for roughly 3 years, the IR kind, 50mg Tramadol HCL, for my pain which strikes at least half the week and can knock me out of action for hours at a time. Tramadol worked wonders, and still does around 70% of the time, but after 3 years, I've been pretty much at the max dose of 400mg daily give or take 50-100mg. Sometimes, even that's not enough over the day to get rid of some nasty attacks, which is why I requested a stronger medicine. My usual doses of Tramadol would normally be split across the day in 3 lots, such as 150/150/100, 100/200/100, 200/100/100, 100/200/0, 100/100/100 and so on. That does a good job a good deal of the time, and leaves me with a calm, relaxed, happy-sedation type feeling, almost numb, but not quite fully there, which is a bonus. Although some days I'd feel that, others I wouldn't, that seemed random.

Moving on, I was always aware of the potential seizure risk, and didn't like that I was on 250-400mg per day, it just seemed excessive but necessary, and surely a stronger drug in a lower dosage would be better for me?! So, I contacted my doctor, and he agreed that I should try something else, and I suggested Oxycodone, now we're talking the straight kind, no other meds mixed in, and instant relief, just like the Tramadol. He suggested take one every 4-6 hours as needed, 20-30mg per day, which is supposed to be around 400-600mg of Tramadol as far as conversation in pain relief?

I know all about the SNRI/SSRI properties of Tramadol, and asked if I'd be fine switching straight over to Oxy without tapering, and he said I should be fine, as did the few similar bits of info I found online. However... all of today, I have felt the same feelings I'd get if I went a day without any Tramadol, it's a weird feeling, and not a nice one, and I'll try my best to describe it. It feels like an energy wants to burst through your skin, like an agitation, almost like the urge one would get to punch something minus the anger, just that urge! It's almost pulsating in quality, but I wouldn't call it restless, as I can sit still, but this isn't a nice feeling at all, and I know I felt this when ceasing Tramadol for a day, so I know I'm in some type of withdrawal from something. I'm also experiencing temperature fluctuations, as in one minute I feel hot, then eventually cold, and back up, in fact my ears are hot right now, which has always been an indication of me being ill.

Today, I've had the following dosages with their times, and in one case, it was near food:

1. 1PM - 5MG (Ate a chicken breast sandwich 15 minutes before and around 20 minutes later)
2. 3:45PM - 5MG
3. 4:50PM - 5MG (felt crap here, so took another to see if that would make me feel normal)
4. 9:05PM - 5MG (could feel some pain creeping in)
5. 2:15AM - 5MG (pain still there, but faint, this didn't help much to my surprise)

And here I am at 8AM, still feel bad, if anything it may be a stronger sensation now. I don't want to take more than 10-25mg a day at this point, for safety reasons, I want to see how this affects my breathing to be safe. Honestly, I don't think I've felt much of anything from Oxy on the first day, I mean I know when Tramadol is working, I can feel the affects on me as stated earlier, while the only time I believe I felt anything on this today was after the 4:50PM dose, probably due to the closeness of the previous one, where I felt slightly sleepy, for a brief amount of time.

To top it off, from what I've been reading here, it seems like Oxy is supposed to be much stronger than Tramadol, yet its almost like I've been taking a placebo all day. Despite the lack of other side effects, I've not felt any of the positive side effects from it either, and surely my opiate tolerance can't be that high for Oxy to work?! I have plenty of Tramadol next to me, and I know if I took 100mg right now, I'd feel normal and relaxed inside an hour, so I'm so confused here. Are the effects of SSRI withdrawal that bad that its stunting the Oxy? If so, how long will this last?

I really don't want to stay on Tramadol due to its risks anymore, but weaker analgesics in the past did nothing to help, and this seems to be not working so far. Actually, I say this, my forehead and maybe my lips feel slightly numb right now, but again, I feel like crap.

Any advice would be appreciated, as my doctor probably wouldn't get back to me today unless I said it was an emergency or something.

PS: If it is SSRI/SNRI withdrawals, would taking 50mg early in the day and late evening be a good temporary fix, at least while my body gets used to it not in my system? I've seen one site flag them as major interactions :/

 

[CFC]

Hi there and welcome to BL.

Sorry to hear you're struggling with the switch. Sounds like you're suffering from tramadol withdrawal akathisia. It also sounds like you were benefiting from the mood-enhancing properties of tramadol and this is something the oxy doesn't have in the same way.

It may be that a separate prescription for an SNRI might be called for. At the moment, a small taper off of tramadol may help. You'd really be best served discussing this with your doctor though, especially if you want to get an SNRI.

Depending on where your pain is, you may also be a candidate for a nerve block procedure, which would eliminate the need to take any tablets at all. This is also something that could be discussed, as a more long-term option.

 

[Keif' Richards]

I' going to echo CFC on this one. I'm willing to bet that you're simply enduring SNRI withdrawal. As we've been discussing, Tramadol has an effect on Serotonin and Norepinephrine in the body. Other common drugs used as antidepressants for this activity would include Effexor (Venlafaxine) and Cymbalta (Duloxetine) are too commonly prescribed SNRI's. It might be a little bit too much trouble at this point, but perhaps you could consult with your prescriber about maybe adding a small amount of one of the aforementioned drugs to help mitigate some of your withdrawal symptoms.

Neither of these drugs are controlled and I can imagine they'd be fairly easy to get.

 

[Conainaily]

Hey guys, thanks for the info and advice, just got back from a holiday so sorry for the late reply.

We decided to keep my on tramadol for now and slowly taper me down until the switch will be easier, as I didn't want to add any SSRI's into my meds.

However, I have another question if you'll indulge me -

I have a ton of stuff to do tonight, and I've had a massive headache all day long, and it's getting worse. I've had my max 400mg tramadol for todays 24 hour period, at the following times:

3AM 200
8AM 100
3:30PM 100

It's now 7PM. I'd have to wait at least another 6 hours before I could take another dose, and by then I'd be ready to sleep. So, will taking a 5MG Oxycodone IR be dangerous at all at this point, as tramadol is out of the question. If it is risky, how much on a scale of 1-10? I'm only concerned about seizures here, thanks.