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Thread: potentiating tramadol

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    #51
    Bluelighter StaffWriter's Avatar
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    What is it with tramadol? I love my opiates and actually still get a buzz off of 400mg of propoxyphene after 10 years of heavy opiate abuse, but all tramadol does is make me nauseated to the point of vomitting.
     

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    #52
    lol, well, i guess the tram aint for everyone to ride...

    It has been quite apealing to me. Long durationg, subtle but noticble effects.
     

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    #53
    Quote Originally Posted by hatedenial
    Tramadol is about 100 times harder on your liver than the old barbituates, seconal , Nembutal , etc. Be careful , maybe you should get a real opiate
    Has anyone followed up on this comment, found the research to back it up?

    I ask because I've been on tramadol for 7 months, and i'm really worried now. I don't feel any worse physically, but I hope my body's okay on the inside...
     

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    #54
    Bluelighter pallidamors's Avatar
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    ^I haven't seen anything that says that it does. If you're taking it in an ultracet formulation, the APAP could.
     

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    #55
    Bluelighter Mr Blonde's Avatar
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    ^ I don't think so... a google search didn't turn up anything except that if you have liver problems you should probably give it a miss.
     

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    #56
    Bluelighter pallidamors's Avatar
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    The only thing I found remotely related was that a veterinarian stated he had used tramadol on pets with elevated liver enzymes, and the critters had no trouble with it, but that he'd be wary of giving it to a pet with liver disease.

    So if you or your pet has a pre-existing condition, it should be avoided but I don't think tramadol itself would cause it.
     

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    GABA + opiates 
    #57
    Quote Originally Posted by Mr Blonde
    Phenibut. I think it was made by the Russians, it's basically GABA with a phenyl group allowing it to cross the BBB.

    SO yeah, it's a drug for pinkos and commies.
    this is curious to me, as i've read that Neurontin (gabapentin) decreases morphine absorption -- (while on the other hand, if you take morphine first, and then a while later (whenever peak plasma level is reached i assume) take the gabapenin, it will increase the absorption of the gabapentin -- but all of that is beside the point.) --- my question/curiosity, is that since this is so, that gabapentin decreases the absorption of morphine (and i assume all opiates, though the article i read only talked about morphine), and gabapentin is practically GABA, which from what i can tell looking it up just now, is about the same as Phenibut, how would Phentibut increase the absorption of Tramadol?
     

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    #58
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    Quote Originally Posted by johanneschimpo
    Anything that induces CYP2D6 (generally the opposite of what you do for most opiates... because you want it to metabolism to M1, which is stronger)
    Iíve tried Tegretol (carbamazepine) with tramadol and it greatly increases the opiate-like effects. Generally, I take 400mg, 200mg in the form of sustained-release tabs and 200mg in the form of IR tabs. I take two 100mg SR tabs at time zero, then take 4 50mg IR tabs over the course of the next 4-8 hours. The high starts off as very stimulating but by keeping a steady stream in my system and letting the Tegretol facilitate tramadolís metabolism into M1, it eventually becomes quite opiate-like. Technically, St. Johnís Wort would be an even more potent inducer, but Iím not willing to risk serotonin syndrome as Iím already on mirtazapine.
     

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    #59
    anyone else tried phenibut and tramadol. think i might buy some
     

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    #60
    Diphen I find is the best potetiator espesciallly to Tramadol Naive users. I used to drop 100 mg before bed with 50 mg Diphen and wake up feeling very euphoric. Obviously this didn't last. I still use diphen but take tramdol every hour say 100-200mg untill I feel the desired effect.

    I'm quite confused here about the dangers of serotonin syndrome. Im scripted 100 50mg trams every 2 weeks and I am also on Escitalopram. I know many people who are also on this combo i.e. anti d and Tram. I have never heard of any problems ( not saying they can't occur), but do you think docs know much more about the risk of SS while using Tram and AD's as they don't seem to mind handing them both out. I've also never heard about a case of SS, so it must be rarer than we think, Yes?

    Are we being too cautious when it comes to AD's and Trams?
     

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    #61
    This is a HR site.

    My doctor tried to give me SSRI + Tramadol and I told her where to go.

    Next visit she says one of her patients was in having seizures due to SSRI + Tramadol. I smiled.

    You make up your mind. The doctors will do if for you if you let them...

    The two most reported side effect from tramadol for poisoning are seizure and SS.

    Maybe you should start a poll? I have seen at least 5 people on this board who believe they have had a seizure due to tramadol, does this include SS?? Who knows.

    Seizure risk
    Convulsions have been reported in patients receiving tramadol at the recommended dose levels. The risk may be increased when doses of tramadol exceed the recommended upper daily dose limit. In addition, tramadol may increase the seizure risk in patients taking other medication that lowers the seizure threshold (see Interactions with other drugs). Patients with epilepsy or those susceptible to seizures should only be treated with tramadol if there are compelling circumstances.

    Use with other serotonergic agents - the presence of another drug that increases serotonin by any mechanism should alert the treating physician to the possibility of an interaction. In isolated cases there have been reports of serotonin syndrome in a temporal connection with the therapeutic use of tramadol in combination with other serotonergic medicines such as selective serotonin re-uptake inhibitors (SSRIs). Signs of serotonin syndrome may be, for example, confusion, agitation, fever, sweating, ataxia, hyperreflexia, myoclonus and diarrhoea. Withdrawal of the serotonergic medicines usually brings about a rapid improvement. Drug treatment depends on the nature and severity of the symptoms.

    Tramal - Product Information
    Last edited by nabollocks; 05-11-2008 at 03:28.
     

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    #62
    I hate how doctors seem to have little knowledge on the medications they prescribe. I definitely think you should start a pole on who has had a seizure on tramadol and how much they took in 24hours, i will if no one else does.
     

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    #63
    ^ That won't get you accurate answers though. Say 3 people reply. Is it 3 out of 3, or 3 out of 3,000? Is it 3 healthy individuals or 3 people already at risk for seizures?

    My answer: dont combine an SSRI and tramadol.
     

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    #64
    Quote Originally Posted by nabollocks
    This is a HR site.

    My doctor tried to give me SSRI + Tramadol and I told her where to go.

    Next visit she says one of her patients was in having seizures due to SSRI + Tramadol. I smiled.

    You make up your mind. The doctors will do if for you if you let them...

    The two most reported side effect from tramadol for poisoning are seizure and SS.

    Maybe you should start a poll? I have seen at least 5 people on this board who believe they have had a seizure due to tramadol, does this include SS?? Who knows.
    That is FUCKED UP!
    WhyTF would she do that??
    stupid or just greedy?

    god, Iv read some stories here on bluelight and sometimes it seems that the docs know fuck-all about drug interactions.
    i bet most responsible BLers can do better.
     

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    #65
    I agree that they are lacklustre (sp?) when prescribing. Sometimes when I go there with info on meds that they didn't know of and they shout and tell me that I'm becoming a self pharmacist> someone's feeling threatened it sounds, I should know better as I know docs hate being undermined. But I have my interest at heart more than them it SEEMS.

    I'm gonna rethink taking trams while on SSRI, but I normally dose a high dose of valium when I do just to be safe.
     

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    #66
    ^Just out of curiosity... how is your depression? I imagine a SSRI with a dose of tramadol would almost certainly end up in a flat lined mood? I mean no ups and no downs...?
     

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    #67
    Well my depression is controlled, I don't really bother with trams much as tolerance has rocketed. I have other opiate addictions, mainly codeine to deal with which isn't helping my depression. But when I was first put on tramdaol I found it very euphoric and for some reason would chain smoke while on it.
     

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    #68
    Quote Originally Posted by DJ25
    and for some reason would chain smoke while on it.
    That is really interesting. I have a study that says tramadol actually hits nicotine receptors, so I would have thought it would stave off nicotine w/d, not the other way around. (Maybe I read the study wrong and it acts as an antagonist at the nicotin receptor? I will find the paper and work this one out)

    Maybe the excessive stimulation you were experiencing made you smoke like a chimney?
     

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    #69
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    Quote Originally Posted by Dr_F View Post
    Iíve tried Tegretol (carbamazepine) with tramadol and it greatly increases the opiate-like effects. Generally, I take 400mg, 200mg in the form of sustained-release tabs and 200mg in the form of IR tabs. I take two 100mg SR tabs at time zero, then take 4 50mg IR tabs over the course of the next 4-8 hours. The high starts off as very stimulating but by keeping a steady stream in my system and letting the Tegretol facilitate tramadolís metabolism into M1, it eventually becomes quite opiate-like. Technically, St. Johnís Wort would be an even more potent inducer, but Iím not willing to risk serotonin syndrome as Iím already on mirtazapine.
    LuxEtVeritas sent me a PM, in which he made a compelling point. Unfortunately, the PM disappeared when the site was having problems, and Iím not able to PM him as I donít have enough posts.
    LuxEtVeritas pointed out that ďit appears [Tegretol] would be a very potent 3a4 inducer and an almost negligible 2d6 inducer. As such it would only slightly at best aid conversion to M1 and at the expense of too quickly metabolizing both tram and its metabolites as a whole into inactive compounds via 3a4 induction.Ē

    I am far from sure that that the carbamazepine facilitated the conversion of tramadol to M1 and that this made the high more ďopiate-like.Ē In fact, I believe LuxEtVeritasí hypothesis is not only tenable, but probable.

    Why? Because the way I went about it was the antithesis of the scientific method. In order to make such a claim, I would need to remain abstinent from tramadol for a period of time, then take 400mg; then Iíd need to remain abstinent for the same period of time, take 400mg plus the Tegretol under similar conditions with a similar mind-state. And even this would be rather weak evidence; Iíd need replication.

    Another reason that I canít support my claim is that there were a number of confounds. First and foremost, at the time I made the post, Iíd been taking 300-400mg of tramadol a day for the last 4 weeks. Furthermore, itís known that redosing increases the bioavailability of tramadol, and that the best way to use it recreationally is to space your doses out throughout the day. Although Iíd been on a ďbingeĒ for 4 weeks, it was not until the last 5 days that I procured tramadol SR. I content that the SR is a more effective way of spacing ones IR doses throughout the day.

    Hereís what I can say: The Tegretol definitely changed the subjective experience. However, I cannot state the exact mechanism(s) by which this occurred. It might very well be that as I have a CYP450 chart in my office (thanks Soundpharm!), I expected the experience to be different and thus I perceived it as different. Iíve taken a holiday from tramadol, and thus far have 6 days. Perchance Iíll try the addition of Tegretol in a more scientific manner
     

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    #70
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    As has been mentioned previously, ethanol is a potentiator of tramadol in that it’s an inducer at CYP2D6. Carisoprodol (Soma) has been mentioned as a potentiator, but to be more concise it’s actually synergistic, as it doesn’t actually potentiate the tramadol. Baclofen is a crappy muscle relaxant and has little, if any, recreational value on its own; I’ve taken 200mg, and although I definitely felt that my muscles were very relaxed (kind of like jello), there was no euphoria. Furthermore, the baclofen made me feel kinda tired, but not sleepy; yet I ended up sleeping for 12 hours and missing a course after going to bed.

    This is a HARM REDUCTION site, so please use extreme caution when mixing depressants, as respiratory depression leading to coma or death are very real possibilities.

    That said, here’s my experience:
    I took a 6 day sabbatical from tramadol. On day 7, I decided to have some fun. Typically, I only feel the SSRI/SNRI effects as I tend to take it on a regular basis- I don’t get any opiate-like effects or sedation. This is great insofar as I can take tramadol as a “booster” to my atomoxetine (Strattera)- I have AD/HD predominantly inattentive type with sub-clinical hyperactive/impulse features. I’m also enrolled in a doctoral program, and the tramadol truly helps me to focus. However, I wanted to take a “vacation” so that I could enjoy the, albeit weak, opiate-like effects of tramadol.

    I’ve taken 400mg of IR tramadol over the last 8 hours. Generally, I wouldn’t take any after 5pm, as it would keep me up all night. However, it’s now 11pm, and I’m not feeling stimulated, but rather somewhat opiated. I’ve taken 100mg of tramadol over the last two hours. Over the last two hours, I’ve also consumed 5 standard drinks (Kentucky bourbon), 1400 mg of carisoprodol, and 75mg of baclofen. I’m feeling rather nice. I think I’ll have another drink over the next hour, then 15mg zolpidem subcutaneously before bed.

    Good night all
     

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    #71
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    I forgot to mention that I also took one 450mg yohimbe tablet, standardized to contain 9mg of yohimbine alkaloids. I generally detest this drug, as it makes me nervous and tingly all over, as if I have goose bumps. However, it seems to have synergized well with the tramadol/carisoprodol/baclofen/ethanol, as I’ve got just the *right* amount of “tingliness” in my extremities.
     

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    #72
    ^ just a tip, you should use the edit button instead of triple posting. i see that you might want to get your post count up so you can PM and whatnot, but you should do that in testing grounds or the lounge, not OD.
    not trying to be a dick, just stating facts.
     

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    #73
    Bluelighter DCBAe's Avatar
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    Barbiturates are good enzyme inducers. Remember Gluthemide and Codeine boost effect?? But they are allmost impossible to get from sometime now.. Except some, One of them is Butalbital, its not so hard to find and it can be bought thru IOP even.. So if you want tramadol potentiation to M1 then you could take something like fiorocet (butalbital) with the tramadol. And if your an regular abuser then a half a glass of wine induces enzymes too.. But go REAL EASY with that, OR BETTER DONT GO THAT WAY.

    Go low, but some butabital (5-allyl-5-isobutylbarbituric acid) that is a barbiturate with an intermediate duration of action. Butalbital is often combined with other medications, such as paracetamol (acetaminophen), aspirin or codeine, and is commonly prescribed for the treatment of pain and headache.

    Some combinations that contains butalbital:
    * butalbital and paracetamol (acetaminophen) (trade names: Axocet, Bucet, Bupap, Cephadyn, Dolgic, Phrenilin, Phrenilin Forte, Sedapap)
    * butalbital, paracetamol (acetaminophen), and caffeine (trade names: Fioricet, Esgic, Esgic-Plus)
    * butalbital and aspirin (trade name: Axotal)
    * butalbital, aspirin, and caffeine (trade names Fiorinal, Fiormor, Fiortal, Fortabs, Laniroif)
    * butalbital, paracetamol (acetaminophen), caffeine, and codeine phosphate (Fioricet #3 with Codeine)
    * butalbital, aspirin, caffeine, and codeine phosphate (trade name: Fiorinal #3 with Codeine)


    If you mix it with and half a glass (or less)of wine with a normal or weaker dose of tramadol seems to boost the production of M1 from tramadol, and M1 is responsable for the most opiate like effect u get from trams..

    You should note that s addictive on his own as Butalbital is a physically and psychologically addictive barbiturate.

    But butabital for safe reasons should not be used with alchool so do not do it or OVERDOIT!
    Read this: Butalbital should not be mixed with alcohol due to increased risk of intoxication, increased respiratory depression, and increased liver toxicity when it is a butalbital combination including paracetamol. There are other potential risks; this list should not be considered all-inclusive.
    Last edited by DCBAe; 16-11-2008 at 19:50.
     

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    #74
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    ^^
    I’ve always been interested in Fioricet (butalbital, APAP, caffeine) but never tried it. Your post about the butalbital potentiating tramadol prompted me to do so.

    I generally take 100-300mg tramadol on a daily basis with an occasional holiday in an attempt to reduce tolerance. I take it for its SSRI/SNRI effects, as it synergizes well with my atomoxetine (an SNRI for AD/HD) and helps me to focus. (I have scripts for both, and atomoxetine combined with tramadol does not put one at risk for serotonin syndrome, as SSRIs do).

    Long gone are the days that tramadol produced anything resembling an opiate buzz. So, I procured some generic Fioricet in the hopes of enhancing the conversion of tram to M1.

    I took 200mg tramadol at time zero along with four 50mg butalbital/325mg APAP/40mg caffeine pills. I took 4 more pills at t plus 3 hours. I certainly noticed the effects of the Fioricet- I was talkative and felt more empathy toward others. However, I did not feel anything resembling an opiate buzz, but rather the effects of the Fioricet. I’ve experimented a few more times, extracting the liver-killing APAP so that I could take larger doses of butalbital (and caffeine, as I don’t have the set-up to attempt that). Still, nothing I would call tramadol potentiation, in the true sense of the word, but rather a synergy. If you want to be “up,” tramadol and Fioricet (or better, Fioricet less the APAP) make a good combo. However, in my experiments, I experienced no potentiation.

    Caveat emptor: It’s my understanding that barbiturates induce not only tramadol but atomoxetine as well; thus my experience might well be different than the experience of others.
     

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    #75
    Bluelighter Tsukasa's Avatar
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    Quote Originally Posted by johanneschimpo View Post
    I don't think Tsukasa has taken 1/10 of the drugs he talks about. I've seen him give out some pretty dangerous advice in the past.

    The one already noted: tramadol + DXM = NO
    Also, two of the "potentiators" he mentioned: citalopram + DXM = NO
    Then, all three of those together: tramadol + citalopram + DXM = NO; are you begging for health problems?

    Good job catching that, nabollocks. We don't want people giving dangerous "advice" like that here.
    You don't need to be a douche man.

    I've taken a therapeutic dose DXM with tramadol before. I felt a little nauseas but nothing related to serotonin syndrome. I was assuming the tramadol would be taken at therapeutic doses.

    Citalopram is very often prescribed to people on tramadol by actual DOCTORS. You are not a doctor, so you wouldn't know better. Tramadol is a weak SRI anyway.

    I agree with you if tramadol is abused at high doses then DXM and citalopram should definately be avoided. But at therapeutic doses it is generally safe, and I know this from experience.
     

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