Opioids Tramadol and suboxone what is the synergy effect? Help depression?

[ColoradoBoy90]

I have heard countless people claim they take Suboxone and Tramadol and they combine perfectly. My question is: in what way?? Is it stimulating, like Oxy was before you got a tolerance? Or does it make you "nod" out. I don't want to nod. I need to function.

But I'm addicted as hell to Tramdol, 12-14 pills a day, so I need something to help me get back down to 8 Tramadol a day (subs should help the WD) and hopefully restore the antidepressant effects. The serotonin action from Tramadol helped better than any SSRI, or SNRI ever! So why did it stop. Why? I know you become tolerant to opioids, but SSRI/SNRI tolerance takes years to build, sometimes never!! So why did Tramadol at first HELPED my depression, OCD, and improved confidence? From the serotonin action. But why did it stop??? The depression relief It was NOT from its weak opioid effects, as I have been on Hydromorphone 40mg daily prior to that, I have 5 years of heavy DAILY opioid tolerance. Opioids provide zero mood boosts to me, they just make me tired now. Tramadol is more stimulating. But I want it's serotonin effects of helping depression and OCD to come back!
I've only been on Tramadol for like 3 months. It helps somewhat, but I still find myself always feeling sad, not confident anymore, OCD has returned, etc. So I don't get it -- if Tramadol is reuptaking serotonin I should have never lost the confidence and my OCD shouldn't have returned?? SSRI's do the same thing and Prozac kept them away for 6+ years, I only quit Prozac because it dulled Oxy - which was my "new addiction".Would Tramadol (ER or IR) and low dose suboxone, like 1mg per day, would that help depression? Or boost mood? Something longer term, not like opioids that so it for 6 months then suddenly do the opposite.. Oxycodone used to be an amazing, stimulating and mood lifting. Now 5 years later? I makes me tired, and zero mood boost unless I Triple the dose, and then it last only 15 mins and is weak. So I don't expect opioids to provide any relief, but serotonin acting drugs have helped me A LOT. On drugs website, Tramadol has a 9.5 score for depression and OCD/Anxiety -- higher than any medication on the market!

Or is my only option SSRI/SNRI/or Wellbutrin for long term depression treatment? I've just VERY interested in Tramadol... Not only did it help wonders for first month or so (until I started to take 14 a day, maybe that's why it's not working. Maybe back down to 8 a day will make it work again? I dunno) but it's the highest rated med out of HUNDREDS for depression, OCD, and anxiety. Stuff like Zoloft made me feel like a zombie after first DAY, Tramadol had very little side effects, most of them positive and energy boosting.

 

[ColoradoBoy90]

If Tramadol and low dose subs don't help depression, what's my BEST bet antidepressants wise -- or off label non antidepressants??

I'm considering Effexor ER. It's supposedly very similar to Tramadol in the SNRI aspect.... and at a dose above 300mg it hits dopamine too!!! So I would get a serotonin increase, norepinephrine, AND dopamine.

Also, I take Remeron/mirtazpine 15mg nightly. Would Tramadol + mirtazapine = California rocket fuel?
Or is that only Effexor and mirtazapine??

My chemical are shot, and down regulated heavily. I burned (or killed them off) from years of HEAVY daily Adderall usage (75mg+ daily), then went to opioids for 5 years..... Now my mood is always down, OCD increased. The Tramadol helped for a good month, like a magic pill, and I felt the serotonin as I know what serotonin release feels like.... But HOW did Tramadol's SNRI effects stop working after just 3 months? Maybe I need 5htp as Tramadol also releazes serotonin, AND reuptakes..

But still VERY curious about Tramadol + Low dose Subs daily for depression, mood lift, etc, I really don't want to do SSRI's again....

 

[My3sons]

Just wean yourself down. Don't go adding more problems. You're used to tramadol and not getting high from it like you used to. That happens with all drugs. Then it just turns unto maintenance.

 

[tacodude]

If you're dependant on tramadol you'll likely end up with PWD, but if you use tramadol after stabilizing on bupe I'd imagine it would block the opiate prodrug action mostly and essentially be a SNRI... That's the only thing I could guess could be seen as a benefit l of taking both. Again though op only take bupe if you can stay off tramadol for a couple weeks.

 

[Jabberwocky]

Have you thought of ketamine therapy for depression?

 

[ColoradoBoy90]

I have thought of ketamine therapy. But I don't know any doctors who do it..
Isn't the theory it "resets" the brain or makes it back to normal? I could google it but will later today.

Also I thought Subs can be taken WITH Tramadol, and no perticapted WD's would happen. I googled this and found many blue on blue light who take them both, some take Tramadol before Subs, some after, but subs don't affect Tramadol for whatever reason. I guess Tramadol doesn't attach strong enough to the mu-receptors? Most people don't know why but many take it.

My problem: I will run out of my script 1-2 weeks early... I tried to cut down to 8 a day and I'm vomiting, dierhaa, runny nose, violent non stop yawning, chills, and all the same symptoms I get from Vicodin or Oxy withdraws, just maybe 10% weaker. It's basically the same... BUT worse arguably, as Tramadol WD also includes brain zaps, and Effexor like WD in addition to opioid WD.

Soo... that's why I said subs. If I take the MIN dose of subs, I can cut back from 12-14 Tramadol a day down to 8 a day without going into bad WD. I planned to take it for a week only. I can't cut back slowly as WD hits me hard, and I work everyday.

 

[Jabberwocky]

Sounds like it would be worth to experiment with what you're thinking. I never had any issues combining tramadol and buprenorphine.

 

[tacodude]

I really think ketamine treatment shouldn't be thrown around lightly as it is not only because it's damn hard and at this point a luxury that really should be a right due to expenses, but also there's not enough research nor enough types of products available to dose right. I'm not saying ketamine shouldn't be used, but that the medical system has the treatment and forms available so wrapped in regulations your better off not bothering or just buying your own vials for nasal administration. The only reason to do it in a medical setting is for a long slow infusion, which definitely can be beneficial, as that's the only hard thing to do with ketamine outside a medical environment and should have someone trained watching over the person being infused of course. Just saying

 

[opiatekrzy]

I have mixed tramadol with Suboxone numerous times, and they're is absolutely no interaction between the two that will cause precipitated withdrawal. Oddly, at pharmacies you cannot be on both at the same time , they will not fill it and will need a prior auth. For switching over, when they don't even interact like traditional opiates do

 

[tacodude]

I swear I've read people who used tramadol regularly and then tried bupe and had pwd... Tramadol is a prodrug to o-dmt (o-desmethyltramadol) and that is an opiod so it would cause an opiate dependancy that would throw someone into PWD if they took bupe after enough tramadol was taken to cause withdrawals if stopped. It's just common sense.


Starting bupe than using tramadol after bupe blockade develops seems a real novel approach at making it a useful combo as you would get the SNRI profile of tramadol that may be the only one to work for some and not only a reduction of opiate effect disregarding the complexities of the full agonist bupe Metabolites it is probably less likely the opiate effect will vary per dose based upon digestive health while tramadol will vary greatly based upon digestive health and how much it can convert into the opioid active metabolite. So it won't change the effect as far as what areas it works much, but it could create balance and stability in the medication that the compound has what seems a natural self relating effect especially with the seizure risks. Makes me wonder what the inventors was thinking when they discovered this compound and it's effect.

This really makes me wonder if anyone's tried starting bupe then after a proper block and stable dose is made then tramadol would be started and to see how much it differs from either being taken alone vs with bupe as well as that by itself too as well as in combos with ssris. If anyone had any reports of personal experiences preferably with the combo although if one has used the combo and for all preferably at least a month it could come together to be useful info. I'd create my own study, but I'm broke and stupid.....

 

[Jabberwocky]

There is a newer detox protocol that uses tramadol in place of buprenorphine (it is used in particular to detox people from methadone) that I had wanted to try, but wasn't able to get the okay from my doctor for.

I guess tramadol doesn't work for a significant number of people, but I personally always thought it was a highly underrated substance. It's not necessarily going to get someone super fucked up or anything, but it has very pleasant, useful effects.

 

[opiatekrzy]

I know for me personally, I have mixed both regularly for years, with no PWD

 

[ColoradoBoy90]

Can anyone explain WHY the serotonin reuptaking stopped working after only a couple momths? If it's an SNRI, it should keep reuptaking serotonin for years.

But for the last 1 month I took it, I felt the effects of increased serotonin A LOT. Now, I hardly feel it. Why??

I can understand getting a tolerance from the opioid effects of Tramadol, but the SNRI effects should keep working for as long as any SSRI/SNRI would... which for many people can be their entire life it works.

 

[ConstanceG]

Tramadol is a funny little drug. I was on it for 8 years and yep, prolonged use took the happy and pain relief away. I found myself double dosing and reaching for the pill bottle way too often.
My nuero tapered me from tramadol with the intro of the butrans patch. I had NO wd symptoms. After watching a bf of mine go from horrific wd and seizures from tramadol, I was pretty happy to have bupenorphine.

 

[kardax1855]

Ok I have a question that's been said thousands of times I'm sure but here it is. I take suboxone and tramadol a lot before! Now when I take team it's 10-12 50mg tabs at a time... Ive not had it for a min tho since I've been on suboxone recently. My question is Ice taken them separate only but now I'm on suboxone and recently got tram back. Now since suboxone has the NALOXONE in it.. will it hurt me to be taking the tram with the suboxone (who's has the nalaxone in it) at the same time? I'm worried to take them together especially since I take such a large dose of tram at a time... So will this be ok or not? I took my 8-2 mg suboxone this morning now want to take the 10-12 50 mg of tramadol _it's been like 5 hrs. Am I ok to take them together or not?

 

[Jabberwocky]

The naloxone has no affect on the tramadol. Please don't take more than 300mg of tramadol if you haven't taken it in a while. I never found buprenorphine to be cross tolerant with tramadol, so there isn't a need to dose high if you haven't taken tramadol in a while. With the doses you had been using, you were asking for a seizure, so please try and avoid dosing so high.

 

[ColoradoBoy90]

Tramadol is like being addicted to Hydro/Oxy. I've been on EVERY single pain prescription expect: Tyneol 3/4 or the patch. I have been given coidiene before, first opiste in fact.... I remember feeling happy on it. Then Hydro, way stronger. Than Oxy, as that's all that was around. Felt just like Hydro just more energetic.

Tramadol causes the same WD's as Hydro/Oxy, and I have minor withdrawals everyday when I wake up. Why only minor? Because I take 200-400mg of ER Tramadol, which lasts for 24 hours... so in theory I shouldn't have any WD waking up, but I still do, but surprisingly I woke up a few times and wasn't sick... that's normally when I take Tramadol ER right before bed. I can sleep 14 hours and not wake up in WD, so their ER formula does work at least 16-18 hours, if not longer, it's superior to any other ER pain med, length wise.

Taking 600-800mg a day, it just sucks. And when you "space doses", that's 8 Tramadol 50mg cut in half = 16 pills, 25mg each per day taken every 30 mins all day + 2-3 100mg ER pills per day. So almost 20 pills a day, in total.


My only concern is how the hell do I get off these. It takes 1-2mg of subs (min) to cancel out Tramadol withdraws. I tried 0.5mg and within a couple of hours I was getting sick again. Had to take 1.5mg to 2mg first day. Tramadol is stronger than most think.... Supposedly 50mg Tramadol is equal to 5 to 10mg of Oxycodone in studies....

Ugh. I wonder if a SHORT (3 day) sub detox + take Effexor ER to help the SNRI withdrawals? It's worth a try.. I'd rather be on an antidepressant for life than opioids. I have depression, without question. So I'd much rather take AD's than opioids.

 

[Jabberwocky]

It's definitely worth trying to replace the tramadol with Effexor or another antidepressant. I'd suggest you deal with the tramadol withdrawal before tackling buprenorphine withdrawal. Both at the same time would be unnecessarily unpleasant. Slow and steady wins this race anyways.

Edit: my bad, you aren't current dependent on buprenorphine. Honestly if you need to detox from tramadol buprenorphine will probably be enough to manage the symptoms, but adding an antidepressant is a pretty good idea when you're detoxing from opioids generally speaking. If not Effexor, buproprion of something.

 

[opiatekrzy]

Tramadol and Bupe mixed together does not cause precipitated withdrawl or any highly unpleasant effects, I have mixed the two daily for over a year, you may experience irritability as that is common for hese opioids in general

 

[opiatekrzy]

Ok I have a question that's been said thousands of times I'm sure but here it is. I take suboxone and tramadol a lot before! Now when I take team it's 10-12 50mg tabs at a time... Ive not had it for a min tho since I've been on suboxone recently. My question is Ice taken them separate only but now I'm on suboxone and recently got tram back. Now since suboxone has the NALOXONE in it.. will it hurt me to be taking the tram with the suboxone (who's has the nalaxone in it) at the same time? I'm worried to take them together especially since I take such a large dose of tram at a time... So will this be ok or not? I took my 8-2 mg suboxone this morning now want to take the 10-12 50 mg of tramadol _it's been like 5 hrs. Am I ok to take them together or not?

it's not do much the naloxone you have to worry about that causes PWD, it's ineffective sublingually, and believe it or not, buprenorphine alone will cause PWD in combination with other opioid drugs