Another Tramadol taper/withdrawal thread sorry

[dredd]

I am starting a new job soon and I've been living my life hooked on Tramadol which was originally prescribed for back pain in order to fight my depression while I was unemployed for so long after losing my last job. Tramadol gave me the motivation to look for work and succeed in securing the job in my work interview. So Tramadol has been tremendously helpful to me, but I don't want to rely on it any longer as I feel it will escalate and cause me more problems than I would like.

I've been on Tramadol around 9 months now. It started with just the one 50mg tablet daily. Then that ended up being two, and then three - so 150mg daily max. I managed to go down to 100mg by doing alternate days of 100mg and 150mg. Then I stuck to 100mg once I felt I had adjusted. I've since managed to go down from 100mg to 75mg, but now I feel stuck here. Any less and I feel like I can't think straight, I have terrible fatigue and I'm depressed.

Since I've been suffering from Depression from the start anyway and that I feel more depression lowering my Tramadol, I thought about going on an SSRI type antidepression instead. I'm not sure how I'm supposed to switch from one to the other. Can I just quit Tramadol on the day, and start taking the SSRI medication the next?

 

[cook]

You probably can, because the tramadol leaves your system pretty fast and the SNRI activity at that dose is low anyway. Is venlafaxine (powerful SNRI) out of the question for you? Personally I have been using tramadol up to 300mgs a day with venlafaxine an mirtazapine with no problems, but of course it is not recommended because of the risk of serotonin syndrome and even seizures.

 

[dredd]

Hey Cook.

I looked at Venlafaxine and the problems with people struggling to get off of it would put me in a similar situation to Tramadol if I wanted to come off, so I don't think that would be good for me. I think a simple antidepressant like an SSRI one will be kinda to me long term.

I appreciate what you are saying, but I need to be sure I can move from one to the other without risking serotonin syndrome.

 

[laCster]

tramadol is not an SNRI. it is a SRA (serotonin releasing agent), NRI, NMDA-blocker, sigma-1 antagonist, nicotinic ACH antagonist, along with a few other modes of action. because it is so "dirty," withdrawal from tramadol has been said to be a bit hellish due to its metabolite's opiate effects and how it affects many other different parts of the CNS.

i recommend a low dosage of DXM (60-90mgs) to stave off WD from the wide range of effects it causes to allow the WD from M1's opiates effects to be a bit smoother.

good luck..

 

[dredd]

How am I supposed to get that?

Btw, I've heard Prozac in low doses is good for eliminating withdrawals because of the way it is metabolised and will reduce the craving for Tramadol. Is this true?

 

[laCster]

it is the active ingredient in cough syrup which is sold around the world in almost every grocery, convenient, and drug store along with some gas stations.

you want a brand which only has DXM as the active ingredient and nothing else. Delsym procures the best effect IMO. a type of robotussin only contains DXM, it usually comes in a blue box but tastes horrid. i'd go with the delsym for your needs.

prozac will not do shit for your WD. by the time your WD is over, the prozac will kick in as it usually takes 2-4 weeks for a person to even feel its effects. DXM acts instantaneously meaning you will feel it after 30-60 mins of swallowing it. prozac will most definitely cost more than a bottle of DXM because first you need an appointment with a doctor or psychiatrist, then you will have to pay for a prescription.

this is what i advise...

stop taking tramadol and wait atleast a day before you take the DXM. i would even wait 2 days because if taken together the combination of both could be deadly because they will both increase each others very similar effects.

then take 60-90mgs of DXM a day for 1-3 weeks, and then stop taking the dextromethorphan. taking diphenhydramine (benedryl) at night to help will greatly help aswell IMO.

do yourself a favor and get some exercise and eat healthy too. this thread will also aid you in your journey to recovery.
http://www.bluelight.ru/vb/threads/562628-The-OD-Opioid-Withdrawal-Megathread-and-FAQ

 

[Swimmingdancer]

I would do some more research before just replacing the Tramacol with dextromethorphan (DXM). Even those doses of DXM make me pretty fucked up, like a weird drunk, numb and drowsy feeling. You also have to make sure that you are actually taking the right number of mg, not ml, because depending on the syrup there can be like 30mg per 5ml. And make sure it is a syrup that contains only DXM and no other active ingredients. Dextromethorphan is a dissociative, along the lines of drugs like nitrous oxide, ketamine or PCP. DXM is an SRI, so it should be helpful with the symptoms of Tramadol withdrawal, but I assume you would still get much of the opioid withdrawal symptoms.

You could talk to your doctor about switching to an SSRI, they would know more about how to make the switch, but I've heard of people doing that with good results. But then you would just be dependent on another drug.

 

[Coraline]

Tramadol is a SSNRI and opioid. It works on noreperniphrine and seritonin. It's a opioid that acts on mu receptors. The pharmacology isn't totally understood.

 

[cook]

I looked at Venlafaxine and the problems with people struggling to get off of it would put me in a similar situation to Tramadol if I wanted to come off, so I don't think that would be good for me. I think a simple antidepressant like an SSRI one will be kinda to me long term.

I would say that tramadol is definitely harder to come off than venlafaxine. I believe that it is the opioid activity that causes most of the depression and discomfort when discontinued. This combined to the SNRI-effects may play together in a bad way. With venlafaxine the withdrawal symptoms are mostly physical and somewhat manageable with proper tapering schedule.