quite a few questions from a new guy

[Twizm]

So I have quite a few questions. I have searched all over the forums for the correct place for this and hopefully I can get some help here. I have been prescribed Tramadol, Hydroxyzine, Gabapentin, and Baclofen for a long time. Like I have a lifetime prescription for these. However my problem has become quite significant and im hoping people here can help me out.

A little but about me, I am disabled and recently my problems have gotten worse. I have a very bad back, very bad knees, severe head aches amongst other problems which I am sure you can guage by some of my prescriptions. Up to about recently the drugs that I am taking havent had the effect I have desired. I have been taking tramadol and hyrdos for quite some time, about 6 months now? I take about 2-4 daily for the pain and 1 used to be enough. Is there anyway for me to increase the pain relieving feeling/euphoria to remove these back pains? Can i mix them all? I was told building a tolerance to Baclofen is very hard. Well in my case I feel it does absolutely nothing.

I heard that hydroxyzine if taken properly can help with the other drugs? My pain is pretty sever and my dr will not give me pain meds (oxys/Vicos/morphine) just yet. I go to pain management soon for my first time, and all my pain can be revealed on x rays. I have a severe case of spondylosis, plica issues in both knees, lumbar 3 is basically shot and i need to relieve the pain. Any help would be greatly appreciated for what i can do with these drugs to help with the pain.

 

[Crashing]

There isn't much you can 'do' with those drugs other than take them as prescribed. If you increase dosage, youll run out before the refill. If the same doctor prescribed you each of those meds, then he must assume that you are taking them simultaneously, but i haven't looked up the interactions. Have you tried hydrocortisone treatment? There's not much you can do for a condition like that other than continue treating it for pain.

 

[Twizm]

the steroid shots? Yup done them in my knee and GOT an epidoral *not fun* and nothing has helped. At one point in time I was prescribed oxys for my knee AFTER surgery and it worked wonders but my mom died of cancer and I watched her get so addicted to them she was on 20 80's a day. Intense nonetheless. I dont want to go there but this knee and back pain is intense. I am a disabled vet and the VA doesnt like to give out better meds then what I have and well its quite bothersome at this point since everything im doing to fix these service related injuires, jumping out of planes and shit, nothing help

 

[jaspersilence]

When u go to your pain management tell him/her this...Instead of gabapentin,something more in the lines of arthritis type pain.Gabapentin is mainly for nerve pain.Instead of Baclofen,try Xanaflex.In my opinion it's the best low habit forming muscle relaxer.Keep the hydroxyzine.Unfortunately it seems u are going to have to get some heavier drugs.Your problems aren't small.The next step up would probably be vicodin.As of now,double dose your trams and take a baclofen.Yeah you'll run out earlier,but if you don't make it a habit I think your doc might have some sympathy,and see that you need more,or something stronger.I am not a doctor,this is just my opinion.They hydroxyzine has been known to make other painkillers more potent.It seems that addiction is inevitable for you,I'm sorry,but with the right combo of drugs you can keep your intake of the heavy drugs to a minimum.

 

[Twizm]

When u go to your pain management tell him/her this...Instead of gabapentin,something more in the lines of arthritis type pain.Gabapentin is mainly for nerve pain.Instead of Baclofen,try Xanaflex.In my opinion it's the best low habit forming muscle relaxer.Keep the hydroxyzine.Unfortunately it seems u are going to have to get some heavier drugs.Your problems aren't small.The next step up would probably be vicodin.As of now,double dose your trams and take a baclofen.Yeah you'll run out earlier,but if you don't make it a habit I think your doc might have some sympathy,and see that you need more,or something stronger.I am not a doctor,this is just my opinion.They hydroxyzine has been known to make other painkillers more potenet

I think my shrink gave me gabapentin, the VA likes to give drugs out for its off label use. Ill ask about the Xanaflex but they dont like to give out WHAT i want. They give out what they want more or less. The VA doesnt like to give out heavier drugs and if i go to another dr and they find out, ill be relinquished of my disability rights. I have tried vicodin, NOT A BIG fan, the stomach burning is just gross and I have to double down on my Ranitidine to make that go away. I cant really run out so to speak, I just refill them online and get them in 2 days. I am not trying to be like a drug pheen, but more or less FIX these problems with what I have. If not I dont know what to do at this point.

BTW im at the point of 200mg of Tramadol a day prescribed btw. Im close to the seizure threshold of 300mg

 

[Crashing]

It's really a dismal situation to try to predict how many years you'll be alive for, and then calculate your opioid dosages/prescriptions accordingly to ensure that you'll never max out on pain med strength, however that might be something to talk about with your doctor if you are going to be on meds forever.

 

[Twizm]

ill bring that up, im 35 they might say that well just keep increasing the dosage. But then you are flirting with disaster with Tramadol and upping dosage as so i have read

 

[Crashing]

Well, you would probably next move to codeine, morphine, or hydrocodone. That's the dosage increase once the tramadol is maxed, then there's the possibility of transdermal time released patches for continuous pain management with a PRN quick acting opiate for breakthrough pain.

have you tried cannabis? that will greatly increase the effects of the pain medications

 

[Twizm]

yeah i wish I had a dr that would give those wonderful pain relievers but in my case that doesnt seem to be the thing. I think the next step is the Tapantadol (sp?) which is the beefier version of tramadol, I put in a request for it. They gave me tramadols for knee and headaches, the funny thing is sometimes it works for the knees but gives me a ridiculous migraine

 

[jaspersilence]

You may need another med to lower your seizure threshold if you up the Trams...Doctors don't usually mind if you recommend drugs you have researched,as long as they are non-narcotic.You will have to be careful when discussing the next step up in painkillers though...But hey,if you neddem you needem,tell; the doc the Trams no longer work,and what they might recommend giving you.good luck.

 

[Twizm]

isnt Gabapentin lowering my threshold so it would be safe to up it?

 

[Crashing]

Correction, you need to RAISE your seizure threshold.

 

[Twizm]

Correction, you need to RAISE your seizure threshold.

advice on SOME NON narcotic drugs lol that I could request that would do that Crashing that works well with all those meds? see the thing is my shrink is very careful on what to give me for PTSD *fucked up war nightmares* that dont mix well with tramadols. So I need to get something to raise it and be in the safe zone so to speak

 

[Crashing]

Now, i'm not really knowledgable on that topic. I know some psychotropic drugs are suspected to raise the threshold, but these are still in testing phase. Magnesium supplementation helps too, but i don't think your doctor will allow you to take a dosage that is unsafe. He would just change the prescription before that danger became too apparent. Assuming he is a decent person.

Also, though rare, there are pharmaceutical companies that design custom creams with many ingredients including nerve blocking agents, topical anesthetics, muscle relaxers, and most importantly ketamine. These custom made creams will literally eliminate almost all types of musco-skeletal pain, however are extremely hard to get any info on. Unfortunately, these creams could replace opiates altogether for many people but sadly our society doesn't work for the benefit of the common man. They're called compound creams. They can contain a WIDE variety of medicines, including tramadol, ketamine, cyclobenzaprine, clonidine etc... I'm sure there is some concoction that that would help you out if you can find the right doc.

 

[Swimmingdancer]

Yes gabapentin should decrease the likelihood of a seizure, but please don't raise your tramadol dose, you'll just run out before your next refill. Tell your doctor your pain is not being relieved and see what they say. We can't help you with suggestions of what drugs to ask your doctor for or what to say to your doctor to get drugs aside from telling him/her the truth. If you are unhappy with your medical care seek out new care. It takes a lot of trial and error to fond a drug regimen that decreases your pain sufficiently to allow you to be functional without too many side effects or risks. That is a difficulty for the majority of us who are in chronic pain. Many people have to learn to live with a degree of pain, find non-drug strategies to help reduce or cope with pain, environmental/lifestyle factors that distract us from the pain and so on. It really has to be a multi-pronged approach and it's not easy. Best of luck to you

 

[Twizm]

Yes gabapentin should decrease the likelihood of a seizure, but please don't raise your tramadol dose, you'll just run out before your next refill. Tell your doctor your pain is not being relieved and see what they say. We can't help you with suggestions of what drugs to ask your doctor for or what to say to your doctor to get drugs aside from telling him/her the truth. If you are unhappy with your medical care seek out new care. It takes a lot of trial and error to fond a drug regimen that decreases your pain sufficiently to allow you to be functional without too many side effects or risks. That is a difficulty for the majority of us who are in chronic pain. Many people have to learn to live with a degree of pain, find non-drug strategies to help reduce or cope with pain, environmental/lifestyle factors that distract us from the pain and so on. It really has to be a multi-pronged approach and it's not easy. Best of luck to you

ty for taking time out to post on my behalf and helping me out. I will ask them to assist I just wanted to throw my meds out there and see what is the "safe" dosage. Ive seen people take 300 and not have any issues, I know that all of you arent doctors just wanted advice. The thing is with the Tramadol, the refill relies pretty much on me, I just submit a form and get a new dosage. It works well sometimes, just not all of what I wish it could be. It seems like most drugs have such a plethora of side effects with the cocktails im on. Its like 10 drugs cause of my issues lol

 

[pasha]

So I have quite a few questions. I have searched all over the forums for the correct place for this and hopefully I can get some help here. I have been prescribed Tramadol, Hydroxyzine, Gabapentin, and Baclofen for a long time. Like I have a lifetime prescription for these. However my problem has become quite significant and im hoping people here can help me out.

A little but about me, I am disabled and recently my problems have gotten worse. I have a very bad back, very bad knees, severe head aches amongst other problems which I am sure you can guage by some of my prescriptions. Up to about recently the drugs that I am taking havent had the effect I have desired. I have been taking tramadol and hyrdos for quite some time, about 6 months now? I take about 2-4 daily for the pain and 1 used to be enough. Is there anyway for me to increase the pain relieving feeling/euphoria to remove these back pains? Can i mix them all? I was told building a tolerance to Baclofen is very hard. Well in my case I feel it does absolutely nothing.

I heard that hydroxyzine if taken properly can help with the other drugs? My pain is pretty sever and my dr will not give me pain meds (oxys/Vicos/morphine) just yet. I go to pain management soon for my first time, and all my pain can be revealed on x rays. I have a severe case of spondylosis, plica issues in both knees, lumbar 3 is basically shot and i need to relieve the pain. Any help would be greatly appreciated for what i can do with these drugs to help with the pain.

Hydroxyzine actually appears to affect the conversion of tramadol to O-desmethyltramadol (M1) negatively because i'ts a CYP2D6-inhibitor. You need tramadol to be converted into O-desmethyltramadol for any analgesic benefit.

Gabapentin and tramadol is a synergistic combination, and has an cooperative effect in significantly increasing analgesia. The baclofen can help with greatly with your spondylosis, but if you want the best muscle relaxant to take with tramadol I would highly recommend carisoprodol, the drug that provides the strongest benefit with tramadol.

Tramadol, carisoprodol, and gabapentin is your best possible option.

I should also note the baclofen carries a risk of dependence, tolerance, and withdrawal.

 

[laCster]

Try switching to Pregabalin(lyrica) from gabapentin.

And switch out shittt baclofen which isn't an anti convulsabt like diazepam or.klonopin. if you are worried about sedation, addiction, and dependency. Go with desmethyldiazepam (clorazepate, nordazepam) which is a partial agonist and will produce less sedation and killed the almost.nonexistence of recreational benzo with clorazepate) or go with oxazepam

Oxazepam has the slowest absorptionrate and slowest onset of effects of all benzos. In addition oxazepam is not heptatically metabolized so there is no build up of blood levels and stacking effect from the last dose. Because of these reasonsx they are the "safest" and the benzos desmethyldiazepamand oxazepam have the least, or lesser side effects associated with use such as solomance, CNS depression,, ataxia, amnesia,ect...

I really recommend one of these benzos because tramadol is.very likely to cause seizures..idk why it is still on the market. Benzos raise your seizure threshold to help prevent the onset or occurrence of seizure


Most.importantly, a benzo and upgrading to lyricA will exponentially increase analgesia of tramadol and hydroxyzine better than gabapentin and baclofen also take naproxen sodium or aspirin daily for pain

 

[Twizm]

Hydroxyzine actually appears to affect the conversion of tramadol to O-desmethyltramadol (M1) negatively because i'ts a CYP2D6-inhibitor. You need tramadol to be converted into O-desmethyltramadol for any analgesic benefit.

Gabapentin and tramadol is a synergistic combination, and has an cooperative effect in significantly increasing analgesia. The baclofen can help with greatly with your spondylosis, but if you want the best muscle relaxant to take with tramadol I would highly recommend carisoprodol, the drug that provides the strongest benefit with tramadol.

Tramadol, carisoprodol, and gabapentin is your best possible option.

I should also note the baclofen carries a risk of dependence, tolerance, and withdrawal.

wow very informative, carisoprodol you can also from a high tolerance from too yes?

 

[Twizm]

Most.importantly, a benzo and upgrading to lyricA will exponentially increase analgesia of tramadol and hydroxyzine better than gabapentin and baclofen also take naproxen sodium or aspirin daily for pain

I cant take ANY FORM of Aspirin, Acetaminophen, or Ibubrofen as I have a bad bad bad case of taking 1000mg of Motrin when I was in the Army and have a severe case of bleeding ulcers, peptic ulcer and gastric ulcers. This is the main reason for the Tramadol over all types of otc drugs like Tylenol and such