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Misc Tramadol, Venlafaxine, Pregabalin for Neuropathy

delphinen

delphinen

Bluelighter
Joined
Mar 20, 2007
Messages
991
Location
Gensokyo
Hello
After some tests, my docs found that I have some kind of peripheral neuropathy, I was on Venlafaxine for depression but now I am on a higher dose of it for depression AND neuropathic pain, plus some Pregabalin throw out there. After getting some relief from the meds I found this:

ssri_tramadol_structuresame.png


I used to take lots of Tramadol for recreational purposes, now I am thinking about telling my docs to add Tramadol for the Neuropathy, would that be a wise move? I get good relief from Venlafaxine and Pregabalin, but I don't feel ANY pain on Tramadol. Could you guys help me?
 
They lookk similar, but they have major differences at a cioser look that majorly changes mechanism of action.
Venaflexine I took once and laid in bed with fear/ seeing spiders/ paranoid ect...
 
I see where you're coming from Delphinen, but mike.vick is right. The similarity in chemical structure shouldn't come as a total surprise though. Tramadol is practically defined by the fact that it's both an Opioid and a Serotonin-Norepinephrine Reuptake Inhibitor, just like Venlafaxine (Effexor). That's great that you're having positive results with your neuropathy though.

Be aware that Venlafaxine and SNRI's in general are typically difficult to withdraw from.
 
So it would be not wise to ask my doc about Tramadol?

PD: yes I am aware, though the times I have ran out of it I didn't experienced bad WD honestly, although it was only for 24hs
 
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You should take one or the other. tramadol and venlafaxine is a risky combination
 
I did 500mg Tramadol today. Didn't feel too high, but all the pain was gone, as usual. I don't mind not getting high if it takes away all my physical pain... but I have no idea how to introduce this idea to my docs, they probably don't know much about Tramadol.. and I am one of the few who gets so many Pregabalin in the whole clinic already.
 
500mg?^ isn't that above seizure threshold? Please don't do this again OP, I would seriously question the venlafaxine too and do some research on the neuropharmacology of as many antidepressants as you can, maybe you could ask your dr, or even start looking for a new one if you can (dr that is). I would strongly suggest finding a dr/clinic that actually seems knowledgable about the meds.
 
Yes. 500 mg is very risky, and it's not a safe dose.

Are you also taking venlafaxine? That's a potentially dangerous combination.
 
500 mg is too much! Anything over 300-400 mg can result in a seizure, particularly if you take another SNRI
 
Venlafaxine and Tramadol are indeed closely related; indeed you could say that Venlafaxine is just a Tramadol analogue that lacks the opioid effect.

As the others in this thread have pointed out, Tramadol and SNRIs/SSRIs really, really don't go together. As it gets metabolized by the liver, Tramadol's serotonergic effects decrease while the opioid effect increases. Venlafaxine competes for those same liver enzymes, so if taken together, Tramadol's opioid buzz becomes weaker while the serotonergic effects are potentiated. What this means is that you can easily get a seizure (or other symptoms of serotonin toxicity) from Tramadol doses of 400 mg or less.
 
mike.vick said:
]
Got tram.. Does taken klonopin w/ it allow you to not seize potentially?
Click to expand...

Yes it would definitely help. I think benzodiazepines are a first line treatment for SS. It might still take a pretty hefty dose to be safe--especially if you have benzo tolerance.
 
Hodor said:
Venlafaxine and Tramadol are indeed closely related; indeed you could say that Venlafaxine is just a Tramadol analogue that lacks the opioid effect.

As the others in this thread have pointed out, Tramadol and SNRIs/SSRIs really, really don't go together. As it gets metabolized by the liver, Tramadol's serotonergic effects decrease while the opioid effect increases. Venlafaxine competes for those same liver enzymes, so if taken together, Tramadol's opioid buzz becomes weaker while the serotonergic effects are potentiated. What this means is that you can easily get a seizure (or other symptoms of serotonin toxicity) from Tramadol doses of 400 mg or less.
Click to expand...

If you look closely, these differences can/will/have substantially altered any similarities.
 
Slow_Mobius said:
Yes it would definitely help. I think benzodiazepines are a first line treatment for SS. It might still take a pretty hefty dose to be safe--especially if you have benzo tolerance.
Click to expand...


Thanks Brother- I've ~trippled my daily dose due to not having my opiate of choice - but I got a strong sertonergic buzz from tram I wanna keep going, gonna slowly pop 50mg every so often (45min-few hours)
 
How much are you taking these days?

I used to take tramadol all the time and I personally find it more euphoric than more hardcore opioids. There was one day that i took about 200-250 mg, but I had also been taking a little more than usual the previous few days. For about 3 hours my muscles were completely rigid and I felt like death. It took every ounce of will power to not lose control of every muscle in my body. Fucking horrible experience. The best way I can describe it is full dysphoria and feeling like I was on the verge of seizing. Ever since that experience I try to caution people on it . Some of the metabolites have super long half lives, and I think in my case, I had some accumulation that put me just over the edge for SS.

Fortunately I was able to ride it out, but I felt pretty off for the next few days. Tramadol is weird in that some people can take a gram and be fine while others, like myself, get symptoms of SS after 250 mg. But clonazepam is a an effective anticonvulsant so I think thatll be safer than tramadol alone.

Sorry for the lecture lol
 
Slow_Mobius said:
How much are you taking these days?

I used to take tramadol all the time and I personally find it more euphoric than more hardcore opioids. There was one day that i took about 200-250 mg, but I had also been taking a little more than usual the previous few days. For about 3 hours my muscles were completely rigid and I felt like death. It took every ounce of will power to not lose control of every muscle in my body. Fucking horrible experience. The best way I can describe it is full dysphoria and feeling like I was on the verge of seizing. Ever since that experience I try to caution people on it . Some of the metabolites have super long half lives, and I think in my case, I had some accumulation that put me just over the edge for SS.

Fortunately I was able to ride it out, but I felt pretty off for the next few days. Tramadol is weird in that some people can take a gram and be fine while others, like myself, get symptoms of SS after 250 mg. But clonazepam is a an effective anticonvulsant so I think thatll be safer than tramadol alone.

Sorry for the lecture lol
Click to expand...
Huh, strange, very strange. sounds similar to precipitated Withdrawal. I am up to ~340-500mg in a 12hr period - only like 4hr half-life tho.
 
I find switching from Tram to Venlafaxine very easy, when I'm going to do one, I don't take the dose of the other, and also make sure to take lots of Lorazepam to prevent seizures.
I keep asking, would it be viable to ask my doctor to switch from Venlafaxine to Tramadol? any of you tried?
 
Yes, that should be a viable alternative. I would also be wary of your drug use. It sounds like you're heading down the poly drug addiction road. It seems like overkill to take an extremely addictive substance to counter a side effect of a less addictive substance
 
delphinen said:
I find switching from Tram to Venlafaxine very easy, when I'm going to do one, I don't take the dose of the other, and also make sure to take lots of Lorazepam to prevent seizures.
I keep asking, would it be viable to ask my doctor to switch from Venlafaxine to Tramadol? any of you tried?
Click to expand...

If it does help with the pain, sure, ask him, but tramadol can be really addictive and withdrawal can be especially bad, because you're withdrawing from an opioid and a SNRI at the same time

Edit: just alternating between tramadol and venlafaxin could still potentially result in serotonin syndrome because of half life's etc.
 
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