Having tried tapentadol, I don't understand why everyone compares it to tramadol & says it's stronger or better. Though I'm aware everyone reacts differently to drugs. Tapentadol is only a partial agonist tho, with no active metabolites. Tramadol is a partial agonist but has a full agonist metabolite that is much more potent, so it's basically a full agonist. Tapentadol IS more potent than tramadol, but all that means is that you need less tapentadol to get an effect than you do tramadol. But since tapentadol is only a partial agonist, it's not going to provide "stronger effects" or pain relief.
To me, tapentadol felt incredibly weird. That norepinephrine reuptake inhibition is waaay too strong. Made me feel like I had a dark cloud hanging over my head whenever I'd take it. It was trash compared to tramadol in my opinion. The withdrawal was a little odd too cause I've never had to come off of a strong norepinephrine reuptake inhibitor like that.
I think a lot of people see misinformation online, cause I've seen a lot of articles & stuff claiming "tapentadol is the better tramadol!" and that it's "10x more potent than tramadol!", which makes it sound like it's going to be better than tramadol. Except potency doesn't mean anything really in this scenario. So they're kind of just preying on people's lack of pharmacology knowledge to make tapentadol sound more appealing than it really is.
Tapentadol has one advantage over tramadol - it's effects are not heavily dependent on liver metabolism.
Also, it is norepinephrine reuptake inhibitor but every single time i took tapentadol i was heavily impaired - it was like strange, nodding combined with diphenhydramine - like delirium and i was simply not functional at all.
Tramadol was designed as functional, stimmy opioid painkiller and it definitelly makes me motivated and functionac especially for the first half of it's 9 hour ( 6-9 ) half-life. It is stimulating and mood lifting just like low dose of some mdma or serotonergic amohetamine. Definitelly functional, longer acting and it's norepinephrine raising effects are actually like classic - mood brightening and energetic nri effects but tapentadol on the other hand is seriously mind impairing and it is like opposite of functional. It doesnt just make me dreamy like some casual opioids and opiates, its like eating pack of benadryl on top of casual opioid sedation.
Good for taking it and jumping in time but u better lay down.
I dont understant what was the motivation behind creating tapentadol when they could put O-DSMT on market because it is just like tapentadol - active substance, nri - and functional one and also it has 9 hour half-life which is in category of opioids double and almost tripple the half-life of other short acting narcotics.
Tramadol is even better for ultrarapid cyp2d6 metabolizers than only pure M1 metabolite but unfortunately this total cyp2d6 dependent activity of tramadol is not good. Even for me ( ultrarapid metaboliser ) it has periods of more M1 metabolite being produced and periods of much less of it produced.
Seizures are heavy danger too but since I take levetiracetam I never had seizure from too much tramadol. Never. But this is probably my lucky individual advantage of levetiracetam working perfectly and it doesn't produce any psychoactive effects for me - zero.
For those of us able to fully use every mode of painkilling action of tramadol ( not lacking important mu-opioid agonist mode of it's action taking 300mg or 400mg daily is very useful medication and not only for pain relief. And I also like taking some diazepam with it.
