Tramadol has a ceiling of around 400mg/24 hour period. If you are already at this suggested dose then I personally dont see the ability for it to "do" any more. Clinical studies have suggested that once you cap your ceiling then the drug is not beneficial. I dont personally like Trams. SO I dont reccomend you do anything other than your dose but you could possibly raise each dose, I dont know, dont want to break any rules here.