long term tramadol effects

[pofacedhoe]

any effects known of long term tramadol use?

 

[TheTwighlight]

I don't even know if I want to know the answer to this one...

 

[MurphyClox]

This may give a hint:

"Open-label study of the safety and effectiveness of long-term therapy with extended-release tramadol in the management of chronic nonmalignant pain."
Current Medical Research and Opinion 2007, 23(10), pp.2531-2542

Background: Tramadol ER* is a once-daily oral analgesic for management of moderate-to-moderately severe chronic pain in adults who require around-the-clock treatment of pain. This study evaluated long-term safety of tramadol ER and effectiveness outcomes in the management of chronic, nonmalignant pain.
Methods: Patients enrolled directly for approx. 1 yr of open-label tramadol ER treatment if they had chronic, nonmalignant pain (n = 919), or 'rolled over' for 38 wk of open-label tramadol ER treatment if they completed either of two 12-wk, placebo-controlled studies of tramadol ER for low back pain (n = 72) or osteoarthritis (n = 61). Tramadol ER was titrated to a dose of 300 mg once daily (patients 75 years) or 300-400 mg once daily (patients < 75 years).
Results: A total of 257 (24%) patients completed the study. Common adverse events, regardless of treatment relationship, were nausea, dizziness (excluding vertigo), and constipation. Mean scores for current pain intensity (from 0 = no pain to 100 = extreme pain) and least, worst, and av. pain intensity over the past week improved at every post-baseline visit. At each post-baseline visit, > 50% of patients provided a global assessment rating of good, very good, or excellent. Study limitations were mandatory titrn. to 400 mg in some patients, concomitant analgesic therapy as a confounding variable, and lack of a placebo comparator.
Conclusions: Individualized dose titrn. and limiting once-daily therapy with tramadol ER to the max. recommended daily dose of 300 mg may balance tolerability and analgesic effects of tramadol ER in patients with chronic, nonmalignant pain.

- Murphy

 

[pofacedhoe]

thanks!

 

[indelibleface]

I would think, in doses above the recommended doses, it might also have similar effects to long-term SNRI or perhaps SSRI therapy, but that's just a guess based on its mode of action.

 

[MurphyClox]

Albeit quite a good guess IMHO. Tramadol is used sometimes (off-label?!) as antidepressant as well...

 

[indelibleface]

Albeit quite a good guess IMHO. Tramadol is used sometimes (off-label?!) as antidepressant as well...

Really off-label I would guess. I can't imagine any doctor I know prescribing an opiate for depression.

I've used it myself as an antidepressant--and it does the job, if you're willing to wake up every morning and feel some mild withdrawals until you take your dose. Ultimately, in my opinion, all antidepressant therapy is somewhat of a losing game, since tolerance sets in eventually with any drug--definitely including neurotransmitter reuptake inhibitors, but especially with opiates. Tramadol seems to take a while for tolerance to set in, but it happens eventually.

It is a good antidepressant, but it should only be used in small doses for this purpose and only for short term depression management that cannot be solved with other, less addictive drugs.

 

[pofacedhoe]

Really off-label I would guess. I can't imagine any doctor I know prescribing an opiate for depression.

I've used it myself as an antidepressant--and it does the job, if you're willing to wake up every morning and feel some mild withdrawals until you take your dose. Ultimately, in my opinion, all antidepressant therapy is somewhat of a losing game, since tolerance sets in eventually with any drug--definitely including neurotransmitter reuptake inhibitors, but especially with opiates. Tramadol seems to take a while for tolerance to set in, but it happens eventually.

It is a good antidepressant, but it should only be used in small doses for this purpose and only for short term depression management that cannot be solved with other, less addictive drugs.

i have been using small doses daily for over a year (150mg in the morning) and have had times where i have been off it for three days (felt incredibly manic). i have bipolar and its depressant action seems to have a good ability to control the excesses of mania without the need for dodgy antipsychotics and the lows of depression as well. i know i should probably not be addicted to this drug but it helps to keep me motivated and positive in a way that nothing else has ever done. i have a far more stable personality on it and can tolerate situations that used to cause insanity inducing anxiety. as for being on an antidepressant drug all the time, its probably not the best but with bipolar it can be very bad for your employment and social life and bank account and i dont feel like risking things now that i have them under control to a degree.