Opioids nucynta... who takes this @ over 1g/day? feeling very weird....

[Phat5o]

does anybody got experience with nucynta?

when i get my pain meds script, which is nucynta, i just run through it in a matter of days. end up taking more than a gram of this during the day as immediate release usually something like 150-175mg every 3 hours, last dose of the day i might re-dose with 50 - 75mg every 30 - 60mins....
after a couple days of this i start feeling super weird, especially when i wake up and i don't have nucynta in me anymore i feel like i can't think straight, like a little de-personalized, foggy.

anybody experiences with this?

right upfront, i don't take any ssri's or snri's or any other medication that effect those type of receptors. however.... when i don't take nucynta i take tramadol, usually 500 - 800mg/day and some codeine syrup (about 2 days out the week @ ~600-800mg/day divided in 3 - 4doses). i have noticed that, even with a 12 - 24 hour break of taking neither of the 2 meds i have mentioned (and i always do), that switching back and forth sucks. like switching back to tramadol is when i feel de-personalized and not able to think straight for about 1 - 2 days.. when i switch to nucynta is the worst though, the first 3 - 5 days i can feel pretty panicky and i see a lot of stuff moving in my peripherals. i mean, even after 10 days of nucynta i see stuff move in my peripherals, but not to the extent i do in the first couple of days when i make the switch. i will also experience auditory hallucinations in the first 3 - 5 days, they will be very mild and mostly only happen if i'm like nodding. i guess i feel kinda delirious. but i also feel angry for some reason, on the edge kind of.

is this from switching the medication? or are these side effects of simply taking too much nucynta? or both?

if it matters, i do take 1mg klonopin/day to sleep, that's the only other medicine i take. i have used 2mg of klonopin during the days after nucynta when i get back on tramadol. doesn't really help, seems like it just makes those 1 - 2 days go by quicker. i have stopped doing this because it's too trivial for the danger of raising my benzo dose as i have a history with benzo abuse as well, although not in very big doses. when i use my 1mg klonopin, the first 3 - 5 days i switch to nucynta, that i usually take at night, in little .25mg doses it does take some of the edge of.

is this serotonin related or just the nature of nucynta?

doe anybody have any advice for me?

 

[sekio]

Nucynta is a norepinephrine reuptake inhibitor as well as an opioid* so it will act as sort of a stimulant and can definitely activate your fight or flight response and make you on edge, doubly so at really high doses until your body adapts to it. Other norepinephrine reuptake inhibitors are stuff like cocaine, Ritalin, Wellbutrin, cathinones - so basically stimulants.

Tramadol isn't a NRI so when you switch from tapentadol to tram you lose the NRI activity and as a result you basically get a stimulant crash. I guess you could try adding reboxetine or atomoxetine (selective norepinephrine reuptake inhibitor, former used as an antidepressant and latter as ADD/ADHD treatment) to tramadol at low doses, see if that helps. Just be careful for drug interactions. I don't advise taking ritalin or cocaine habitually though

Kratom would also be a viable option - it increases the release of norepinephrine through adrenergic agonism and is also a mu-opioid.

Taking more than about 400mg of tramadol a day predisposes you to seizures and other bad interactions. Just FYI. It's probably better to stick to lower doses of tram and bigger on the codeine, if possible?

* The reason it's a NRI at all is because norepinephrine release causes analgesia (you don't want to whine about your broken toe if you have to sprint out of danger). Another supporting element is that amphetamine was found to potentiate morphine's painkilling action quite strongly.

 

[Rybee]

Quite interested in this thread as I'm about to change over from MS Contin and Oxycodone to Dosulepin (Previously known as Dothiepin - though don't think it's licensed for use in the USA) and Tapentadol (Nucynta) which I've done a fair amount of research on so far.

In order to help you further, may I first ask about the history/nature of the reason you take it?

1) Do you legitimately use it for pain? If yes, what kind of pain? I'm guessing neuropathic pain, possibly in the lower back?
2) If so, is Tapentadol the only thing you use to control it?
3) Do you use other than opiates for pain relief or recreationally?
4) Do you use any other medications for pan relief? NSAIDs/TCAs/SNRIs/SSRIs/Pregabalin/Gabapentin/Muscle/Skeletal Relaxants. If not, why not?
5) How long have you been using Tapentadol?
6) How long is your script supposed to last you for?
7) Why do you go through your script so fast?
8) Do you think that Tapentadol has much abuse potential?
9) You say you often use more than a gram per day, if it is prescribed for pain, what are the directions of use written on it?
10) Tapentadol is fairly similar to Tramadol in the sense that it's not a typical opiate (or in Tramadol's case, fully synthetic opioid)

Hopefully, once you've answered the questions I should be able to assist you in what's going on with a little bit !

 

[Rybee]

Nucynta is a norepinephrine reuptake inhibitor as well as an opioid* so it will act as sort of a stimulant and can definitely activate your fight or flight response and make you on edge, doubly so at really high doses until your body adapts to it. Other Norepinephrine Reuptake inhibitors are stuff like cocaine, Ritalin, Wellbutrin, cathinones - so basically stimulants.

Nice reply as always sekio, I have question though for me instead of the OP. I don't want to hijack the thread but it's on a similar kind of theme so thought I'd chime in...

I'm currently weaning off of 200mg MSContin at 20mg per week down to 100mg, then 10mg per week from thereon in, with 10mg Oxycodone P.R.N. for breakthrough pain (trying to keep to 20mg MAX per day). I'm now down to ~40mg MSContin. 4 weeks ago was put on Dosulepin/Dothiepin (I don't think it's licensed for use in the US, but it's a TCA similar to Amitriptyline) starting at 25mg for week 1, 50mg for week 2, 75mg for week 3, and 100mg from thereon after for several reasons as a long-term plan for relieving the nerve pain that I'm experiencing in my lower back.

Having been on Fentanyl/Methadone/Morphine, it seems that my nerve pain (2x herniated spinal discs) aren't really responding to opiates in terms of pain relief very well. On paper, Methadone sounded the most promising because of its long half life, compared to Morphine and Fentanyl, and its activity on NMDA receptors (I'm sure you know more about this than I do though), though I couldn't continue it because I suffered from bad heart palpitations, possibly linked to the Methadone.

Now, I mainly come on Bluelight to research pain killers and chronic pain management to get a better understanding of my own pain management options, and to discuss what others across the world do. So I wouldn't classify myself as an addict/hard core drug abuser (though a little bump in dosage here and there puts me in a nice place) so for me personally, 200mg of MSContin daily was quite substantial. It'd get me very high before the pain started to go away, and the same can be said for the 100µg Fentanyl patches. As such, we were looking for ways in which I could manage my pain without Fentanyl/Methadone/Morphine, and preferably without opiates, because we're so conservative about them here in England, and the ones I've tried didn't prove so successful (however Oxycodone for breakthrough pain has been significantly better than the Oramorph which is great news).

So we agreed on trying Dosulepin/Dothiepin as a sustainable long-term solution, which coincidentally has helped brilliantly with my sleep and also for migraine prophylaxis so it's been a bit of a wonder drug for me. As for a painkiller in the traditional sense, my anesthetist/pain-management-consultant suggested Tapentadol to replace the Oxycodone as he didn't want me on Oxycodone for the rest of my life - which is fair enough, I totally understand that. He said something along the lines of 'It's a relatively new medication that works on hormones in the brain (when I asked, he cited norepinephrine) and then went on to say that, it's major role in reducing pain is its Norepinephrine re-uptake inhibiting properties.' He also said that it had a 'very, very small amount of opioid action within it.

It's hard to explain this, but when he said that, I pictured it to have almost no opioid action within it, say, equivalent to 30mg of Codeine Phosphate. I know this may seem like a hard question to answer, because it's quite a novel drug, but dismissing the NRI properties that it has, how much power does it have on the opiate receptors?

I understand that this is taken from Wikipedia, and so should be taken with a pinch of salt, but the claims are cited. It states: 'Unlike Tramadol, it has only weak effects on the re-uptake of serotonin, but is a significantly more potent opioid and has no known active metabolites.[3][4] Its general potency is somewhere between that of tramadol and morphine.[5]'

[3] Singh, DR; Nag, K; Shetti, AN; Krishnaveni, N (July 2013). "Tapentadol hydrochloride: A novel analgesic.". Saudi Journal of Anaesthesia 7 (3): 322–326. doi:10.4103/1658-354X.115319. PMC 3757808. PMID 24015138.

[4] Raffa, RB; Buschmann, H; Christoph, T; Eichenbaum, G; Englberger, W; Flores, CM; Hertrampf, T; Kögel, B; Schiene, K; Straßburger, W; Terlinden, R; Tzschentke, TM (July 2012). "Mechanistic and functional differentiation of tapentadol and tramadol.". Expert Opinion on Pharmacotherapy 13 (10): 1437–49. doi:10.1517/14656566.2012.696097. PMID 22698264.

[5] Tzschentke, TM; de Vry, J; Terlinden, R; Hennies, HH; Lange, C; Strassburger, W; Haurand, M; Kolb, J; Schneider, J; Buschmann, H; Finkam, M; Jahnel, U; Friedrichs, E (2006). "Tapentadol Hydrochloride". Drugs of the Future 31 (12): 1053. doi:10.1358/dof.2006.031.12.1047744.

Now if that's true, he seemed to be really down-playing it's opioid receptor activity? He gave me the impression that the opioid activity was nowhere near as that as Tramadol, (even at 50mg) and certainly not in between that and morphine. So my questions are:

1) Would you agree with the statement on Wikipedia
2) To your knowledge or experience, dismissing the NRI capabilities (i know that's hard, since it's its main function in pain relief) how strong an opioid is it?
3) I know codeine comes with addiction warnings, more out of principle than reality, is Tapentadol addictive? And to what extent? I've been taking a mixture of Fentanyl/Morphine/Methadone/Oxycodone for a good 6 months now at fairly high doses every day.
4) Including its NRI and it's effect on μ-opioid receptors how good a painkiller is it?
5) Does it have any abuse potential?


Would really appreciate any feedback at all on those 5 questions. I'm going to consult my Psychiatrist before I start taking Tapentadol/Nucynta because I'm a little bit worried on how that, mixed with Dosulepin, may affect my mood. I've been off of anti-depressants for 6 months now and I'm doing really well so in one sense I'd rather just carry on taking the Oxycodone... when there are actions that start interfering with Serotonin/Norepinephrine/Dopamine, I get a bit unsettled.


Thanks, Rybee

 

[Phat5o]

Nucynta is a norepinephrine reuptake inhibitor as well as an opioid* so it will act as sort of a stimulant and can definitely activate your fight or flight response and make you on edge, doubly so at really high doses until your body adapts to it. Other norepinephrine reuptake inhibitors are stuff like cocaine, Ritalin, Wellbutrin, cathinones - so basically stimulants.

Tramadol isn't a NRI so when you switch from tapentadol to tram you lose the NRI activity and as a result you basically get a stimulant crash. I guess you could try adding reboxetine or atomoxetine (selective norepinephrine reuptake inhibitor, former used as an antidepressant and latter as ADD/ADHD treatment) to tramadol at low doses, see if that helps. Just be careful for drug interactions. I don't advise taking ritalin or cocaine habitually though

Kratom would also be a viable option - it increases the release of norepinephrine through adrenergic agonism and is also a mu-opioid.

Taking more than about 400mg of tramadol a day predisposes you to seizures and other bad interactions. Just FYI. It's probably better to stick to lower doses of tram and bigger on the codeine, if possible?

* The reason it's a NRI at all is because norepinephrine release causes analgesia (you don't want to whine about your broken toe if you have to sprint out of danger). Another supporting element is that amphetamine was found to potentiate morphine's painkilling action quite strongly.

wow. thank you for that response. this might be why i sleep 12 hour nights when i get back on tramadol... i have never had anything but a couple coke crashes after a night of light use so i don't have any reference for a real amphetamine typa crash, but i do have friends and they sleep a lot after a couple days on a run. i sleep regular hours but 12 is just not normal for me. this makes sense. it's trippy though, since i get very noddy on tapentadol.

thank you for clearing that up too, about why i might be on edge. especially on the first couple days, when the euphoria is not there u just feel irritated and snappy.

the biggest reason i keep buying codeine syrup was to keep my tramadol down at like 400 - 500 mg (in my country max oral dose is 500mg as far as i know, and i'm aware this is not the case in the us or a lot of other countries). i do hear ya on that though. the opposite usually tends to happen though as codeine is not that pleasant to me sometimes i end up using it in low dosages to enhance the trams a bit.

thanks again

Quite interested in this thread as I'm about to change over from MS Contin and Oxycodone to Dosulepin (Previously known as Dothiepin - though don't think it's licensed for use in the USA) and Tapentadol (Nucynta) which I've done a fair amount of research on so far.

In order to help you further, may I first ask about the history/nature of the reason you take it?

1) Do you legitimately use it for pain? If yes, what kind of pain? I'm guessing neuropathic pain, possibly in the lower back?
correct on both counts
2) If so, is Tapentadol the only thing you use to control it?
tapentadol and tramadol like i said. for the neurophatic type of pain tramadol to me seems superior to most for some weird reason, especially when u take it for a while it seems to work even more (i think the tapentadol too) because it works so long. downside to it, and the biggest reason i don't just stay on it is it just seems to stop working pretty abruptly and u can't just keep increasing your dosage. that's another plus for tapentadol, the tolerance thing isn't that bad for me.. the worst ever i thought was hydromorphone, i felt like i had to increase my dose every 2 days lol. gabapentin is obviously a huge help but i stopped taking it regularily, only wen i really need it for my leg. i take ibuprofens half of the day as well when it gets bad. besides that, for the general back pain stuff, tapentadol, oxycodone, hydrocodone, hydrocodone etc etc i feel like they're all equally as good to treat it if the dose is right. if i could pick between tapentadol and oxycodone i'd pick tapentadol...
3) Do you use other than opiates for pain relief or recreationally?
if you're asking if i use any other opiates recreationally....not when i'm on tapentadol. once in a while i'll take 2mg of klonopin at night instead of my nightly 1mg dose.
4) Do you use any other medications for pan relief? NSAID's/TCAs/SSRIs/SNRIs/Pregabalin/Gabapentin/Muscle or Skeletal Relaxants. If not, why not?
ibuprofen - and they do make a big difference in taking some edge off when combined with the other meds.. gabapentin as needed for now, i feel a bit better these days so i came off gabapentin, now i only take it when my leg gets real bad. muscle relaxants don't really help anything for me.
5) How long have you been using Tapentadol?
~2 years, back and forth with tramadol. like 1/3 of the time i'm on tapentadol, the rest of the time i'm on tramadol.
6) How long is your script supposed to last you for?
depends on how much i am prescribed at the moment, usually a month, sometimes 2.. they're not precisely calculated to the dot for a certain amount of time because we still get medications in blister packs in the country i reside in for now.
7) Why do you go through your script so fast?
because i enjoy tapentadol. then after being on tapentadol for like ~10 days the tramadol works better again until i get my next tapentadol script. it helps a lot too on not having to raise my doses.
8) Do you think that Tapentadol has much abuse potential?
yes. tapentadol is NOT tramadol. nor does it feel like it in anyway. it feels like oxycodone to me, or very similar. a lot of people on the net talk like it does nothing and it's worthless...i have no idea what they took or how much they took
9) You say you often use more than a gram per day, if it is prescribed for pain, what are the directions of use written on it?
every 12 hours i get a long release 200mg pill. back in the states all they would give me was instant relief pills (1-2 50mg every 4 hours as needed so i was allowed up to 500mg/day) because they said 'long release pills get you addicted'.. lol.
10) Tapentadol is fairly similar to Tramadol in the sense that it's not a typical opiate (or in Tramadol's case, fully synthetic opioid)

Hopefully, once you've answered the questions I should be able to assist you in what's going on with a little bit !

^i've written the answers into the quote

 

[Phat5o]

Nice reply as always sekio, I have question though for me instead of the OP. I don't want to hijack the thread but it's on a similar kind of theme so thought I'd chime in...

I'm currently weaning off of 200mg MSContin at 20mg per week down to 100mg, then 10mg per week from thereon in, with 10mg Oxycodone P.R.N. for breakthrough pain (trying to keep to 20mg MAX per day). I'm now down to ~40mg MSContin. 4 weeks ago was put on Dosulepin/Dothiepin (I don't think it's licensed for use in the US, but it's a TCA similar to Amitriptyline) starting at 25mg for week 1, 50mg for week 2, 75mg for week 3, and 100mg from thereon after for several reasons as a long-term plan for relieving the nerve pain that I'm experiencing in my lower back.

Having been on Fentanyl/Methadone/Morphine, it seems that my nerve pain (2x herniated spinal discs) aren't really responding to opiates in terms of pain relief very well. On paper, Methadone sounded the most promising because of its long half life, compared to Morphine and Fentanyl, and its activity on NMDA receptors (I'm sure you know more about this than I do though), though I couldn't continue it because I suffered from bad heart palpitations, possibly linked to the Methadone.

Now, I mainly come on Bluelight to research pain killers and chronic pain management to get a better understanding of my own pain management options, and to discuss what others across the world do. So I wouldn't classify myself as an addict/hard core drug abuser (though a little bump in dosage here and there puts me in a nice place) so for me personally, 200mg of MSContin daily was quite substantial. It'd get me very high before the pain started to go away, and the same can be said for the 100µg Fentanyl patches. As such, we were looking for ways in which I could manage my pain without Fentanyl/Methadone/Morphine, and preferably without opiates, because we're so conservative about them here in England, and the ones I've tried didn't prove so successful (however Oxycodone for breakthrough pain has been significantly better than the Oramorph which is great news).

So we agreed on trying Dosulepin/Dothiepin as a sustainable long-term solution, which coincidentally has helped brilliantly with my sleep and also for migraine prophylaxis so it's been a bit of a wonder drug for me. As for a painkiller in the traditional sense, my anesthetist/pain-management-consultant suggested Tapentadol to replace the Oxycodone as he didn't want me on Oxycodone for the rest of my life - which is fair enough, I totally understand that. He said something along the lines of 'It's a relatively new medication that works on hormones in the brain (when I asked, he cited norepinephrine) and then went on to say that, it's major role in reducing pain is its Norepinephrine re-uptake inhibiting properties.' He also said that it had a 'very, very small amount of opioid action within it.

It's hard to explain this, but when he said that, I pictured it to have almost no opioid action within it, say, equivalent to 30mg of Codeine Phosphate. I know this may seem like a hard question to answer, because it's quite a novel drug, but dismissing the NRI properties that it has, how much power does it have on the opiate receptors?

I understand that this is taken from Wikipedia, and so should be taken with a pinch of salt, but the claims are cited. It states: 'Unlike Tramadol, it has only weak effects on the re-uptake of serotonin, but is a significantly more potent opioid and has no known active metabolites.[3][4] Its general potency is somewhere between that of tramadol and morphine.[5]'

[3] Singh, DR; Nag, K; Shetti, AN; Krishnaveni, N (July 2013). "Tapentadol hydrochloride: A novel analgesic.". Saudi Journal of Anaesthesia 7 (3): 322–326. doi:10.4103/1658-354X.115319. PMC 3757808. PMID 24015138.

[4] Raffa, RB; Buschmann, H; Christoph, T; Eichenbaum, G; Englberger, W; Flores, CM; Hertrampf, T; Kögel, B; Schiene, K; Straßburger, W; Terlinden, R; Tzschentke, TM (July 2012). "Mechanistic and functional differentiation of tapentadol and tramadol.". Expert Opinion on Pharmacotherapy 13 (10): 1437–49. doi:10.1517/14656566.2012.696097. PMID 22698264.

[5] Tzschentke, TM; de Vry, J; Terlinden, R; Hennies, HH; Lange, C; Strassburger, W; Haurand, M; Kolb, J; Schneider, J; Buschmann, H; Finkam, M; Jahnel, U; Friedrichs, E (2006). "Tapentadol Hydrochloride". Drugs of the Future 31 (12): 1053. doi:10.1358/dof.2006.031.12.1047744.

Now if that's true, he seemed to be really down-playing it's opioid receptor activity? He gave me the impression that the opioid activity was nowhere near as that as Tramadol, (even at 50mg) and certainly not in between that and morphine. So my questions are:

1) Would you agree with the statement on Wikipedia
2) To your knowledge or experience, dismissing the NRI capabilities (i know that's hard, since it's its main function in pain relief) how strong an opioid is it?
3) I know codeine comes with addiction warnings, more out of principle than reality, is Tapentadol addictive? And to what extent? I've been taking a mixture of Fentanyl/Morphine/Methadone/Oxycodone for a good 6 months now at fairly high doses every day.
4) Including its NRI and it's effect on μ-opioid receptors how good a painkiller is it?
5) Does it have any abuse potential?


Would really appreciate any feedback at all on those 5 questions. I'm going to consult my Psychiatrist before I start taking Tapentadol/Nucynta because I'm a little bit worried on how that, mixed with Dosulepin, may affect my mood. I've been off of anti-depressants for 6 months now and I'm doing really well so in one sense I'd rather just carry on taking the Oxycodone... when there are actions that start interfering with Serotonin/Norepinephrine/Dopamine, I get a bit unsettled.


Thanks, Rybee

in my opinion tapentadol is a major opioid, just the same as oxycodone, or at least similar. if i take 150mg of tapentadol it will feel like ~20 - 25mg of oxycodone and the abuse potential is there accordingly.
the withdrawals almost seem harsher to me than your classic opioids. like i said in my last post, it's NOTHING like tramadol.

i agree on oramorph being total bs for breakthrough pain.

and in regards to opiates not really responding to nerve pain, i feel the same way... it helps take some edge off but lyrica or gabapentin is superior in my opinion... at least in my case. tramadol and tapentadol do help me more with the nerve pain than for example morphine or oxycodone.. i don't know why. tapentadol does have a building up typa effect i have noticed as well. after 1 - 2 weeks on it you'll feel a lot better pain wise than you did in the first couple of days

 

[Phat5o]

@Rybee

please let me know when you have read my posts. i might want to edit them a bit... nucynta has a pretty shit rep on the internet for now, i ran into it only by coincidence and have found it to be somewhat of an undiscovered gem. even though they're pricey to manufacture and a lot of insurance companies don't even cover them (i think), they're very cheap to buy still if you don't have a prescription because most people don't know what they are worth. i think it has a lot to do with how it was marketed as well.... 'it's just like tramadol, just a little stronger.' of course a lot of people are going to say it sucks based on that. i want to keep it that way... a little on the low. there's nothing wrong with pointing people, that may need it, into the right direction, especially privately, but on a public forum might not be so smart. popularity and demand make some pharmaceutical drugs almost unaffordable. i mean, just looking how much the going rate for oxycodone is now compared to 10 - 15 years ago.... it's ridiculous. i think a coke habit might be more affordable than an oxy habit for non needle users.

there is one thing i have forgot to mention to you about tapentadol as well. when you take higher doses you feel a little stupid. like a little slow and your thoughts/ideas keep slipping. from a second to the next you could forget what you were just thinking about. i catch myself having to read or listen to things over and over again. this is the biggest downside it has to me. that's why i'm always glad in a way too, to get back on tramadol to hold me over for a couple weeks so i can focus again. i'm pretty sure i have read that tapentadol is a deliriant somewhere, so i guess where that comes from.

 

[granddeception2]

It gets easier

 

[FromHell]

Tramadol is a reuptake inhibitor of norepinephrine and is a serotonin release agent, the Tramadol inspired derivative Nucynta (tapentadol) is only a norepinephrine reuptake inhibitor, though more potent than Tramadol. Tapentadol was created to mimic O-desmethyltramadol which is what Tramadol is metabolized into by the liver at roughly 10% to 20% of the parent drug and has 200 times the affinity for the mu opioid receptors! Tramadol has weak affinity for the mu opioid receptors and some at the delta opioid receptors according to researchers. In my own experience Tramadol (off 400mg daily to zero) has a nasty withdrawal! I was taking heavy doses of methadone and went cold turkey off of that so I know what a horrible withdrawal is like! The Tramadol withdrawal is shorter, but is not any kind of fun at all! The mind 'zaps' along with the RLS and other symptoms associated with norepinephrine reuptake inhibition and the serotonin release agent effects are in addition to the opiate withdrawal symptoms! To put it bluntly, it sucked big time! I was quite sick and dysfunctional for several days, could not sleep and wanted to jump out of my skin, let alone the diarrhea, nonstop sneezing, yawning and nausea/vomiting! This after being told that Tramadol withdrawal was mild comparatively? REALLY? methadone withdrawal sucked and lasted longer, but was MILDER in some ways than Tramadol was? I have also withdrawn off codeine, dilaudid (short but HELLISH!), hydrocodone and Fentanyl (also short and HELLISH!)! At least with the pure opioids. loperamide with either Claritin or omeprazole squashed most of the withdrawal symptoms once I learned about this option? Lopes combined with Kratom killed all the symptoms even with Tramadol (RLS and zaps)! Also used DXM initially with lopes which also helped the RLS and zaps! These days I am steering clear of the pharmaceuticals, I use Kratom and OTC stuff to help with pain, at least until Kratom is egregiously outlawed by the prohibitionists? The ones in office are the worst cause they do it to retain power and profits by keeping it all ILLEGAL! The savagery going on south of the border is being maintained and fueled in part by these policies so the next video on Youtube where some poor woman or other alleged wrongdoer is being tortured or beheaded you can thank the ones in DC who keep promoting the War on Innocents (ie failed Drug War) for the vids!

 

[Phat5o]

Tramadol is a reuptake inhibitor of norepinephrine and is a serotonin release agent, the Tramadol inspired derivative Nucynta (tapentadol) is only a norepinephrine reuptake inhibitor, though more potent than Tramadol. Tapentadol was created to mimic O-desmethyltramadol which is what Tramadol is metabolized into by the liver at roughly 10% to 20% of the parent drug and has 200 times the affinity for the mu opioid receptors! Tramadol has weak affinity for the mu opioid receptors and some at the delta opioid receptors according to researchers. In my own experience Tramadol (off 400mg daily to zero) has a nasty withdrawal! I was taking heavy doses of methadone and went cold turkey off of that so I know what a horrible withdrawal is like! The Tramadol withdrawal is shorter, but is not any kind of fun at all! The mind 'zaps' along with the RLS and other symptoms associated with norepinephrine reuptake inhibition and the serotonin release agent effects are in addition to the opiate withdrawal symptoms! To put it bluntly, it sucked big time! I was quite sick and dysfunctional for several days, could not sleep and wanted to jump out of my skin, let alone the diarrhea, nonstop sneezing, yawning and nausea/vomiting! This after being told that Tramadol withdrawal was mild comparatively? REALLY? methadone withdrawal sucked and lasted longer, but was MILDER in some ways than Tramadol was? I have also withdrawn off codeine, dilaudid (short but HELLISH!), hydrocodone and Fentanyl (also short and HELLISH!)! At least with the pure opioids. loperamide with either Claritin or omeprazole squashed most of the withdrawal symptoms once I learned about this option? Lopes combined with Kratom killed all the symptoms even with Tramadol (RLS and zaps)! Also used DXM initially with lopes which also helped the RLS and zaps! These days I am steering clear of the pharmaceuticals, I use Kratom and OTC stuff to help with pain, at least until Kratom is egregiously outlawed by the prohibitionists? The ones in office are the worst cause they do it to retain power and profits by keeping it all ILLEGAL! The savagery going on south of the border is being maintained and fueled in part by these policies so the next video on Youtube where some poor woman or other alleged wrongdoer is being tortured or beheaded you can thank the ones in DC who keep promoting the War on Innocents (ie failed Drug War) for the vids!

yea i have been thru a 500mg/day tramadol withdrawal before... that was not fun at all. they were pretty intense the first couple of days but it seemed like PAWs were a lot less severe.. i've gone thru multiple oxycodone withdrawals as well. those weren't fun at all either. but the PAWs were terrible and lasted for many months. i was still sweaty and clammy 4 - 5 months later. but i have to say i was on a 8 year binge as well and the tramadol was only after 6 months or less even. i think nucynta withdrawals would/will be nothing short of hardcore...

if i was to ever stop tapentadol for good do you think it would make sense to go on a norepinephrine reuptake inhibitor when dropping the tapentadol completely? or do you think it might make more sense to transition to a traditional opiate first, maybe a codone or morphone, to get the norepinephrine reuptake withdrawals over with first? or maybe even divide it up
something like tapentadol -> tramadol -> hydrocodone -> DETOX with lope and gabapentin
or tapentadol -> hydrocodone -> codeine -> DETOX with lope and gabapentin

??

 

[Hammilton]

Sekio, what do you mean tramadol isn't a norepinephrine reuptake inhibitor? I see many studies saying it is.

 

[sekio]

Brain fart. It is a NRI too. Not as strong as tapentadol I think though.