Official Tramadol Discussion Thread - Second Swallow

[edgewise1]

Lot of good thoughts and comments about tramadol and true in my estimation. I've been on tramadol for ten years and I still enjoy and appreciate it!

One thing it ain't, is candy!

 

[El_Toro]

^ Excellent advice!

My aim is to help especially the newbies who think Tramadol is on the same level of aspirin (as it was said in a thread I posted).

Moreover, and this is very important, I want to stop the myth of Tramadol behaving as a SSRI because this can lead to devastating consequences. Tramadol primarily acts on the serotonin system as a releasing agent and as such will also mildly act as a reuptaker hence, when combined with other serotonergic substances, you are exposing yourself to serotonin toxicity. This is exactly what happened to Shambles, had Tramadol behaved as a serotonin reuptaker, his combo of Tramadol and LSD would have been blunted but instead, he had a severe case of SS.

I read of people saying Tramadol is ok to mix with LSD, MDMA and other serotonergic drugs because it is an SSRI and that is very dangerous advice. Tramadol has been hinted to behave as a 5HTP releasing agent since almost 15 years ago so I don't know why people keep repeating this myth. The fact that SS comes in different grades is what is stopping most people realise that they are fucking themselves up mixing methamphetamine with Tramadol as mild SS can be mistaken with a mild overdose.

Be very careful people.

All the best.

 

[DHCuser]

I'm a tad confused? So it is a norepinephrine uptaker but not a serotonin reuptaker? I thought that's what an NRI was?

- Seizure risk: it is impossible to predict when you will seize. Some people can use over 400mgs without a hint of seizing activity whilst others can go down on much less. Tramadol not only reuptakes norepinephrine but is also a GABA antagonist and "could" be a delta opiod agonist which in high doses causes convulsions.
Whilst seizures will occur when least expected, you should know when you are approaching seizure risking doses when you experience your limbs twitching/jerking. Do remember that even when most of the Tramadol is converted to the o-desmethyl version, you are STILL at risk of seizures as the metabolite has NE reuptaking properties
2) Tramadol is not an SSRI nor is it a SNRI!!! Tramadol is a norepinephrine reuptaker and it is a serotonin releasing agent not a reuptaker and by default it is also a mild serotonin reuptaker! This means that it will cause serotonin syndrome instead of blocking the effect of drugs such as MDMA or LSD. This is extremely important to emphasise as I read people giving recommendations based on the belief that Tramadol is a SNRI or even worse, an SSRI. Tramadol SERT releasing properties together with NE reuptake is why it feels like low dose MDMA the first few two hours of use. For references to the claim of Tramadol being a releasing agent please check Wikipedia's entry which everyone should be doing before using Tramadol. Check references 6,7,8,9.

3) Tramadol is an incredibly effective AD. I find that it will provide the best mood lift the first two hours of use which is when it is most active as a NE reuptaker and SERT releasing agent.

And you can understand where people make the error. The drug bank states that:
(http://www.drugbank.ca/cgi-bin/show_drug.cgi?CARD=APRD00028)
"The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS"
And even the wiki says:
Tramadol is somewhat pharmacologically similar to levorphanol (albeit with much lower μ-agonism), as both opioids are also NMDA-antagonists which also have SNRI activity
and
"It is recommended that patients physically dependent on pain killers take their medication regularly to prevent onset of withdrawal symptoms and this is particularly relevant to tramadol because of its SSRI and SNRI properties"

Also several quotes from one of the wikipedia citations you gave:
Tramadol also blocks 5-HT uptake
Similarly, the racemic mixture and (+)-enantiomer significantly slowed 5-HT uptake.

Am I right in thinking 5-HT is the name for serotonin? And does this not mean it is inhibiting uptake thus making it an SSRI?

Please could you explain in more detail? As from what I'm reading it seems to act as both a releasing agent and an uptake inhibitor.

 

[sid3]

Nice job. But please allow me my opinion. I have come to the conclusion that FOR ME, tramadol is no more effective than taking an aspirin. Maybe even less as it doesn't lower my BP. If I were to change my mind based on your research, god forbid I developed a tram addiction and had to deal with it's wicked wds..... In this case, I'd rather stay ignorant on any possible recreational value in trams. Also, you seem to be minimizing your abuse of trams by pointing out that H and oxy users need to get high of their ass. I find that to be very misinformed. Ok, your addiction is not as bad, you must be above those 'addicts' Educating people is a noble thing, the noobie comment, eh not so much. Hey, no worries, I respect your opinion, even if you do't respect mine.

 

[Jamshyd]

El Toro: One interesting combination that I found synergized quite well (on the AD side of things) was Tramadol with Tianeptine. What is your opinion on that?

For the record, I have found Tianeptine to almost completely alleviate after-effects caused by Serotonin releasers (namely MDMA an meth) - as in it almost completely negates what would have otherwise been a suicidally-depressive crash.

 

[ugly]

This thread has rescued me. I never could understand what the deal was with people doing Trammies. I've done them a million different ways and never with much success. Today I've done 50 mg every half hour for 200 mg. And tonight I see how this is the best way to get the most from the experience. Thank you, Bluelighters.

 

[El_Toro]

I'm a tad confused? So it is a norepinephrine uptaker but not a serotonin reuptaker? I thought that's what an NRI was?
And you can understand where people make the error. The drug bank states that:
(http://www.drugbank.ca/cgi-bin/show_drug.cgi?CARD=APRD00028)
"The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS"
And even the wiki says:
Tramadol is somewhat pharmacologically similar to levorphanol (albeit with much lower μ-agonism), as both opioids are also NMDA-antagonists which also have SNRI activity
and
"It is recommended that patients physically dependent on pain killers take their medication regularly to prevent onset of withdrawal symptoms and this is particularly relevant to tramadol because of its SSRI and SNRI properties"

Also several quotes from one of the wikipedia citations you gave:
Tramadol also blocks 5-HT uptake
Similarly, the racemic mixture and (+)-enantiomer significantly slowed 5-HT uptake.

Am I right in thinking 5-HT is the name for serotonin? And does this not mean it is inhibiting uptake thus making it an SSRI?

Please could you explain in more detail? As from what I'm reading it seems to act as both a releasing agent and an uptake inhibitor.

If you read what I wrote, I say that Tramadol is a 5HTP releasing agent and by default it also acts as a reuptaker. This is common with releasing agents as they compete for the transporter affinity (think of it as homeostasis). MDMA and amphetamines also behave as mild reuptakers despite their main mechanism of action is the release of amines.

The point is, without getting lost in the minutae, that Tramadol is a releasing agent of serotonin and can thus very much precipitate serotonin toxicity if mixed with other serotonergic substances. The myth that Tramadol is a SNRI solely should be written off as this may make people think that mixing MDMA with Tramadol is safe, and IT IS NOT. I have seen enough ill advice that I am trying to make this visible because people are combining Tramadol as if it were skittles.

 

[El_Toro]

El Toro: One interesting combination that I found synergized quite well (on the AD side of things) was Tramadol with Tianeptine. What is your opinion on that?

For the record, I have found Tianeptine to almost completely alleviate after-effects caused by Serotonin releasers (namely MDMA an meth) - as in it almost completely negates what would have otherwise been a suicidally-depressive crash.

Jamshyd, I am not an expert in psychopharmacology so I am taking an educated guess here.

If I remember correctly this is a funky AD in that it doesn't reuptake serotonin but rather enhances its reuptake and subsequently leads to a rapid increase in mood. The fact that it is also hinted as an anti-convulsant (I am going by what I remember, so correct me if wrong) would make it an interesting combo. I have not tried tianeptine so I cannot say from a subjective point of view. However, from what I have read it is an extremely fast acting mood elevator, the likes of Tramadol, makes it a very interesting substance. I would like to see such discussed in ADD.

In any case, I find St John's Wort a good substance for Tramadol withdrawal (however it needs to be standardised to a potent hyperforin content as this is the molecule that does all the amine reuptaking). That, coupled with a strong psychostimulant such as nicotine gum is enough to make thw WD not hell.

As to how Tianeptine saves you from the crash, I'd venture to say that its serotonin lowering mechanism might be re-setting receptors from the super fast increases previously made from those potent substances. In any case, I think we could discuss this in ADD.

 

[El_Toro]

This thread has rescued me. I never could understand what the deal was with people doing Trammies. I've done them a million different ways and never with much success. Today I've done 50 mg every half hour for 200 mg. And tonight I see how this is the best way to get the most from the experience. Thank you, Bluelighters.

As with most drugs, it is IMPERATIVE to take Tramadol on an EMPTY stomach to maximise its effects. I find that having an even semi-full stomach decreases effects by 50% as well as increases the time for onset.

This is why Tramadol first thing in the morning with some caffeine works like charm and is the main MOA of those who use Tramadol as a mood elevator.

 

[Moral Decay]

If you read what I wrote, I say that Tramadol is a 5HTP releasing agent and by default it also acts as a reuptaker. This is common with releasing agents as they compete for the transporter affinity (think of it as homeostasis). MDMA and amphetamines also behave as mild reuptakers despite their main mechanism of action is the release of amines.

The point is, without getting lost in the minutae, that Tramadol is a releasing agent of serotonin and can thus very much precipitate serotonin toxicity if mixed with other serotonergic substances. The myth that Tramadol is a SNRI solely should be written off as this may make people think that mixing MDMA with Tramadol is safe, and IT IS NOT. I have seen enough ill advice that I am trying to make this visible because people are combining Tramadol as if it were skittles.

Somewhere in this thread (or perhaps the previous one) I told a story of Serotonin syndrome when taking mdma after dosing tramadol a few hours previously. I also had a problem with DXM which induced serotonin syndrome. The best advice one can give to avoid trouble with tramadol is nto to take it with ANYTHING that affects serotonin. PERIOD!

I have however taken tramadol the next day after MDMA and been fine, though I strongly advise against doing this.

 

[Moral Decay]

As with most drugs, it is IMPERATIVE to take Tramadol on an EMPTY stomach to maximise its effects. I find that having an even semi-full stomach decreases effects by 50% as well as increases the time for onset.

This is not entirely true, I actually read in a physicians desk reference that food has no effect on the absorption of tramadol into the blood stream.

Personally I found the best results when I took my morning dose and then IMMEDIATELY at some breakfast. The best way to take tramadol for me personally was to take my morning dose with a large 20oz coffee or mountain dew followed immediately by a moderately sized breakfast. I would then take a second dose half the size of my initial dose about 1-2 hours later. All subsequent doses were taken immediately prior to a meal.

Perhaps I am still getting the empty stomach effect, however I am always taking my dose with in 5 minutes of eating a meal.

 

[Pillthrill]

Hey guys,
I have been on this thread FOR EVER and was using Tram for 4 years or so.
I recently quit, make it through the w/ds. Had to flush the pills to not take them though.
I've gotten to the point that even taking codeine gives me a Tram like headache.
So I won't be offering my usual "Tram girl" bit here.
But I'm always up for more questions, new or regarding my old posts here. Just hit me up on the PM.

Goodbye Tram!
PT

 

[edgewise1]

Glad to see you have beat these pills from hell PT! From the sounds here and your thread on TDS, it looks like you have 'em beat. CONGRATS!!!

 

[El_Toro]

This is not entirely true, I actually read in a physicians desk reference that food has no effect on the absorption of tramadol into the blood stream.

Manufacturers like to write that on the PDR because patients would be reluctant to take a drug which's effect is impaired by food content. Imagine having to take a drug in the morning before breakfast and then if you want to dose again, have to wait 6 hours after the last meal. Unless the absorption impairment is huge, they will write that stomach content has no effect, the same as they do with benzodiazepines yet stomach content has a big subjective impact on their effect. Do remember that we are talking in the context of abuse here, not of therapeutical use.

One of the positive effects of Tramadol is the rapid mood elevation and this is best done on an empty stomach as the substance rapidly travels to the intestine to be absorbed. I have extensive use of Tramadol and the difference is of hours between empty and full stomach. Tramado does lower blood sugar levels though (which can also cause seizures) hence taking something light is a good idea if you want to redose throughout the day.

 

[El_Toro]

Somewhere in this thread (or perhaps the previous one) I told a story of Serotonin syndrome when taking mdma after dosing tramadol a few hours previously. I also had a problem with DXM which induced serotonin syndrome. The best advice one can give to avoid trouble with tramadol is nto to take it with ANYTHING that affects serotonin. PERIOD!

I have however taken tramadol the next day after MDMA and been fine, though I strongly advise against doing this.

I knew someone who was a wise ass and was about to take 300mgs Tramadol after having dropped some E. I cautioned him that it was a dangerous combination and he told me nothing would happened as Tramadol was a serotonin reuptaker and if anything it would numb the emphatogenic properties of the roll. I tried my best to convince him that he was plainly wrong.

Anyway, he left with some other buddies and I told them (his buddies) to keep an eye on him. About an hour later I saw one of his buddies in the nightclub (big rave) and he told me the guy was rushed off to hospital with convusions and covered in sweat as if he had jumped in a swimming pool.

It is a good idea to always have some cyproheptadine and clonazepam at hand if you are going to play being a chemist.

 

[karona]

There is a risk of seizure. Especially with high doses or when taken with SSRI's i believe. Correct if am wrong.

I know of people that would rather have trams than vicodin and one even said over morphine! Suppose that is because it mimicks/ is similar make up as morphine.

One question! Why the hell does tramadol make one sweat their nuts off? Is it for the fact that it plays a role in serotonin release?

 

[DHCuser]

Manufacturers like to write that on the PDR because patients would be reluctant to take a drug which's effect is impaired by food content. Imagine having to take a drug in the morning before breakfast and then if you want to dose again, have to wait 6 hours after the last meal. Unless the absorption impairment is huge, they will write that stomach content has no effect, the same as they do with benzodiazepines yet stomach content has a big subjective impact on their effect. Do remember that we are talking in the context of abuse here, not of therapeutical use.

One of the positive effects of Tramadol is the rapid mood elevation and this is best done on an empty stomach as the substance rapidly travels to the intestine to be absorbed. I have extensive use of Tramadol and the difference is of hours between empty and full stomach. Tramado does lower blood sugar levels though (which can also cause seizures) hence taking something light is a good idea if you want to redose throughout the day.

I also have extensive experience and I can honestly say I have not noticed food in the stomach making any difference. The speed of onset seems to be entirely random. Once I felt intense opiate effects with 15minutes after being in a sauna -not sure if that had any effect- but that was on a full stomach. Other times it's taken me 2 hours or so even on an empty stomach.

 

[volp]

I hate tramadol, but I love tramadol. I'm rx'd it in conjunction with norco for nerve pain. I am one of the unlucky ones who seem to have a naturally high tolerance. So while 2 trams 4x a day is the rx, I don't get much relief from them. But it does seem to fill the gaps left by the norco, which only works for the pain at 30 or 40 mg. Tram does help with my leg pain and minor issues. It sucks that it can be dangerous at such a relatively low dosage.

 

[DHCuser]

I take about 400mg or so. Get work done during the manic speedy period (sometimes compulsively cleaning for no reason). And then go and lie down during the opiate bit which kicks in after about 3-4hours. The thing is, I don't fall asleep even though my eyes are shut, and I do it to have loads of sex fantasies (sorry to be crude) although sometimes whatever comes into my head is hard to control and I just go with it. Is that what a nod is? I hear people talk about "nods" and did wonder. I was tempted to start a new thread but I've started so many recently people will start to get annoyed.

Also, what about the sex fantasies? Is this a common thing on opiates to think of or am I just depraved? I can't have them when sober, I just get bored and fall asleep so it's one of the draws to them. When I had a girlfriend and was actually having sex I stopped drugs without noticing. I love thinking about guys or girls I have no chance with.

 

[chompy]

I use tramadol with codeine since tramadol is speedy for me and I can never get to sleep. I stayed up all night last night taking 50mg tramadol every 2 hours or so. It's noon now so there's no point in sleeping. Gonna take more tramadol in the evening, smoke pot all day and end with codeine/doxy to nod off.