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  • N&PD Moderators: Skorpio

tramadol as an anti-deppressant?

I guess this would be more suited for OD, but to answer your question anyway; AFAIK it's a moderate pain relieving opoid and in adition to that a SNRI, which means it inhibits the reuptake of serotonin and norepinephrine, so yes, it should be mood lifting.

Just don't go above 400 mg a day (or take a benzo with it, though mixing depressants can be dangerous) to avoid seizures.

For futher information, see the almighty wiki.
 
how fast does tolerance build to tramadol and is the ratio of tolerance disproportionate for the SNRI and MU properties?

Could somebody go on tramadol for longterm and use it as an anti-depressant or would tolerance build too quickly?

Is it ever prescribed off-label as an anti-depressant?
 
caizar, no offense man, but you start the worst threads.

If you used the search function/google, you wouldn't have to start 90% of them.
 
no probs mate i should start to use the search engine more than i do...Peace!:)
 
I sure think it is. Much like all Opioids IME it provides a nice lift in mood and Tramadol like nothing else is very stimulant like. From what I've read this is most likely due to the inhibition of NE. Tolerance builds much quicker IMO than other opioids.
 
Adjunct memantine in effort to retain effectiveness would be interesting. (to bring up THAT versatile, intensely interesting molecule for the billionth time, today)

As opioids go, I am more interested in buprenorphine for the use as motivating stimulant/antidepressant.
 
I have a friend that self medicates on tramadol, he takes 200mg a day, and finds it a very good anti depressant.
I think he uses it for mood regulation (he claims that it flattens the emotional lows and highs), apparently he still gets a "high" from it if he takes 150mg+ in one go.
 
hehe, the friend of you could be me. :)
i also do eat 200-300mg tramadol each day and it works fantastic as an anti-depressant plus these low doses produce nearly no tolerance.
each morning i get up, i firstly feel unmotivated and generally shitty. then i eat tramadol, pouring it down with a cup of coffee and half an hour later i feel the effects kicking in. my mood lifts, i get motivated for learning and doing my housework and so on.
i think the key for getting (mental) health benefits here is not a constant level of active tramadol in the blood like it is thought for common antidepressants for them to be effective, but rather to get this kick reliably each morning.

btw: i've tried the same with buprenorphine the last few days but was not that convinced from it. tolerance builds up quite quickly, i think that's mainly due to its long plasma half-life. when you put in your dose in the morning, you actually still have one half of a dose in your body leading to constantly increasing blood-levels and thus inevitably tolerance.
so i'd prefer tramadol for motivation-related purposes but maybe a buprenorphine derivative with a shorter half-life could turn out to be superior.
 
morphiquet said:
hehe, the friend of you could be me. :)
i also do eat 200-300mg tramadol each day and it works fantastic as an anti-depressant plus these low doses produce nearly no tolerance.
each morning i get up...etc...
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I knew some from our opioid-lover-fraction would turn up here ;)

I wouldn't actually consider 200-300 mg as low dose. 100 mg is already the recommended therapeutic dosage for heavy pain. But that idea of a morning kick to keep the day running sounds absolutely interesting to me.

And you really do not notice tolerance after a week? Even more interesting. :) Could you elaborate this a bit? Do you make weeks off tramadol, like a 2-week-on-1-week-off rhythm or something like that?

Peace! Murphy
 
I don't think buprenorphine tolerance builds quickly either. Quite the opposite. Without full efficacy, why would it?
 
MurphyClox said:
Do you make weeks off tramadol, like a 2-week-on-1-week-off rhythm or something like that?
Click to expand...

I would imagine that there would be withdrawal symptoms from doing this, but I am not entirely sure how quickly physical dependency develops in respect to tramadol.

Does anyone know what the withdrawal syndrome is like from tramadol? I would imagine it would be relatively nasty, and probably of short to moderate duration.

The "kick" in the morning that is being described sounds like a pretty typical opioid addiction, but tramadol is certainly unique and somewhat stimulating, so I don't know...
 
^ I have actually attempted using Tramadol as antidepressant and while it works very well (better than all other opioids in this respect), the withdrawals are nasty. I'd say something like a combination of Hydrocodone withdrawal and Amphetamine comedown. That said, dependence seems to take considerably longer than other opioids to set in - one time I have used it for 3 weeks at around 300mg/day and had no withdrawal symptoms at all when I stopped. YMMV, of course. It is also much easier to taper with it than other opioids.

Surprisingly, there seems to be no tolerance buildup for the antidepressant effects. But for the typical opioid high, yes - its only a matter of days before one requires a dangerous (seizure-risk) dose.
 
Surprisingly, there seems to be no tolerance buildup for the antidepressant effects. But for the typical opioid high, yes - its only a matter of days before one requires a dangerous (seizure-risk) dose.
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Yup, exactly what my friend reported.

As for withdrawals, apparently the first day and night aren't too bad, then it gets nasty, particularly with regards to muscle pain and insomnia.
 
i've never noticed any withdrawal symptoms from tramadol though i've been consuming it for 6 years irregularly and for 1 year regularly now. therefore, i think that each claim of withdrawal is pure imagination, maybe some sort of anti-placebo or depending on one's current psychological condition.

tolerance is more arguable. of course it doesn't kick in like the very first time when you're eating it on a daily basis but as there is nearly no more tramadol in your blood when you wake up in the morning, you'll feel it kicking in each day.
and that is what definitely increases the quality of (my) life.

and, of course, i'm a pretty typical opioid addict, what else should i be consuming them every day? :)

edit: @hammilton: tramadol (or rather o-desmethyltramadol) shows around the same intrinsic activity at the µ-receptor as buprenorphine ( ~20%, i believe, compared with morphine=100% ). i'll look that up in detail soon.
 
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I get good (short-term) relief from tramadol as well. It's not compareable to SNRI effects for me at all. Either tramadol has yet another mechanism of action, or it is simply the opioid action.

Selective NaRIs don't have serious stimulant effects for me, so I'm wondering what exactly gives tramadol its stimulant effects. Again, it might just be the opioid agonism.

Thus, I wouldn't count on the SNRI action to somehow make tramadol a more sustainable antidepressant than classical opioids with their known problems. On the other hand, the delayed onset is a plus.

Currently thinking about taking 2-3 days per week or so. The question is whether depression would be worse during the other days.
 
morphiquet said:
i've never noticed any withdrawal symptoms from tramadol though i've been consuming it for 6 years irregularly and for 1 year regularly now. therefore, i think that each claim of withdrawal is pure imagination, maybe some sort of anti-placebo or depending on one's current psychological condition.

tolerance is more arguable. of course it doesn't kick in like the very first time when you're eating it on a daily basis but as there is nearly no more tramadol in your blood when you wake up in the morning, you'll feel it kicking in each day.
and that is what definitely increases the quality of (my) life.

and, of course, i'm a pretty typical opioid addict, what else should i be consuming them every day? :)

edit: @hammilton: tramadol (or rather o-desmethyltramadol) shows around the same intrinsic activity at the µ-receptor as buprenorphine ( ~20%, i believe, compared with morphine=100% ). i'll look that up in detail soon.
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Please stop spreading misinformation.

The fact that naloxone will cause precipitated withdrawal with Tramadol is enough to prove that the withdrawals are not "imaginary".

ps. Morphine's affinity for µ is not 100%. I believe this is simply impossible. If someone has something intelligent to correct me with, please do!
 
Nope. I would rather agree. 100% affinity (not sure if "%" is the right 'scale' here) would do a very nice toxin. The receptor would get deactivated due to prolonged activation.
 
i said ACTIVITY, not AFFINITY.
that means, assuming that morphine would activate the receptor to about 100% (meant as a reference value), then o-desmethyltramadol and buprenorphine would do the same in the range of 20%. these values mean maximum stimulation, that's also the reason why buprenorphine has a ceiling effect at higher dosages, when all receptors are saturated but all do only 20% of what they actually were capable of doing.

@jamshyd: well, your definition of withdrawal might be another one than mine. but i insist on the fact, that tramadol-withdrawal does not produce any real existing symptoms, just like caffeine-withdrawal doesn't.
of course, if you stop your daily tramadol (or coffee) consumption, you are going to be in a bad mood, unmotivated for most things, quickly upset and sometimes even aggressive. but that's not what i would call a "withdrawal" in its usually accepted meaning.

for further reading regarding the fact that even the withdrawals of harder opiates are in their most extent not much more than conditioning, i.e. imagination (or in a larger sense, maybe mass psychology), i suggest this:

amitai et al.
discrete cues paired with naloxone-precipitated withdrawal from acute morphine dependence elicit conditoned withdrawal responses.
behav. pharmacol., 2000, may p. 213-222

this article basically reports about inducing an opiate "withdrawal" out of pure imagination. maybe you find more such studies, i'd be glad if you'd post them :)

puuuuuh, you drove me to writing a whole novel with your critizism 8)
 
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