Opioids Tramadol causing withdrawal?

[Bambooshoot]

"Patients Physically Dependent on Opioids Ultram is not recommended for patients who are dependent on opioids. Patients who have recently taken substantial amounts of opioids may experience withdrawal symptoms. Because of the difficulty in assessing dependence in patients who have previously received substantial amounts of opioid medication, caution should be used in the administration of Ultram to such patients."


This is an extract from an article on Tramadol. It did not elaborate further for the reason stated. Considering tramadol binds to µ-opioid receptors why would it possibly cause withdrawal in someone who has has substantial amounts of other opioids? I was wondering because I have been using tramadol to get through withdrawals these past couple of days and thought I should read up a bit more. Thanks.
Source:http://www.opioids.com/tramadol/prescribe.html

 

[shroompharmer]

This is an extract from an article on Tramadol. It did not elaborate further for the reason stated. Considering tramadol binds to µ-opioid receptors why would it possibly cause withdrawal in someone who has has substantial amounts of other opioids? l

My best guess would be that because tramadol is a relatively weak opioid. Someone who has been on large doses of a strong opioid such as oxycodone or morphine would not be able to achieve an equianalgesic dose with tramadol. ie - the amount of tramadol you would have to take to prevent withdrawal would be larger than is safe. The recommended maximum daily dose of tramadol is 400mg (which IMO is nothing compared to a decent oxy or morphine dose) - anything above this and you can be at risk of seizure.

 

[fizzymk]

My best guess would be that because tramadol is a relatively weak opioid. Someone who has been on large doses of a strong opioid such as oxycodone or morphine would not be able to achieve an equianalgesic dose with tramadol. ie - the amount of tramadol you would have to take to prevent withdrawal would be larger than is safe. The recommended maximum daily dose of tramadol is 400mg (which IMO is nothing compared to a decent oxy or morphine dose) - anything above this and you can be at risk of seizure.

I used to take ultram, looong ago, and for awhile i felt great on it, but I still had to take more than I was prescribed, usually take about 4-(50mg) pills in the morning and then 4 more later in the day, and this would make me feel good most of the day, I felt the euphoria, no aches or pains anywhere, could do great job at work, felt really sociable, etc. but after a couple weeks of this kind of use, I had to take alot more and usually no matter how many I took, I never got that same good feeling back until I went a week with nothing, and I had a few black outs or seizures from taking too many.

I remember once, I took 5, then was not feeling anything, took 5 more, and after about 10 minutes..I started feeling my upper lip like twitching and curling, then I woke up in an ambulance, my girlfriend was in the next room, and said she saw me fall to the ground like a sack of potatoes, my eyes went back in my head, my head hit the table on the way down and I had to get 15 staples, the EMTs kept asking me my name and who was president, I remember this was very scary, cuz I did not know any of the answers to their questions, and I knew this was BAD, but by the time they got to the hospital, I was back to normal and all my memory came back. they made me drink charcoal and sent me home, although the next morning, I was feeling like shit and of course, tried taking more ultram...but I only took 3, and did not feel anything, at this point, my tolerance was way high and if I took enough to get feeling good, i would black out, so it was not worth it anymore.

I got my docs to switch me to perc 7.5 at this point.

 

[shroompharmer]

I used to take ultram, looong ago, and for awhile i felt great on it, but I still had to take more than I was prescribed, usually take about 4-(50mg) pills in the morning and then 4 more later in the day, and this would make me feel good most of the day, I felt the euphoria, no aches or pains anywhere, could do great job at work, felt really sociable, etc. but after a couple weeks of this kind of use, I had to take alot more and usually no matter how many I took, I never got that same good feeling back until I went a week with nothing, and I had a few black outs or seizures from taking too many.

I remember once, I took 5, then was not feeling anything, took 5 more, and after about 10 minutes..I started feeling my upper lip like twitching and curling, then I woke up in an ambulance, my girlfriend was in the next room, and said she saw me fall to the ground like a sack of potatoes, my eyes went back in my head, my head hit the table on the way down and I had to get 15 staples, the EMTs kept asking me my name and who was president, I remember this was very scary, cuz I did not know any of the answers to their questions, and I knew this was BAD, but by the time they got to the hospital, I was back to normal and all my memory came back. they made me drink charcoal and sent me home, although the next morning, I was feeling like shit and of course, tried taking more ultram...but I only took 3, and did not feel anything, at this point, my tolerance was way high and if I took enough to get feeling good, i would black out, so it was not worth it anymore.

I got my docs to switch me to perc 7.5 at this point.

Yep, IMHO, tramadol is one dirty, dirty drug. I have never had seizures, but I have had some pretty unpleasant side effects from the stuff - nausea (not the normal opioid kind of nausea, which I am ok with), dizziness, headache and just a general feeling of being unpleasantly 'out of it'

 

[Bambooshoot]

My best guess would be that because tramadol is a relatively weak opioid. Someone who has been on large doses of a strong opioid such as oxycodone or morphine would not be able to achieve an equianalgesic dose with tramadol. ie - the amount of tramadol you would have to take to prevent withdrawal would be larger than is safe. The recommended maximum daily dose of tramadol is 400mg (which IMO is nothing compared to a decent oxy or morphine dose) - anything above this and you can be at risk of seizure.

Yes but it does not say tramadol is unlikely to ease withdrawal symptoms in patients with a large opioid habit. It says that if may cause withdrawals. It is not the same thing.

 

[Mr.Scagnattie]

^^^

I don't see where it says tramadol will cause the withdrawals. It just says that people on high doses of opiates, may experience withdrawals after taking tramadol, but that doesn't mean it's because of the tramadol. I take that to simply mean that, like it said earlier in the paragraph, it can be hard to gauge individual tolerance, and therefore the persons habit might be too big for the tramadol to take care of, hence they would experience withdrawals even with the tramadol in their system as they would have without it.

It's not written in a very good way, but what it's saying is that patients dependent on high doses of opioids, should not use tramadol because it probably wont be strong enough to keep their withdrawals at bay. Not that taking tramadol will cause withdrawals. That's just not true, but either way, that's not what I took them to mean. It's just poorly written.

 

[The Doc.]

Even though its a weak Opiod when coming off tramadol people go crazy and get depressed as hell I find that tramadol causes this more than any other opiate because of its serotonergic effects on the brain it seems to work like an anti depressant with the same symptoms of withdrawal as many anti depressants.

 

[Bambooshoot]

@mrscagnattie: Yeah I think you are spot on. I just read it wrong. Like you said it is quite poorly written. Just close this then. My bad. >_>

 

[Mr.Scagnattie]

^^

No problem, man.