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Tramadol habit prior to rolling -harm reduction question

MndrbinderEntrprse

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Ok guys,

I am a long-time tram user currently taking 300-400mg tramadol daily. I am going to a concert on Saturday with friends who plan to roll. My plan is to take my last tram dosage on Wednesday around noon. the concert is on Saturday giving me 80+ hours between the tram and ecstacy dosing. I also have (10) 5/500 vicodens to help stave off any tram w/d between wed and the show on sat night.

Does this seem like a safe plan to you guys? Do you think the ecstacy will work or be diminished? Do I have any serotonin syndrome issues to be concerned about? Any suggestions on how to best use the vicodens to avoid nasty tram withdrawals?

I would appreciate any and all thoughts/experiences/suggestions on the subject.

Thanks
 
Tramadol in the morning, MDMA in the evening?

I currently take Tramadol for pain...aprox 200mg when I wake up and then a few more throughout the day (total max being around 350mg)...I used to take oxy but it was too addictive...Im going to have to take some Tramadol in the morning but I plan on taking some MDMA around 10pm that evening...will this be ok? I read something about seizure threshold, I know valium helps that I beleive so maybe the night before I will take some valium and try and only take 200mg tramadol in the morning that way at least 12 hours will pass before my MDMA dose....this sound good?
 
I do not think there should be any problems with normal tramadol use and mdma use. Some serotonin syndrome possibly?? High seizure risks when combined with mdma??? Maybe it is risky!:? Sorry I did not help I guess i am saying I would not try it until you can find out. I know there are risks associated with everything.
 
The risk involved with tram and MDMA is that they both lower the siezure threshold. taking them together may be enough to cause you to have a siezure. I read somewhere a long time ago (so my numbers could be off) that you are risking siezure when taking 700mg or over of tram in a day. I don't know if the risk of siesure deminishes imediately after the tram is out of you system or if it takes a while to go back down. tram has a short half life so a few days without it should be enough for it to be totally out of your system....my gut it to say as long as you are not taking them at the same time and you wait a few days until the tram has worked its way out of your body you should not have any issue.

...Didn't I answer this already in a thread yesterday?
 
Do NOT do it

Tramadol is not a very safe drug to be taking on a regular basis.
It has a rather nasty withdrawal syndrome, including a higher risk of suicide than traditional opiates.
And 200 mg is a fucking high dose.
350mg throughout the day is even more.

In elderly patients, 400mg is known to cause serotonin syndrome on its own.
In young patients, 400 is still considered to be quite high and definitely lowers seizure threshold.

Taken in combination with ANY other serotonergic drug is a SURE risk of serotonin syndrome.
Since tramadol has a very long half-life, it takes MUCH longer than 12 hours to leave your system.

At the minimum, it is going to minimize your roll because it is a serotonin releaser and you are taking it regularly.
At most, it could cause Serotonin Syndrome.
This is a much more VIOLENT event than the name suggests.
Take it from someone who has experienced it.

It is defined as 'too much serotonin activity in the brainstem' combined with a constellation of symptoms.
Very important - SS is a quick onset disorder.
There is NO warning, it just hits you like a brick in your mouth.

Severe tachycardia is a common first sign - enough to make people dial 911 claiming heart-attack and impending death.
Altered mental state, lack of speech, diaphoresis, abdominal pain, muscle rigidity, and anxiety like you have NEVER felt in your life.
For me the intestinal cramping was SO severe I thought they would burst!
The swelling began just below my stomach and continued south for 3 hours.

Fever is a sign of advanced SS.
101.4 is considered very serious.
At 104 or above, organ damage and death are more common.

Skeletal muscle tissue can break down into myoglobin and destroy your kidneys.
The brain can release SO much anti-diuretic hormone that water fills your intestines and bloodstream.
Then it starts to squeeze your brain.

Stroke and cerebral edema are the greatest risk with SS, but kidney and liver failure are also possible.
Just about every account of SS that I have read indicates something along the lines of - "my insides were tearing me apart!"

Serotonin Syndrome only occurs when two serotonergic drugs are taken together.
MDMA is a POWERFUL serotonin releaser, and is associated with SS with less harmful drugs than fucking tramadol.

I will also point out that during my year long recovery from SS, I have found tramadol to be very risky.
It was previously a preferred drug for me, and I could take 100mg or more without concern.
Now, I take 50mg on rare occasions, and still suffer lots of discomfort, including mild SS symptoms.

Again, the least that will happen is it will minimize your roll.
Opiates, opioids, and morphine simply do NOT mix with MDMA.
Why take these and a stim together?
There is just no logic behind it.

And there is a substantial risk.
You do NOT want to experience SS, my friend.
Anyone who has been there can tell you this - it is among the scariest of events you will ever go through in a lifetime.
Think about this - the breakdown of skeletal muscle that destroys the kidneys...
It is called Rhabdomyolysis and it is typically only seen with CRUSHING injuries, such as during an earthquake!

That is what your body does to itself when trying to compensate for 'too much serotonin activity in the brainstem'.

If you chose to go forward anyways, here is the typical treatment for SS in the ER.
The same treatment is given with 'acute MDMA reactions'.

Lower body temperature aggressively, as this directly modulates serotonin toxicity.
Give the patient electrolytes - this aids the kidneys in removing water from the bloodstream. You should be sipping gatorade.
Give the patient benzodiazapene to control tremors, or even a paralytic agent if necessary.
And if these methods fail to control the progression of symptoms, use a serotonin antagonist to reverse the effects.

Tramadol is a fun drug, but it belongs nowhere near your roll, IMO.
You should be clear of it for at least several days before rolling.
And if you are a regular user of tramadol - give it TWO WEEKS.
Again, tramadol has a LONG withdrawal period.
I don't even recommend that you take it - hydrocodone would be safer.

Good luck.
 
Damn thanks for the reply...I dont wanna take it together its just ive been using it instead of oxy for a couple months now...i didnt know about SS I thought taking a few 50mg tabs throughout the day was fine my doc never mentioned anything....I know if I tried to not use it for a few days then do mdma by itself i would be in withdrawl...should i subtitue some oxy instead? i just wanna eat a couple mdma pills tomorrow night....will valium tonight help as far as the whole seizure thing?
 
From a similar thread.

Tramadol is not a very safe drug to be taking on a regular basis.
It has a rather nasty withdrawal syndrome, including a higher risk of suicide than traditional opiates.
And 200 mg is a fucking high dose.
350mg throughout the day is even more.

In elderly patients, 400mg is known to cause serotonin syndrome on its own.
In young patients, 400 is still considered to be quite high and definitely lowers seizure threshold.

Taken in combination with ANY other serotonergic drug is a SURE risk of serotonin syndrome.
Since tramadol has a very long half-life, it takes MUCH longer than 12 hours to leave your system.

At the minimum, it is going to minimize your roll because it is a serotonin releaser and you are taking it regularly.
At most, it could cause Serotonin Syndrome.
This is a much more VIOLENT event than the name suggests.
Take it from someone who has experienced it.

It is defined as 'too much serotonin activity in the brainstem' combined with a constellation of symptoms.
Very important - SS is a quick onset disorder.
There is NO warning, it just hits you like a brick in your mouth.

Severe tachycardia is a common first sign - enough to make people dial 911 claiming heart-attack and impending death.
Altered mental state, lack of speech, diaphoresis, abdominal pain, muscle rigidity, and anxiety like you have NEVER felt in your life.
For me the intestinal cramping was SO severe I thought they would burst!
The swelling began just below my stomach and continued south for 3 hours.

Fever is a sign of advanced SS.
101.4 is considered very serious.
At 104 or above, organ damage and death are more common.

Skeletal muscle tissue can break down into myoglobin and destroy your kidneys.
The brain can release SO much anti-diuretic hormone that water fills your intestines and bloodstream.
Then it starts to squeeze your brain.

Stroke and cerebral edema are the greatest risk with SS, but kidney and liver failure are also possible.
Just about every account of SS that I have read indicates something along the lines of - "my insides were tearing me apart!"

Serotonin Syndrome only occurs when two serotonergic drugs are taken together.
MDMA is a POWERFUL serotonin releaser, and is associated with SS with less harmful drugs than fucking tramadol.

I will also point out that during my year long recovery from SS, I have found tramadol to be very risky.
It was previously a preferred drug for me, and I could take 100mg or more without concern.
Now, I take 50mg on rare occasions, and still suffer lots of discomfort, including mild SS symptoms.

Again, the least that will happen is it will minimize your roll.
Opiates, opioids, and morphine simply do NOT mix with MDMA.
Why take these and a stim together?
There is just no logic behind it.

And there is a substantial risk.
You do NOT want to experience SS, my friend.
Anyone who has been there can tell you this - it is among the scariest of events you will ever go through in a lifetime.
Think about this - the breakdown of skeletal muscle that destroys the kidneys...
It is called Rhabdomyolysis and it is typically only seen with CRUSHING injuries, such as during an earthquake!

That is what your body does to itself when trying to compensate for 'too much serotonin activity in the brainstem'.

If you chose to go forward anyways, here is the typical treatment for SS in the ER.
The same treatment is given with 'acute MDMA reactions'.

Lower body temperature aggressively, as this directly modulates serotonin toxicity.
Give the patient electrolytes - this aids the kidneys in removing water from the bloodstream. You should be sipping gatorade.
Give the patient benzodiazapene to control tremors, or even a paralytic agent if necessary.
And if these methods fail to control the progression of symptoms, use a serotonin antagonist to reverse the effects.

Tramadol is a fun drug, but it belongs nowhere near your roll, IMO.
You should be clear of it for at least several days before rolling.
And if you are a regular user of tramadol - give it TWO WEEKS.
Again, tramadol has a LONG withdrawal period.
I don't even recommend that you take it - hydrocodone would be safer.

Good luck.
 
Tramadol withdrawal is harsh. I've got boxes of the stuff in my cupboard. I cannot get NSAIDs so these sorts of painkillers are all that is left for me when pain gets really bad. But I've learned not to take them for more than 2-3 days on the trot. Otherwise I know I'm going to have to come off them and feel really shit for days. I just wish I get bottle the motivation I get from them - I get a lot done when I'm on tramadol.
 
Andronicus thanks but you really didnt address the thread's point.... i am worried about my normal daily dosage of 300mg tramadol on average and trying to take less the day of using mdma to reduce the risk of seratonin sydrome
 
Anacer, listen to your elders.
I'm 30 and Andronicus is in his 40s.
We both know a little more about tramadol than you.

Even before I became sensitive to it from serotonergic damage, I 100% agree with his assessment.
Tramadol has a NASTY withdrawal syndrome.
I learned very quickly that taking it more than 2-3 days in a row was a BIG mistake.
Even at 100mg doses.
And I loved the stuff.

You have NO business taking that stuff in such high doses in the first place.
That is just CRAZY.

It is 'milder' than opiates as far as its intensity goes.
But it LAASTS A LOOOOOOOOOONG TIME.
It also converts to morphine in your body.

It is not the harmless drug you think.
I have read a few accounts of tramadol + SSRI = horrible serotonin syndrome DEATH.
And your doctor should not have you on that ridiculous amount.
I am going to go out on a limb and suggest that maybe you are buying it online by yourself?

You need to go ALL the way through withdrawal before rolling my friend.
That is the ONLY answer.

Benzos should be used to control withdrawal symptoms, but NOT with the belief that they will help you roll safely.
They can help you withdraw in ORDER to roll LATER.
But seizures are NOT the greatest concern with rolling - Serotonin Syndrome is.
Tremors, or myoclonic seizures are common with SS, but they are not the primary symptom, or the most dangerous.
Fever, stroke, cerebral edema (swelling around the brain), kidney damage, and LONG-TERM brain damage are!

You have NO business rolling until you have had FULL withdrawal from tramadol.
If you can't face the music, why are you trying to roll at all?
MDMA is a harsh drug in itself.
Even 'normal' use involves a cascade of symptoms that mimic full blown SS.

Listen to me, bro.
You do NOT want to tempt fate on this one.
Get the MDMA, but HOLD ONTO IT.

Earn that roll, by tapering off that stupid tramadol.
Two weeks, minimum abstinence.
Got it?
No exceptions.
Some people take MONTHS to withdraw from tramadol, goddammit.

If even a moderate version of SS happens to you, it will not be 'rolling'.
There will be no euphoria. Only anxiety and pain.
It will be a wasted pill, at the minimum.
It will be a wasted life, at the maximum.

Just.
Don't.
Do it.

k?
 
Andronicus thanks but you really didnt address the thread's point.... i am worried about my normal daily dosage of 300mg tramadol on average and trying to take less the day of using mdma to reduce the risk of seratonin sydrome

Truth of the matter is, I don't know the answer to your question. My guess is that it's not safe to take on the same day due to the serotonin effects and longevity - i.e. essentially what FBC said. Also since if you stop taking it for 24 hours you'reffectively in withdrawal, I'm not sure what effect a massive serotonin and dopamine boost from MDMA will have. Probably cut through the withdrawal somewhat that's for sure but after that I can't see it being good. But it's all guesswork. Nobody tests this sort of interaction so you'd need to guess from first principles - looking at SSRIs and so on.
 
definitely NO. tramadol's and its metabolites' half-lives are between 5-9 hours meaning tramadol will still be in your system later that night.
 
Good info and thanks for the reply. While 80+ hours may be enough time for tram to clear before taking e, I agree that the risk just isn't worth it. I have rolled successfully after taking 3 days off of the tram (not an enoyable 3 days mind you) but at the time the tram habit was only 150mg 3-4 days a week and only a few months of dosing...I do believe the residual buildup over time of a heavier habit warrants more caution. Tram isn't worth the hundreds of interactions (hell, you shouldn't even have a beer while on it) but it is a nasty habit to kick...I am going to pass on the e this weekend as it just doesn't seem worth the risk. Time to taper the tram use as well.
 
Very smart choice.
Glad to see people taking my advice.
Have some withdrawal info:

Tramadol is associated with the development of physical dependence and a severe withdrawal syndrome.[35] Tramadol causes typical opiate-like withdrawal symptoms as well as atypical withdrawal symptoms including seizures. The atypical withdrawal symptoms are probably related to tramadol's effect on serotonin and norepinephrine re-uptake. Symptoms may include those of SSRI discontinuation syndrome, such as anxiety, depression, anguish, severe mood swings, aggressiveness, brain "zaps", electric-shock-like sensations throughout the body, paresthesias, sweating, palpitations, restless legs syndrome, sneezing, insomnia, vivid dreams or nightmares, nonsense and weird thoughts, micropsia and/or macropsia, tremors, and headache among others. In most cases, tramadol withdrawal will set in 12–20 hours after the last dose, but this can vary. Tramadol withdrawal lasts longer than that of other opioids; seven days or more of acute withdrawal symptoms can occur as opposed to typically three or four days for other codeine analogues. 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, and, when the time comes to discontinue their tramadol, to do so gradually over a period of time that will vary according to the individual patient and dose and length of time on the drug.[36][37][38][39]
 
Just for the hell of it..

Tramadol is associated with the development of physical dependence and a severe withdrawal syndrome.[35] Tramadol causes typical opiate-like withdrawal symptoms as well as atypical withdrawal symptoms including seizures. The atypical withdrawal symptoms are probably related to tramadol's effect on serotonin and norepinephrine re-uptake. Symptoms may include those of SSRI discontinuation syndrome, such as anxiety, depression, anguish, severe mood swings, aggressiveness, brain "zaps", electric-shock-like sensations throughout the body, paresthesias, sweating, palpitations, restless legs syndrome, sneezing, insomnia, vivid dreams or nightmares, nonsense and weird thoughts, micropsia and/or macropsia, tremors, and headache among others. In most cases, tramadol withdrawal will set in 12–20 hours after the last dose, but this can vary. Tramadol withdrawal lasts longer than that of other opioids; seven days or more of acute withdrawal symptoms can occur as opposed to typically three or four days for other codeine analogues. 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, and, when the time comes to discontinue their tramadol, to do so gradually over a period of time that will vary according to the individual patient and dose and length of time on the drug.[36][37][38][39]
 
Thanks guys no i am not buying it online.....What is the big difference between tramadaol and oxy as far as everyone talking about seratonin syndrome and mdma?
I used to take oxy all the time and would take 60mg oxy in the morning....roll at night and then continue my oxy the next day....wouldnt this have more seratonin issues? I never had any bad side effects, im not doubting u just curious why tramadol is more dangerous with mdma versus oxy...or is it not?
 
I never had any bad side effects, im not doubting u just curious why tramadol is more dangerous with mdma versus oxy...or is it not?

Tramadol's action on the brain is very different from oxy and other traditional opiates. There is plenty of info if you search for it. A couple things I found:
And finally if the only effects on the 5HT system tramadol has is its inhibition of this enzyme, what does this mean in terms of influencing MDMAs effects/effectiveness? Well I don't know if tramadols ONLY effect is by inhibiting SERT, all I know, is that it definatly does inhibit SERT. By inhibiting/competeing at cyp2d6 tramadol will unpredicabley boost MDMA concentrations in the blood, but then paradoxically reduce its serotonergic effectiveness through SERT inhibition. In conjunction with its epilepto-genic actions... tramadol and MDMA gets a two thumbs down from me.

This is interesting, I took 300mg of tramadol on 23/4. Then on the 25th I went to a day-rave and took 1/2 a (reasonably strong) pill. BTW my MDMA tolerance is very low, I can and have peaked off half a strong pill.

Anyway I got the most bizarre and unpleasant effects I have ever had from E. I think set and setting were major contributors to this, but I have also since wondered whether Tramadol SSRI interactions could have played a part too.

Basically the pill made me feel incredibly sad. I couldn't enjoy myself, I just sat around feeling unbelievably sad until the drug wore off. Only then did I start to be able to gety back into it and have a good time. It was quite a strange experince. I cant be sure it was due to the tramadol though.
PimpTurk

Mixing tramadol and MDMA is not a good idea. It might even be dangerous if you stop taking tramadol days before you take the roll, especially if you take tramadol daily. Oxy just doesn't have the significant effect on serotonin that that tramadol does. Mixing oxy and other drugs could result in serotonin syndrome because of enzyme inhibition, but this would be pretty rare.
 
ok so i usualy take about 300mg a day tram max....which doesnt do much considering i used to take 60-90mg oxy.....if my last tram was only 200mg today by 11am...and i plan on rolling at 11pm tomorrow thats what 36 hours without tram? I should be fine correct? I have an OC 10 (slow relase oxy 10mg) should I try this tomorrow if i expereince any withdrawl from teh tram? Ive done 60-90mg oxy 12 hours before using MDMA without any problems..but im now learning tram and oxy are different......would valium tonight be a good idea for the seizure aspect of it?


also should i start out with half of a mdma pill see how i feel then go from there as far as re dosing? 36 hour no tram should be fine by the time i roll right?
 
Yup, it's the snri effects of tram that are the real issue with MDMA. Oxy in the am and MDMA at night is apples to oranges with tram in the am and MDMA at night.

Enacer- do NOT take the tram dose the morning before you roll....I am not even chancing it with 3+ days between tram dose and MDMA...SS is no joke. Shambles has a post explaining his experience with a light dose of tram 50-100mg in am and LSD at night. His experience was hellacious! While I don't know for sure, I suspect MDMA is a stronger serotonin agent than LSD. Bad bad bad idea to take those trams. If you do decide to roll, start light 1/2 pill and give it time. My prior experience taking e after 3 day break from a mild tram habit was a very delayed onset with the pill...2 hours before I felt it kick in. My freinds on the same pill were floored in 1 hour...i believe the delayed onset was due in part to the tram habit. Anyways, It is tempting to take another pill after an hour with no effects but give it time and do not overdo it...1/2 pill at a time and wait it out. I still would not reccomend taking the e but if you do, go easy...
 
ya i hear ya, im not taking any trams this morning....i guess i will have to substitute something else if i feel the withdrawls....hopefull with 300mg tramadol out my system for 36 hours before i roll i will be fine....Are these people talking about SS with mdma/tram people that use it on the regular? I could see how they could think a few hundred mg is a high dose, im assuming those people dont take it on the regular....5 or 6 50mg tramadols throughout the day to someone who previously had an opoid depenedcy and tollerance doesnt feel like it does that much as far as seratonin...where as if you gave that much to someone who doesnt take it on the regular they would be floored.....i known people whove taken 100mg of tramadol and thought it was awesome where as you or i wouldnt really feel much....get where im going?
 
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