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  • BDD Moderators: Keif’ Richards | negrogesic

Tramadol & Serotonergic Medications

BlackOnWhite

BlackOnWhite

Bluelighter
Joined
May 4, 2010
Messages
91
Location
Perth
I have currently been switched from oxycodone & hydromorphone to tramadol to see how I react for pain relief, shocking I know :( Anyhow, I'm on 50mg hcl capsules and need to take a maximum of 6 per day, says the instructions. However, anybody that abuses opiates doesn't pay attention to the labels, I am no different. Problem is, I'm on 20mg of lexapro (escitalopram) a day and we all know tramadol is one of those drugs that effects serotonin, so what should my maximum dose be daily for abuse potential without entering the "danger zone"?

Also, what is the best route of administration for tramadol? I'm guessing oral since bioavailability goes up every dose
 
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Not dosage advice

Um, why don't you try the 6 per day, if you're going for recreational purposes you can take 6 at once...
Why don't you call a pharmacist, they can give you more information.
 
That would be stupid taking six at once, it's better to up the dose of tramadol over 45-1 hour since bioavailability increases each dose. And ringing the pharmacist is pointless, I'm trying to find out how much I can take for rec purposes, they'll just tell me the exact same as what's on the label.
 
Look, you say six at once is stupid i took 15 this morning.
Granted I have a tolerance. 6 at once will give you a nice high man, im not lying to you.
 
6 is only 300mg man, I've never had a seizure on this med "knock on wood" i've taken up to 20 at once. But I also had a tolerance. I've heard of seizures at 500mg or more never lower than 500mg..

Tramadol is NOT that strong, it will require at least 5 or 6 to get a nice buzz gion


I also said to ask a pharmacist about your lexapro man. I don't know how those two will interact, but I do know they interact.
 
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No I do believe you, I have used tramadol in the past and have taken upto 1000mg+ before, but this was before I was on lexapro. I have to be very careful now.
 
Right, so ask a pharmacist abotu the Interactions.


GENERALLY AVOID: The coadministration of selective serotonin reuptake inhibitors (SSRIs) with tramadol, which has weak serotonin reuptake inhibiting effect, may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5HT1A receptors. Patients receiving this combination may also have an increased risk of seizures. Pharmacokinetically, coadministration with certain SSRIs, namely fluoxetine, paroxetine and possibly sertraline, may result in decreased plasma concentrations of the active O-demethylated (M1) metabolite of tramadol due to inhibition of CYP450 2D6, the isoenyzme responsible for the formation of the metabolite. The clinical significance of this potential interaction is unknown. However, M1 is thought to possess up to 6 times the analgesic effect of tramadol, thus diminished therapeutic response to tramadol should be considered.

Read more: http://www.drugs.com/drug-interactions/lexapro-with-tramadol-1013-565-2221-0.html#ixzz0ndUQAvm8
Click to expand...

MANAGEMENT: In general, the concomitant use of SSRIs and tramadol should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients treated with the combination should be closely monitored for signs and symptoms of excessive serotonergic activity such as CNS irritability, altered consciousness, confusion, myoclonus, ataxia, abdominal cramping, hyperpyrexia, shivering, pupillary dilation, diaphoresis, hypertension, and tachycardia.

Read more: http://www.drugs.com/drug-interactions/lexapro-with-tramadol-1013-565-2221-0.html#ixzz0ndVJE31d
Click to expand...
 
yeah i had serotonin syndrome once. it was awful, one of the worst things that ever happened to me. it was from excessive dxm though, not combinations of SSRIs.
 
a quack VA Psychiatrist Rx'd a serotinergic antidepressant and never looked at my chart . i had been taking tramadol for a couple of years at that time .

Citalopram + Tramadol = seratonin syndrome

i had no idea of what was happening to me . fell on my puss, couldn't form sentences couldn't think . first time in 35 years in the ER . never associated what was happening to me with drug/drug interaction . never trust a med again - always look at the PDR for drug/drug interaction checker site when prescribed strong meds again .

If i knew what was happening I would have just sat it out in a chair as it washes out of one's system in less than a day's time .
 
Nexius said:
So you have your answer

Just don't do it
Click to expand...

Lol, nobody has answered my question yet apart from experiences with serotonin syndrome. I'm asking what dosage is the limit for people who are on another SSRI. And as for asking the pharmacist, they are going to tell me the exact same thing that is on the information label, regardless of what they think, if I overdosed I could sue them.

Hobhead and specture, what MG's where you on?
 
Well then call me an idiot but while I'm off oxycodone and hydromorphone I have no choice but to take tramadol, and this is under my doctor's orders. So, who would like to answer my question? LOL
 
"Hobhead and specture, what MG's where you on?"

300 mg tramadol daily / 40 mg citalopram (celexa) for one day and the combination brought me catastrophic results
 
hobhead said:
"Hobhead and specture, what MG's where you on?"

300 mg tramadol daily / 40 mg citalopram (celexa) for one day and the combination brought me catastrophic results
Click to expand...

So it didn't take much! Dang. I'm guessing I may have a higher threshold since I've been able to take 1000mg+ within 5 hours and only have slight tremors, but I better not jynx myself. :\
 
kunmo said:
Im taking tramadol and flexiril in combination with WEED and neurotin so its not a huge deal some people are more proned to SSRI stuff than others.
Click to expand...

At higher doses, have you experienced any minor side effects such as tremors or sweating?
 
no but i have yet to break the 1G mark so im kinda a noob at the really high doses. BUt i did 300 my first time with no issues. And i was on 20MG FLexiril and other crap plus pot....
 
well it only last for a little bit at least lol..... what exactly is lexapro?

Also when i mixed the muscle relaxer (flexiril) with the Trammy Dolls i was advised against it for the serotonin syndrome but i didnt get it.
 
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