Antidepressant Dupe for Tramadol that really Is?...chemicall, etc.

[pesto]

Hello,

I used to take Tramadol, no more, but it did improve my mood. My doctor started me on Cymbalta (Duloxetint} a month ago, felt nothing, and he just added Abilify. Why are they No antidepressant with the exact qualities?...or a combination of drugs. I've herd this many times and there just not seem to be a dupe...does anyone know why??

 

[Skorpio]

Tramadol is an opioid and an snri. You're doctor probably doesn't want you copping a habit. Unfortunately the mood lift could very well be from the opioid effects of tramadol. That being said, opioids are not sustainable long term as anti depressants.

 

[Nagelfar]

Venlafaxine and mirtazapine: different mechanisms of antidepressant action, common opioid-mediated antinociceptive effects--a possible opioid involvement in severe depression?

↑I'm on Pristiq (which is des-Venlafaxine) & Remeron (Mirtazapine), there's postulation that Venlafaxine, the generic for Effexor, is an SSRI with opioid effects like Tramadol. The structural similarity is striking, so if you want a "duplicate" of Tramadol that's widely available, Effexor should be your go-to.

Pristiq wasn't covered by state health insurance but Effexor is. (had to have a genetic test for state insur. to pay for my Pristiq ℞)

*However* I actually seem to notice what I'd call more of an opioid effect from Mirtazapine / Remeron, including side effects such as more continent bowel motility.

Similar effects of tramadol and venlafaxine in major depressive disorder — Roy R Reeves et al. South Med J. 2008 Feb.

Venlafaxine-tramadol similarities — J S Markowitz et al. Med Hypotheses. 1998 Aug.

 

[DeathIndustrial88]

I disagree that opioids can't work long term for depression.

I used tramadol for over 10 years. And while you do build some tolerance to the opioid effect, I found that even staying at a dose of 300-400mg retained daily antidepressant benefits for weeks on end for me. I am on Suboxone now which also has antidepressant benefits, but they're not nearly as good as tramadol. Tramadol has that "get up and go" factor to it & it just makes life feel more joyful. The things I love (like music) would entertain me for hours and hours on tramadol.

On suboxone however, there is no strong "get up and go" like trams. One of my favorite things to do on tramadol was get up and clean. Can't say the same about buprenorphine. Subs dull my emotions and make me feel bored and flat, where as Tramadol actually gave me feelings of happiness, love, peace and an incredible amount of energy and stamina. I could also get a good nod going on, but also had the ability to snap out of it and get back to work easily.

I'm actually struggling very hard now with Suboxone and not having any access to tramadol or heroin (heroin also gave me that 'get up and clean' feeling). I actually got on Effexor thinking it might feel like tramadol, but it does not feel like trams in any way whatsoever. It's actually a very gross and disgusting feeling. It feels like a jittery version of an SSRI.

So I don't believe that it's either just trams "SNRI" effect or their "opioid effect" that makes them so special. Tramadol's pharmacology isn't completely known yet either I don't think. I believe it also releases serotonin (rather than just inhibits it's uptake), along with doing some things at nicotine receptors I believe. It's very complex. If you metabolize tramadol well, it's actually ODSMT that does most of the mu-agonism. I could see ODSMT possibly contributing to some of the antidepressant effect tho, more-so than any SNRI effects.

I've been really struggling with energy, anhedonia, melancholy, sadness & body pains. I lost my tramadol connect in November and am still having these issues, even while on buprenorphine.

I really wish they could offer tramadol for maintenance instead of buprenorphine cause I'm not sure I'm ever going to get any better without it. Knowing there is a pill out there that will make me feel alive and happy again but I cannot get my hands on it and must endure this anhedonic, pointless feeling is quite the struggle. Just another unfortunate casualty of the drug war.

 

[allone]

well put! thanks for this review basically. ive also used tramadol and suboxone. still use suboxone actually. and its NOTHING like tramadol. tramadol was one of my favorites few years back. ill do heroin or other hard hitting opiates and instead of going back to SHITBOXONE ill just get back to tramadol and feel AMAZING! i still love it, and i miss it. thanks for reminding me of it though :s
in fact, thanks to this reminder, im gonna look out for some more eventually. i really really hate SHITBOXONE. doesnt help depression, about 0 in total, and its not very useful AT ALL.
tramadol was like 10 and SHITBOXONE is like 1

 

[Nagelfar]

↑Since my last post in this thread I am off Pristiq, Remeron & everything except Suboxone (even quit my nicotine vaporizer, no nicotine for over a week) and I have to agree:

Buprenorphine / Suboxone is a horrible drug. Esp. for long term maintenance. It doesn't help my cravings, makes me feel trapped due to it's obverse/inverse (wholly adverse) effects.

I could be doing heroin: feel great or at least good and ‘sometimes to often’ feel bad and/or sick, occasionally: or do Suboxone and feel just barely normal, alright possibly but certainly not good or any better if I took more; and then sometimes (or if I stop, often) feel horrendous, horrid, heinous, awful, hellacious, horrible.

Range of possible subjective feelings of wellness attainable between the two, as I understand it personally:
heroin: +9.5 — -6
Suboxone: +2.5 — -10

I can feel normal while risking feeling terrible (with less risk because I am prescribed it) to a large degree.

Otherwise I can feel good to great, risking (a bit more often, solely because it is not regulated) feeling bad, but not so terrible.

According to this above summation of the experiences: heroin's only drawback is its illegality.

 

[Zephyn]

↑Since my last post in this thread I am off Pristiq, Remeron & everything except Suboxone (even quit my nicotine vaporizer, no nicotine for over a week) and I have to agree:

Buprenorphine / Suboxone is a horrible drug. Esp. for long term maintenance. It doesn't help my cravings, makes me feel trapped due to it's obverse/inverse (wholly adverse) effects.

I could be doing heroin: feel great or at least good and ‘sometimes to often’ feel bad and/or sick, occasionally: or do Suboxone and feel just barely normal, alright possibly but certainly not good or any better if I took more; and then sometimes (or if I stop, often) feel horrendous, horrid, heinous, awful, hellacious, horrible.

Range of possible subjective feelings of wellness attainable between the two, as I understand it personally:
heroin: +9.5 — -6
Suboxone: +2.5 — -10

I can feel normal while risking feeling terrible (with less risk because I am prescribed it) to a large degree.

Otherwise I can feel good to great, risking (a bit more often, solely because it is not regulated) feeling bad, but not so terrible.

According to this above summation of the experiences: heroin's only drawback is its illegality.

I agree, there should be free heroin clinics.

 

[allone]

lol @t free clinics!

nagelfar, how long have you been trapped on the suboxone now? i mean years, and doses. how much you take regularly now days? do you skip a day or two? can you describe more how the WD is like. I have been taking days off the shitboxone on and off here and there but ive always dosed on something else so im not sure how horrible it can get. definitely dont make me feel good when im off it for a while. BUT i feel even worst when im on it!! thats the absolute definition of being TRAPPED!!!!

funny story about shitbuxone btw. ive tried to help several heroin addicts giving them free to help them. ALL OF THEM stopped responding to me and never talked again after trying shitbuxone. as far as i know, at least 2 are back on methadone and feel better on it. loll imagine this, free shitboxone and people hate you for it. BLOCKED! it must be a real shit drug, i tell you that much...

 

[Nagelfar]

Since Sept. ‘19, so a year and a half. I started on 8mg a day, within three months or so moved to 24mg a day (2× 12mg strips) and stayed on that the majority of the time.

Around six months ago I began tapering. Cutting it in half, from 24 to 12; then twelve back to the 8mg strips, followed by eight halved to four. These were all easy transitions, (I believe my system was already entirely saturated to capacity) but during this time I was on four additional psychotropic drugs (desvenlafaxine, bupriopion, mirtazapine, lamotrigine), which I was likewise tapering. These all gave me intense sleep paralysis and night terrors. I can't parse the benefits from one on the impact they had on my Suboxone taper in the beginning, for obvious reasons.

Now I am off everything else, and I was previously down to as little as ⅜ths of a 2mg strip. My Oxford House roommates said it was all in my head, my Suboxone clinic prescriber wants me to jump from 2mg to nothing. However, knowing, from having taken an eight before ever being on a continual regimen: it staying in my system for excess of ten days; I know it builds in your system. I have had continual diarrhea and job performance at work has been quite hindered. So I am back up to 1mg (½ a 2mg strip) a day and am struggling with that.

It could be that, because, I am only several months off of four psychotropics and nicotine as I said, of which I had likewise been on those for a year and a half, but the Suboxone discontinuation symptoms are highly exaggerated for me at this point. I have been telling work that I require some days off (they have no one who can replace me or trained to do so: I have been working six days a week for a year and a half, and on Sundays, my sole day not at work, I have Oxford House meetings & duties as the local Chapter Chair's assistant and individual with next most seniority behind the State Representative, this is in the state with the most Oxford Houses in the nation.)

 

[G_Chem]

I have plenty access to other opioids but much prefer Suboxone. It allows me to feel as normal as possible while still getting a slight buzz and energy, and even after 10+yrs on it I still kind of enjoy it.

My problem with it lately though is all the new generics, none of them feel like the brand name and put me into withdrawal/generally make me feel nasty. Who here uses brand name VS generic?

My one hope is that the problem with generics relates to the inactive ingredients (of which the shitty generics have much more, and toxic ones at that). I’m hoping a purification of some sort can render a product actually worth taking. Otherwise I may be stopping buprenorphine unexpectedly. Starting to prepare for the idea of it after being on these since like 07.

Other opiates work for me but I hate having to take them 6-8 times a day just to feel right. Morphine esters at most get you ok at 4-5 times a day, buprenorphine I can take 3-4 times a day and have a nice even buzz throughout.

-GC

 

[Nagelfar]

I use brand name Suboxone.

I used to feel much better on it, until I got on it as a prescription. The longer on it I have been the worse it made me feel.

I used to go on long walks (still do, but used to also*), 40 minute walks, fast paced, daily: on opioids (even megadoses of loperamide) and feel wonderful, no fatigue. However the first six months doing this on Suboxone actually increased my pain, and burning feeling in legs. I actually had to stop every ten paces on one day, beginning my Suboxone regimen. I asked my prescriber if that could be due to the naloxone content and he denied that any naloxone gets into your system from under your tongue taken sublingually (which I find highly improbable and doubt the logic of) and that only the buprenorphine absorbs via that route; He also claimed that insurance wouldn't cover Subutex, due to possibly abusing it using other administrative routes.

(*realized unintentional quote by M. Hedberg)

 

[G_Chem]

I use brand name Suboxone.

I used to feel much better on it, until I got on it as a prescription. The longer on it I have been the worse it made me feel.

I used to go on long walks (still do, but used to also*), 40 minute walks, fast paced, daily: on opioids (even megadoses of loperamide) and feel wonderful, no fatigue. However the first six months doing this on Suboxone actually increased my pain, and burning feeling in legs. I actually had to stop every ten paces on one day, beginning my Suboxone regimen. I asked my prescriber if that could be due to the naloxone content and he denied that any naloxone gets into your system from under your tongue taken sublingually (which I find highly improbable and doubt the logic of) and that only the buprenorphine absorbs via that route; He also claimed that insurance wouldn't cover Subutex, due to possibly abusing it using other administrative routes.

(*realized unintentional quote by M. Hedberg)

I got to see Mitch Hedberg right before he died as a kid, one of the only comedians I’ve ever seen live. So grateful for that, dude had me dying..

That’s understandable though many report a similar progression with buprenorphine, I must be an odd case.

I’ve got zero problems with it effecting my physical performance and similar to other opiates it helps me push harder.

The only other variable I see is that I continue to use brand name Suboxone made years ago, much of it 2014-2017, it was stockpiled. I wonder if the product has changed in some way since, I’ve yet to try brand name from more recent times.

Gosh either way I hope I figure this riddle out soon cuz I’ve got 6months or so left before I’ve got some tough decisions to make. The Dr Reddys and Alvogen generics leave me unable to do anything.

-GC

 

[DeathIndustrial88]

Nagelfar, going walking use to be one of my favorite things to do too. This is coming from an agoraphobic, lazy, anxiety ridden person.
But as soon as I'd feel my heroin or my tramadol, I would immediately grab my headphones and off I'd go to go walking for hours & hours. Never being bothered by the pains of existence at all. I really miss it.

My situation sounds like yours kind of. I originally was buying my buprenorphine off the street long before I ever got my own prescription. And back then, I would go on heroin binges off and on and usually I would take the subs when my tolerance was super low. Usually like a corner of a strip, maybe 1mg sublingual. And it would last all day and actually felt GOOD. It had almost identical effects to the other opiates I love, just with it's own flavor. Plus it was cheaper and longer lasting than heroin.

That was back in 2016-2017. I got on them for real in 2017 and been on them daily ever since, with little vacations and breaks here or there. And my experience mirrors yours, in that the longer I've been on them, the shittier they feel.

Bupe is TOO long acting for me. And I say that because even if it does give me some good feelings after I take it, they only last maybe an hour and then I'll just feel lethargic, tired, dulled down the rest of the day. And even a bit sore and uncomfortable. Usually dosing more subs doesn't even do anything for me either except extend the duration of shitty feelings. I would almost compare the feelings suboxone gives me to being on some kind of psychiatric drug that dulls me down. I don't like it at all, but I don't think I could get off of them either, not without replacing them with some other form of opioid.

I think the shorter acting opioids retain their positive benefits much better than long acting ones. The long acting ones continue to build upon each dosages until your just fully saturated all the time. Where as with the shorter acting opioids, I would get a boost every time I dosed. I could get away with living on 3-4 good sized doses of quality heroin a day if I had the choice.

I feel pretty stuck where I'm at honestly. And I even stick to low doses of bupe everyday, none of this 8mg-24mg stuff.

@allone, maybe those H addicts weren't aware that taking suboxone too soon would throw them into withdrawal? Lol Maybe that pissed them off?

I have experience using brand name Suboxone for years and then having to switch to Dr Reddy's strips and now finally my insurance only covers the tablets, but G_Chem & I aren't on good speaking terms. lol I've actually run tests and taken both brand name and generic in the same day and haven't noticed too much of a difference except that the Dr. Reddy's strips feel less potent.


I agree with the consesus though. We need free heroin clinics. Or they need to loosen the restrictions on methadone, cause this is bullshit.
I will give bupe some credit in the beginning. They helped me stay away from alcohol and they almost completely eliminated my self destructive behavior and suicidal behavior. At least for awhile. But now those issues are starting to return, since bupe feels like shit now and leaves me craving all day long.

I find bupe to only really be enjoyable if I use cannabis or meth with it. Which I don't want to have to do.

I completely agree with @Nagelfar, that heroin's only issue is it's legal status, which causes a myriad of other issues that people wouldn't have to deal with if they could just get their drugs without hassle. But alas, we still have these people who think drug users are less than human out there running things.

 

[Nagelfar]

Buprenorphine stays in your system for a long time.

I tend to think that once one's system is completed balanced out to its mixed-inverse-agonism at whatever dose you've been taking, that there isn't much you can do but choose between: becoming subjectively normal (by satisfying the physical dependance) or not continue dosing and become sick for a long time until you balance out to baseline normal.

The onset is so delayed that there isn't even the relief brought on by maintaining a baseline dose, on a daily schedule, with what amount one's body is used to as one does on other opioids. Even upping the dose doesn't make me feel better, less aware of negative feelings, perhaps, but it is a fight then to lower your dose once again.

I suppose this is the argument against any opiate, but it seems so much more keenly futile with the mixed agonist/antagonist type as buprenorphine, in my opinion. Raising the dose has no added benefit that I can acknowledge.

 

[freskafreska]

I'm on methadone for years and it does help tremendously with my mood especially at peak plasma, where I am the most productive and sociable. Tramadol doesn't do much for me though other than make me feel nauseous.

I have a weird ability to smell drugs, that is after I drink methadone or shoot H, the molecules circulates to the lungs, gets exhaled into the air and my olfactory nerves pick them up on the way out. Alcoholic drinks smell like vinegar due to the metabolite acetate part way thru the hepatic pathway via Cytochrome P450 CYP2E1/ALDH.

Meds like methadone, morphine & diamorphine, oxycodone, fentanyl, hydromorphone smells highly similar where tramadol does not. The familiar smell plays a huge role for me in confirming the drug is actually working and brings comfort.

This is why I prefer paracetamol over ibuprofen when I don't need the antiinflammatory properties thereof because it has a particular smell which I can detect within 5 minutes of oral consumption.

I could even smell the unlisted and undocumented additive they put into BD Posiflush whatever it is which is supposed to be only normal saline!

So tramadol doesn't do much for me even though it is suppose to hit the opioid receptors nor does Kratom for the same reasons. Venlafaxine an SNRI just makes me sweat profusely and caused hyperhidrosis even when some doctors claim it's suppose to stop or reduce sweating has the complete opposite effect on me!

 

[Nagelfar]

My Suboxone prescriber at my clinic said that if I didn't feel benefits at 24mg that my only option was switching to Methadone. Which wasn't an option for me at the time because I was in a state Work-Release program and Suboxone was the only option they allow due to the structured living arrangement of supervision / custody. I couldn't even leave to give random UAs with the treatment program they made me be on to take Suboxone, because you need passes to leave the facility signed 48 hours in advance by a Dept. of Corrections officer.

It wasn't the case however because he admitted prescribing more than 24mg a day to another individual. Glad I didn't go higher, however. I've used many times my prescribed dose and felt no extra effect.

 

[G_Chem]

Nagelfar, going walking use to be one of my favorite things to do too. This is coming from an agoraphobic, lazy, anxiety ridden person.
But as soon as I'd feel my heroin or my tramadol, I would immediately grab my headphones and off I'd go to go walking for hours & hours. Never being bothered by the pains of existence at all. I really miss it.

My situation sounds like yours kind of. I originally was buying my buprenorphine off the street long before I ever got my own prescription. And back then, I would go on heroin binges off and on and usually I would take the subs when my tolerance was super low. Usually like a corner of a strip, maybe 1mg sublingual. And it would last all day and actually felt GOOD. It had almost identical effects to the other opiates I love, just with it's own flavor. Plus it was cheaper and longer lasting than heroin.

That was back in 2016-2017. I got on them for real in 2017 and been on them daily ever since, with little vacations and breaks here or there. And my experience mirrors yours, in that the longer I've been on them, the shittier they feel.

Bupe is TOO long acting for me. And I say that because even if it does give me some good feelings after I take it, they only last maybe an hour and then I'll just feel lethargic, tired, dulled down the rest of the day. And even a bit sore and uncomfortable. Usually dosing more subs doesn't even do anything for me either except extend the duration of shitty feelings. I would almost compare the feelings suboxone gives me to being on some kind of psychiatric drug that dulls me down. I don't like it at all, but I don't think I could get off of them either, not without replacing them with some other form of opioid.

I think the shorter acting opioids retain their positive benefits much better than long acting ones. The long acting ones continue to build upon each dosages until your just fully saturated all the time. Where as with the shorter acting opioids, I would get a boost every time I dosed. I could get away with living on 3-4 good sized doses of quality heroin a day if I had the choice.

I feel pretty stuck where I'm at honestly. And I even stick to low doses of bupe everyday, none of this 8mg-24mg stuff.

@allone, maybe those H addicts weren't aware that taking suboxone too soon would throw them into withdrawal? Lol Maybe that pissed them off?

I have experience using brand name Suboxone for years and then having to switch to Dr Reddy's strips and now finally my insurance only covers the tablets, but G_Chem & I aren't on good speaking terms. lol I've actually run tests and taken both brand name and generic in the same day and haven't noticed too much of a difference except that the Dr. Reddy's strips feel less potent.


I agree with the consesus though. We need free heroin clinics. Or they need to loosen the restrictions on methadone, cause this is bullshit.
I will give bupe some credit in the beginning. They helped me stay away from alcohol and they almost completely eliminated my self destructive behavior and suicidal behavior. At least for awhile. But now those issues are starting to return, since bupe feels like shit now and leaves me craving all day long.

I find bupe to only really be enjoyable if I use cannabis or meth with it. Which I don't want to have to do.

I completely agree with @Nagelfar, that heroin's only issue is it's legal status, which causes a myriad of other issues that people wouldn't have to deal with if they could just get their drugs without hassle. But alas, we still have these people who think drug users are less than human out there running things.

Why aren’t we on good speaking terms? Lol, was I an asshole?..


Part of me often wonders how I’d feel off these subs, I’m on a pretty low dose and have been most of the time I’ve used them but with so many reporting negative long term outcomes it’s got me curious if I’d be better off without it.

That said I’ve tried switching back to other short acting opiates a few times with no luck, my body even when saturated with full agonist still craves the bupe. My body might just be a weird one..

-GC

 

[Nagelfar]

…My body even when saturated with full agonist still craves the bupe. …

-GC

That someone should have this reaction isn't surprising to me.

It even makes a kind of intuitive sense to my understanding how receptor saturation works:

i.e. …Due to up-regulation being a process which makes more receptors for the chemical ligand to which one is exposed. So tolerance functioning through a neuromodulation which then requires a higher percent of all existing receptors occupied to have the same effects that would have been a smaller amount were there a lower expression of ligand sites.…

It's as if the balance of what percentage is occupied in mixed fashion sets one groundwork for which anything beyond taken up in full agonism is perceived by the whole chemical homeostasis of the brain in a way that it is conditioned to respond to. Just as any exogenous chemical alone might convey getting used to. Polydrug use and dependance gets complicated.

 

[DeathIndustrial88]

Why aren’t we on good speaking terms? Lol, was I an asshole?..


Part of me often wonders how I’d feel off these subs, I’m on a pretty low dose and have been most of the time I’ve used them but with so many reporting negative long term outcomes it’s got me curious if I’d be better off without it.

That said I’ve tried switching back to other short acting opiates a few times with no luck, my body even when saturated with full agonist still craves the bupe. My body might just be a weird one..

-GC

Nah, I think I was the asshole a little bit. lol It was over the whole not wanting to move to Portland ordeal in another thread. I ended up responding in a not so very kind manner that day. But it was no real big deal and I don't tend to hold any grudges or negative feelings toward people I've never actually met before, so it's all good. I had responded on your post on the bupe forum & figured since you hadn't acknowledged it, that maybe we weren't on good terms.

Did you ever do that experiment and find out what kind of ingredients they were using in the Dr. Reddy's strips? I've never had the pleasure of trying the alvogen ones or any of the other strips. But the tablets with an M on one side and an N8 on the other are much better than the Dr. Reddy's strips, if you can get them. Then again, I prefer tablets as they're easier to take for a different ROA.

I've noticed that even when I do take breaks and use shorter acting opiates, it's like my body still craves bupe too. I took a few day vacation awhile back with some hydrocodone. And while I did achieve a tiny bit of euphoria and a 'high' from them, it was incredibly short lived & it still felt like I was having bupe withdrawals at the same time. I almost couldn't wait to be done with the hydrocodone so I could take my bupe again and just go back to feeling a long duration 'normality' for lack of a better term.

Bupe is a strange one.

You don't actually take 24mg a day do you @Nagelfar ? I found that keeping my doses low worked better for me personally, as it allows my blood levels to drop (especially when I'm in bed) and then rise again when I dose, which gives me more relief from cravings. I might be an anomaly but I find 25-50mg of ephedrine or 120mg of psuedoephedrine potentiates my bupe dose by a lot. As in I'll actually get half assed nods if I throw some ephedrine/psuedo ontop of my dose. But it's probably just my personal body chemistry.

My sub clinic doesn't offer methadone or I'd probably go that route. I don't have the means to go to a clinic every day either to dose, so unfortunately that option isn't available for me or I'd switch in a heart beat.

 

[Nagelfar]

You don't actually take 24mg a day do you Nagelfar?

↑Please read above.

Search for the ‘⅜’ symbol, even.

I was as far down as a forth of a 2mg strip for a month, and went two days without anything (clinician wants me to drop from 2mg to nothing), when I had to go back to work next day after my sole day off, I backslid and took my prescribed 2mg.

Since then I have been cutting a 2mg strip in half a day. Taking 1mg. Waking up at 5AM, taking half a 2-strip, still being cold and not wanting to crawl out of bed at 7AM. Diarrhea first thing in morning; and this is coming up from 0.5mg a day for a month(!). I doubled my dose I had tapered to, instead of halving it; I feel as bad in the morning as if I had halved it again (probably feel better through the day than I would if I had halved it, but as bad if not worse in morning)