Talk:Tramadol

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Contents 1 Who said tramadol is not addictive? 2 Tramadol is less addictive than Morphine 3 Antidepressant effects (?) of Tramadol 4 Not meant for extended use 5 Length of use 6 Tramadol VS Dihydrocodeine 7 Opioid? 8 My Personal Experience 9 A Cure for Tramadol Addiction? 10 Reacrational Drug 11 Illegal/Recreational Use 12 Tramadol Withdrawl

[edit] Who said tramadol is not addictive?

I've been addicted to tramadol for at least a year, maybe two or more (difficult to estimate). During this summer I've tried to get rid of them by phasing them out. I've had severe problems with abstinence.

I'm writing this because I think this matter is of importance, and it's in my interest to help people avoid what I experienced.

- Repabil 22:20, 5 Aug 2003 (UTC)

I replaced but is not addictive with therefore it's also addictive. - Repabil 13:16, 9 Aug 2003 (UTC)

- I added a reference to the Ortho-McNeil prescribing information which does discuss the potential for dependence and abuse. 66.166.22.146 18:04, 15 February 2006 (UTC)

It sure works to almost erase physical withdrawl from opiates so you tell me its not one, I say OK, but I get the same warm fuzzy as with a vicoden - not quite as good, but if you are having withdrawls, get some and forget what these goofballs say.

[edit] Tramadol is less addictive than Morphine

First  : it'is impossible to take large amount of tramadol otherwise you get convusion due to the action on serotonine recapture Second : by acting on serotonine receptors it have two way of acting

This is not true. It is definitely possible to take a large amount of Tramadol. The more you take, the more you have to take for it to work. nut-meg 05:23, 23 January 2007 (UTC)

=> then you could'nt have a large morphinomimetics effect with tramadol

tramadol is not a very potent morphinomimetics, not like methadone, or very more potent : fentanyl and there analogues

Tramadol have a semi long timelife in your body : it'is good for pain medication, it make the comming on tollerence slower

But of corse if you use tramadol a long time ( and especially without pain ) you can get dependend .

You have right it is codeine structure related, but it'is 100% syntetic

Tramadol belong on the class IIb of the analgesics, it'is not the most lightest of the opiates.

I think that the opiates that have acte on morphinomimetics receptors + the nmda receptors are better than thous that acte only on morphinomimetic receptors. Methadone do it, dextropropoxyphen, there is now a combinaison that is called Morphidex.

Hope that a day we got good medication against pain, that are not acting on morphinomimetics repectors

I realise you probably aren't well-versed in medical terminology, but I thought I might try to clarify a few things for you. Tramadol may be "morphinomimetic" in the sense that it mimics the action of morphine; however there is no such thing as a "morphinomimetic" receptor - you're probably referring to the μ-opioid receptor. And while it is a synthetic structure unrelated to the opiates, it is still an opioid with all the same problems associated with opioids (largely mediated by the aforementioned μ-opioid receptor). Tolerance does not depend on the rate-of-onset or the half-life of the drug, tolerance will occur to an agent regardless. You're probably confusing tolerance with psychological drug dependence where drugs with a rapid euphoric effect (e.g. intravenous heroin) are associated with a higher occurence of dependence. I was not aware that any of the opioids had any action at glutamatergic NMDA-receptors, but even so this would not have any significant effect of making them "better" in terms of the known pharmacology of glutamate and opioid receptor systems. Techelf 06:20, 10 Nov 2004 (UTC)

[edit] Antidepressant effects (?) of Tramadol

Due to its purported inhibition of reuptate for norepinephrine and its potentiation of serotonin effects, I have heard it mentioned that Tramadol can exert an antidepressant effect. I have noticed no drowsiness, for example, as I might even get with codeine---no muddledness. Also, the notion that an upper limit exists for ingestion per day is an indication of its limited drowsiness potential. As for withdrawal, I did notice mild withdrawal for 2-3 days, but I think it would indeed be minor---consistent with anecdotal reports of its limited addictive potential. Apart from issues of seizure activity in susceptible individuals, it appears to be a safe and effective painkiller for lower back pain (in my experience).

Also - quite anecdotally, as well - I imagine antidepressant action. Mu receptor involvement might be the "third rail" of comtemporary psychiatric practice, with practitioners considering mu receptor involvent (bona fine neurotrammiters receptors like the other noncontroversial ones such as serotonin and norepinephrine) are off-limits in moderating depression. Tramadol offered this to me in my experience (concommitant to back pain relief), and I hope it might be given consideration in that capacity.

I can understand, theoretically, how the adrenergic and serotonergic effects might lead to the conclusion that tramadol has antidepressant effects. And while I have seen several studies published, based on in vivo studies in rats, which show some efficacy; this is insufficient evidence to justify its use in humans for this indication. To the first poster in this thread, I find it quite surprising that you did not notice any drowsiness, given that sedation is a common effect of μ-opioid receptor activation and 5-HT reuptake inhibition. It may be that your body had already developed tolerance to the sedative effects of opioids from previous codeine use. To the second poster, μ-opioid receptors are indeed bona fide - and one of the known effects of μ-opioid receptor activation is to produce euphoria. This, however, is not the same as alleviating major depression. Using μ-opioid receptor agonists as a therapy for major depression is hardly rational - if they are effective in depression you would expect that more potent and selective opioid receptor agonists (e.g. morphine or fentanyl) would also be effective; however they are clearly NOT. This suggests that, if tramadol really is effective in depression, it may be an idiopathic effect - particularly since the mechanism of action of current antidepressants is also poorly understood. In the coming years the role of the endogenous opioids (dynorphins, endorphins, enkephalins) should be more substantially characterised and we shall see whether this hypothesis is correct. And even if tramadol or other opioids are shown to be clinically efficacious in humans, the risk of using opioids as antidepressants would be unjustified in light of their propensity to produce dependence/tolerance and risk of abuse compared with SSRIs. Techelf 06:20, 10 Nov 2004 (UTC)

Egad! Fentanyl is a serious CNS depressant, and would be as bad a candidate for an antidepressant as a bottle of vodka. Quite right that one would never treat major depression with opioids per se. However, tramadol has much more than mu activity. . . Look at its panoply of neurotransmmiter effects. A soupcon of mu activity (the lack of it) is of course a component in depression; if we had no natural opioids, we would terminate our lives in short order. Drowsiness or muddledness is, in fact, much reduced in tramadol, probably because of the comcomitant GABA, norepinephrine and serotonin effects. I am here to tell you---and since you are likely a medical professional you are aware of this---that SSRI's and others outside that class like Wellbutrin are only truly efficacious to 50-60%, so one should keep an open mind. My point is that simply because an opioid effect is present, many will rule it out as a possible treatment for depression. One last point: more exists in patient issues than major depression. Minor depression is widely dealt with by myriad Rx's; my implication was tramadol's possible consideration in minor depression.

What you are presenting here is original research. If you feel Tramadol should be used as an antidepressant you will need to back it up with literature references. While we need to keep an open mind, Wikipedia is not a forum for original research unless you can back this up (and a web page is insufficient, I'm talking peer-reviewed stuff here). There is a lot of amateur psychopharmacology on the web anyway. JFW | T@lk 12:35, 18 Nov 2004 (UTC)

Tramadol definitely has theoretical antidepressant potential as an SNRI (similar to venlafaxine). See http://opioids.com/tramadol/ultramantidep.html and http://opioids.com/tramadol/tramadol.html They both come from reputable publications, but mostly involve studies on mice, not humans.

[edit] Not meant for extended use

Tramadol has warning about quantity per day and "not for long term administration". Its unknown mechanism of action could produce changes in the synaptic gap similar to antidepressant effects but of no or of harmful value. Long term or overuse could produce personality change, anxiety symptoms and other disorders.

In practice many people are on long-term tramadol, most with no long-term repercussions. JFW | T@lk 05:09, 5 February 2006 (UTC)

Me included. I was prescribed it for long term usage, and that's with my stipulation to my doctor that I not be prescribed any medication with mood/personality affecting effects. ⇒ SWATJester ^Ready Aim _Fire! 05:30, 14 April 2006 (UTC)

I started using Tramadol about two weeks ago for severe burning and spiking sensation in my feet, hip pain, lower back pain and fatique. Tests have ruled out diabetes, hepatitus etc. While the tramadol is not really helping the pain it has dulled the burning sensations in my feet when I am at rest but not while working and it also has greatly alleviated my fatigue and depression. I was not expecting this as the precautions said it would cause drowsiness. I do not feel hyper, doped up or anything unusual suprisingly i feel normal like I am not even taking medicine. I do not feel addicted or have cravings for more of the pills. I take it as prescribed 2 every 4-6 hrs. While I would not keep taking tramadol for its non pain relieving effects I will keep taking it for its non narcotic uplifting effects.

[edit] Length of use

I have been taking Tramadol for a year for pain associated with fibromyalgia. My doctor decided to change medications. I was on 100 to 300 mg per day.

I am most definitely experiencing physical symtoms as I am limiting the use of the drug. Within the last week I have gone from 300 mg to 50 per day. I am experiencing pretty severe anxiety and chills along with insomnia, and some physical discomfort. How long can I expect this to continue? When should I just stop the meds completely? I would have to agree that I have experienced physical dependence with the use of Tramadol. Is a year to long to have been on this medication? —This unsigned comment is by Jodygaff (talk • contribs) .

Hi Jodygaff,

Wikipedia cannot give medical advice (nor can wikipedians), so I need to advise you to speak with your physician. Opioid withdrawl syndrome is quite variable and duration seems to depend on the individual as well as the substance. While typical heroin withdrawl is over within 48-72 hours, acute methadone withdrawl has been said (anecdotally) to last much longer, perhaps even weeks. Some experience little or no withdrawl symptoms at all. I don't know of any studies offhand regarding the duration (or even existance of) tramadol withdrawl. It's important that you speak with your physician about the symptoms you are experiencing regardless. --Bk0 (Talk) 00:16, 15 March 2006 (UTC)

--Rick53 09:56, 20 June 2006 (UTC) I too want to agree with Jodygaff,withdrawing gives me anxiety and chills,sneezing, runny nose,also bouts of crying and physical discomfort internally,i use 100mg Tramal per day. My main reason for going off Tramel is it makes my mouth stimulate so much saliva ,also the end of my tongue has a metalic taste,& lastly an irritation of air bubbles under the tongue & also on the top to the roof of my mouth,which is driving me to a point of despair

[edit] Tramadol VS Dihydrocodeine

I read in the DHC artical that the potency was 30% that of morphine

Tramadol is 10%

Is Dihydrocodine really 3 times more potent than Tramadol????

Somethings wrong; right?

Yes, the article on dihydrocodeine was incorrect. With respect to IM administration, approximately 130 mg codeine/dihydrocodeine or 100–120 mg tramadol is considered of similar analgesic potency to 10 mg morphine – not taking inter-individual variability of course. -Techelf 10:38, 26 May 2006 (UTC)

[edit] Opioid?

Tramadol is an opioid? News to me. A couple of years ago I was able to order 100 tablets of it from a Swiss mail-order pharmacy, without a prescription. AFAIK, no other opioids can be shipped internationally, at least on the consumer market. Does anyone have URLs for any whitepapers on the subject, which determine that it is, in fact, an opioid and not merely a strong non-opioid analgesic? Clearly, I need to be enlightened on this subject. Avalyn 14:48, 30 June 2006 (UTC)

Yes an opioid, and yes in UK most definitely is a Prescription only Medicine (meaning anyone supplying the drug without a prescription, in the UK, would be breaking the law). Likewise Ciailis & Viagra are POMs, yet as much spam email attests to often available without prescription from suppliers operating out of other countries. David Ruben ^Talk 21:09, 30 June 2006 (UTC)

ive been using 300mg to 600mg of Dihydrododeine a day for over 4yrs now.i have been trying to detox off it for years now but have not suceeded.would Tramadol work in helping me through withdrawals? I have tried so hard to get off Dihydrocodiene but the withdrawls are so horific,not being able to sleep,flu like symptons,sever Depresion.the Doctor has put me on 120mg of Dihydrocodeine continus a day but i am still suffering withdrawls.Would the Tramadol Hydrochloride help my withdrawls?

[edit] My Personal Experience

I just recently quit taking Tramadol HCL tablets. I had been taking them for about 3 yrs. on a daily basis. Without other references to back me up I have only these things to add:

- Tramadol produces a feeling of euphoria -

- Long term use of Tramadol leads to tolerance and dependance -

- Tramadol is widely available without seeing an actual doctor through internet pharmacies -

- Tramadol can be a recreational drug -

- Tramadol is a great drug for treating mild pain -

- Sudden discontinuation of Tramadol causes withdrawal similar to opiate withdrawal -

Right now, as I write this, I am going through Tramadol withdrawal. I had been taking up to 600 mg daily in large doses between 100-200 mg. This is the result of years of taking the medication on a nearly daily basis. My symptoms include: insomnia, hyperthermia, severe anxiety, severe saddness, and slight muscle tremors.

I would personally love to see Tramadol, or a combination of it with another drug, become available for those suffering from depression and anxiety. In my personal experience taking the drug, I have found that can sucessfully treat these disorders, as I suffer from both. My mistake was that I started using the drug for recreational purposes, just to get high or buzzed. As a result, I acquired a tolerance and dependence on the medication due to taking ever increasing doses to counter my growing metabolic tolerance to the drug. I am now paying the price for my mistake. I think its wrong to abuse a drug as irresponsibly as I have, but I honestly believe the drug has other beneficial uses besides pain control. i must put in a small comment i used this drug tramadol for 2 years fro my pain from multiple sclerosis , i got mine online without a script and it is not of high quality like from your pharmacy in yout town . i had all kinds of issues from muscle pain in my back and shoulders next bottle this would go away the next would have some other effect to it . if you can get off it and all the acetominephen is not good on your kidneys and liver . thanks patrick

[edit] A Cure for Tramadol Addiction?

Patrick btw is my name too. I was suffering tramadol withdrawal, but was unable to either wean myself off it, or go cold turkey. So I presented the problem to my psychiatrist and he prescribed Seroquel and Gabapentin for sleep. And a Catapres patch to relieve withdrawals during detox. I've been using tramadol for 14 months and take an average of 400-600 mg per day during that time. The doctor also prescribed a Catapres (clonodine} patch. The doctor said leave the patch on for a week, and that should be long enough for the body to detox. He's an addictionologist and he used a calculator to figure out dose and wear how long based on dose of tramadol and length of use. He seemed to know what he was doing, and says i will experience little or no discomfort during detox. So for me, in a week it's supposed to be a done deal. And I feel less agitated now that i have the patch on. I wiki'd catapress (clonodine) and it is indeed described as an opioid detox medicine. Good luck!

I'm on day 4 now, and not so comfortable. I guess the patch has its limits. Still I guess wouldn't have lasted this long cold turkey without it. It's hard to say.

[edit] Reacrational Drug

Like yall said, it can be a recreational drug. Ive given it to many of my friends and taken high doeses myself. I added a recreation section (10/11/06) that includes the side effects and its possible dependence and tolerance. I dint use any sources, but yall above me (and the people ive given this drug to) will probrably agree with me that my added section is fact

—The preceding unsigned comment was added by 71.71.71.43 (talk • contribs). (01:27, 12 October 2006)

Unfortunately neither your personal claim (which counts as WP:No original research or those of yoyr friends will count as WP:Reliable sources as far as adding material to an encyclopaedia. And yes material in wikipedia must be sourced. Many drugs could be used "recreationally", but that does not automatically mean that they are, or that so used by a trivial number of people (large number, if can WP:VERIFY woul dneed mentioning of course under WP:NPOV).David Ruben ^Talk 01:14, 12 October 2006 (UTC)

well it has been 72 hours sine my last pill and it has been a roller coaster ride now just have aching flu like symptoms but the mood and anxiety was a bad deal . i went from being okay to crying over my ex that i have been divorced from for 2 years to anyhting it was wild i think if these flu like symptoms go away i will be fine i have found that alternating advil and asprin every 4 to 6 hours does cut the edge somewhat and allows you to get some sleep . i swear i wll never take this stuff again ever . it has to stop sometime and by god i am tougher than this stuff i quit smoking cold turkey and i can quit this . it will pass in time i hope but the runny nose cough and sneezing and flu like aching is all i feel now so maybe it has about run it's course . i feel so sorry for anyone who had to go through this . this stuff should be taken off the internet like it is the FDA needs to ralize just how bad of a addiction you can achieve from this drug i will keep you posted good luck and god bless you all Patrick

[edit] Illegal/Recreational Use

Rephrased the "recreational use" section, as it appeared to advocate illegal use and abuse of the drug. Removed uncited "study" claim of being less addictive than other drugs. Editors with more knowledge should fact check this section. nut-meg 05:11, 23 January 2007 (UTC)

[edit] Tramadol Withdrawl

Currently in the main article, the only mention of withdrawal is:

In addition, there are widespread reports by consumers of extremely difficult withdrawal experiences.

For people going through withdrawal, WP will be one of the many sources that people will look at. I have just gone through this experience myself after being on only 150mg/day for about 6 weeks for back pain. I personally found it to be a totally horrible week, that started not too bad before 4 days I'd rather forget, but now a week later I'm out the other side.

WP however needs to have not personal experiences, like mine, but well researched information and in areas like this, preferably from a medical expert. I spent a lot of time looking for medical reference material around this area and found little material that would meet the quality standards for WP, although I found a huge amount of posts denoting personal experiences.

So this is a request for expert help to extend this article to benefit WP readers, especially people who have been on this drug and medical professionals (my own GP had a look at this page checking for info). I am more than willing to help in this task, with guidance. --Mendors 02:34, 4 March 2007 (UTC)