400 mg of tramadol is the maximum daily dosage. You can't stop taking it for two reasons: 1. Your body is used to it and you're going through withdrawal and 2. And maybe most importantly, tramadol lowers the seizure threshold, you're putting yourself at risk of having a seizure even with no prior history... I feel bad for you. Tramadol is great when it's working, but so hard to get off of. With the slow release, your body is used to a constant amount in your blood stream all day long. You should taper down. 300 mg for 3 - 5 days, then 200 mg for 3 - 5 days, then 100 mg for 3 - 5 days, then 50 mg immediate release every 8 - 12 hours for 2 - 3 days, then 25 mg, then 12.5 mg, etc. Keep cutting the pill in halves every 3 days until it's practically dust. Tramadol is a pretty bad withdrawal, but a painstakingly slow taper can help a lot. Orange juice, hot showers, and eating anything crunchy will also help. Withdrawal can go on anywhere from 5 to 14 days. I wish you all kinds of luck, let us know how you're doing, hope you get past this sooner rather than later.
Follow up thoughts: if you're having trouble sleeping, maybe try advil pm or unisome (there's two on the market, but only one of them actually works, but I forget which is which at the moment, sorry). Hopefully your rls symptoms are just from the tramadol and will go away once you're off of it, which is why I suggest using sleep aids to get you through it in the short term here. But there's also refractory rls that can be brought on after several things, one of which being surgery (i used to have mild rls at night, but after hernia surgery in 2010 I have moderate to severe rls all day long). I hope that's not the case for you. I mention this, though, because I'm worried if you go to the doctor with rls symptoms he might go right for the dopamine agonists, which can cause compulsive disorders as well as at some point possibly making rls symptoms worse instead of better. So hopefully you can taper off the tramadol and see if your rls symptoms go away with it.
See the list of Drugs and Foods to Avoid on rlshelp.org on the treatment page. LOTS of the PM formulas have that evil ingredient, ookla, and also cold and allergy meds. You are in the US, yes? Read all labels before buying OTC meds, also nothing that has pseudoepinephrine in it, ( allergy and cold meds like Sudafed for example) Diphenhydramine is pure poison to most of us. We have to do our homework.
Narcotics, Norco 7.5/325, are more effective for pain and safer then Tramadol, which is a very dangerous drug, and the Hydrocodones(Norco) are somewhat effective over RLS.
My advice, rethink your options and research much more...medscape.com to begin with
Norco might be a better option for short term pain relief, but might not be such a good idea for treating RLS... long term use of acetaminophen can really mess up your liver.
Yes, acetaminophen's a hazard. I take N-Acetyl-Cysteine(NAC) as a detoxifier, since I take Norco 10/325 QID. I was hit by a bus 9/1/04, Pain is an issue as is RLS. I'd like to return to Morphine. It's safer and more effective. US Doctors are wary of prescribing opiates, Just the mention of them irritates their Litigious zone, located behind their wallet
Oxy? sure. Morphine works well for me. Four Norco 10/325's don't help. Oxy's not bad but Sister Morphine' more Natchul like endorphins. Three 30 mg Extended Release daily does it. Doesn't sedate me I have a Very High Pain Level, on the silly # scale 8-10 constantly. 24000 Lbs whacking into you rings your bell for life. I still feel there internal vibrations ringing like a gong inside me. The bus driver said he was sorry he hadn't seen me. He went into shock leaving the bus resting on my degloved leg for three minutes. I lay there patting the tire making very bad jokes
Morphine Sedates and/or Nauseates if man pain level wasn't highest enough to need The Gift That Merck Gave Us in 1827. When my Pain's been up in the Screaming Agony zone. Morphine normalizes me, I can function. I know I must sound like a heavy drug user, maybe so, I've had some incredible encounters with Pain Trigeminal Varicella Shingles being the worst Morphine, Heroin wouldn't have put a dent in that. I ate 3 oz of good pot a week and stayed detached. My Medical Life has made me personally knowledgeable of what works for me, of course. Only if a doctor is monitoring should the Heavies be used. Physicians in the US have become such cowards about treating Pain. This forum is in the UK, You're wise enough to use Heroin. Under supervision its safe...at least that's what Keith Richards says. In the States over prescribing of Oxy has made it legally dangerous for doctors to effectively treat Pain. I have a degloved Left Leg from the impact of the bus in '04. The VA is treating soldiers returning from the ME with degloved legs from roadside bombs. They're using opiates to control spasms, i.e. RLS. There are several doctors in the Portland area doing this in their practices, because I have the 'wrong' insurance, Medicaid, I can't see these docs. I'm open to anything to stop this nuisance...inviting a fer-de-lance over for a bite.
Short of this long, There is research going on about RLS, because of the ME Wars. I challenge anyone to uncover this research. I only know it's going on. Met a mother who's son had a degloved leg and was being treated successfully with an array of Powahful Opiates. His doctor won't accept my insurance. Frustrating. I obviously have too much to say on this topic. Sorry to Hog Forum Space
Really? I was on 15 mg ms contin (the slow release morphine) and could barely stay awake even while talking to someone... if that's the less sedating kind, I can't even imagine how the immediate release would affect me. Geez, I'm such a lightweight with all these meds.
Well, I am in the US, and take slow release morphine and hydrocodone (low dose) and have no issues staying awake, etc. I also need it for my back and neck pain after 5 surgeries, and have been taking both for over 10 years. They pretty much take care of my RLS. I also have other meds for other things, so one has to watch what one mixes together.
I think he is referring to seizures, and that is rare and only if you are prone to seizures MOST of the time. But being a synthetic opiate, that would be the only reason, and it is no more dangerous than any other opiate, and like I said it is synthetic, so less addictive, for most of us. We all have our own experiences. BBguess. If one has a seizure disorder than yes, it is not as safe for you, but you have to make that clear when you say a statement like that. It is actually safer for MOST people.
Tramadol has been a godsend for me. I used to suffer severe rls and plmd but as long as i continue to take the tramadol the only problem i have is insomnia but at least its painless. For the past 6 years ive been taking 100mg slow release at around 5pm and if i feel I'm starting to get uncomfortable i take a 50mg instant. I have tried all the usual rls drugs with no joy. Tramadol has massively improved my quality of life.
It can cause Gran Mal seizures. I had a beut in 2011. If it works for you, stick with it. RLS is Hell. I'm still searching for something for me. I'm focusing on returning to cardio and weight workouts again to exhaust the legs, The Tens unit approach works for some. It produced violent spasms in me, Mg Citrate 500 mg BID works well at lessening the intensity of my spasms.
If Tramadol works for you, use it. I run all my medications and supplements through Medscape's Drug Interaction database regularly. Doctors and Pharmacists are busy and really don't have the time to check and double check medications. Knowledge about interactions changes too. Being our own doctors is wise
Cheers for the responses... I've been back to my doctor and explained my situation and he's put me on amitriptaline in small doses 10mg I can take 3 a night.... Doctor was concerned that all the prescribed sleeping tablets are addictive ?? I tried off the shelf remedies and 2 nights on the amitriptyline and still no joy
I've only taken 2 x 100mg Tramadol in one week, still like awful but reckon if I persevere another few days I'm hoping I will be ok.
amitriptyline tops the list for exacerbating RLS along with the SSRI antidepressants. Would seriously think about that one! Most doctors who know RLS would never prescribe that. My experience was the worst I ever had over any med. So, you should really read about that. rlshelp.org And, that is pretty much universal for 99% of all RLSer's, there are always exceptions. But ,if it is not helping you, you should consider talking to your doctor as soon as possible.
You do know that amitriptyline can make RLS worse for most people with RLS. ? I hope you are one of the lucky ones that it doesnt.
Strongarms, it sounds like you never had RLS prior to back surgery. There is a strange phenomena where some people will develop RLS (temporarily!!!) after surgery, especially it seems after back surgery and some people's RLS is made worse after surgeries. As I remember, the article states that within a few months it subsides. I will try to find the article. There may also be some meds that if you stop them you will develop RLS even if you never had RLS before. A drug called Abilify is one of them. Maybe get your hemoglobin checked? In the meantime try one iron tablet with vitamin c on an empty stomach before bed.
Look at person #8 - Wildcat. They too developed RLS after surgery. But that's not that the article I'm looking for:
If you look under the "medications" (very last item thereunder) section of this article you will see that spinal anesthia can cause a temporary RLS (at least they're calling it RLS) that will resolve in several months. Well Strongarms, that's you I bet! You can be our giant lab in the meantime since yours will resolve shortly. Maybe try taking some potassium at night, or listening to music or elevating the foot of your bed or sitting on a stability ball. Good luck, keep us posted, we won't be hearing from you for long
And absolutely stop the amitriptaline. Try magnesium and taurine instead for nerves and mood but no quick fix with those supplements. Potassium and/or iron with vitamin c MAY give you a quick temporary fix but has to be repeated every night. Check with doc and check for anemia.
yes, and they usually add an anti nausea med into the anesthesia. There will be more studies coming SOON on RLS that happens post-op. Too many people report this happening for them to ignore this any more! The one anti nausea med that is "safe" is Zofran, previously only used for chemo patients, but now you can get it for any surgical procedure and one should always meet with the anesthesiologist before surgery because of this issue. I had Zofran for my last two spinal surgeries and gall bladder and total hysterectomy, never had any RLS like I did for other surgeries when the right anti nausea med is used.
Hi ,I am on Tram I take 2 tabs 50mg yes I do still feel so tired been on them 2months. Why were you on them 10yrs if they didn't help what are you on now
Hi I was on 100mg twice a day for my knee. I was given them for the pain while the hospital decided when to replace it.
I went to a new doctor just over 12 months ago to be told a new knee would have crippled me it was gentic. It was so easy just to get the repeats and I never thought any more about it.
I only take paracetamol now so 10 years unessasary. Given out like sweets then.
I feel more awake now I am of them. Good luck Rose
Just a question,I am about to ring doc I don't think I can take any more Tramodol as the sick feeling and sleepiness I can't function next day. I have tryed cutting down and mixing them but still feel rough tram do take the pain away. I might ask for Requip XL have had those befor any answers befor 12.00 much appreciated xx
Hope he Changed them for you . The Tramadol side affects get worse with time I used to feel sick and tierd all the time and sweat where I didn't think I could. Glad I have come of them let me know how you go on. Rose
Hi Beady, Clonazepam is more for sleeping than RLS. alot of people take it but usually along side of another med. It might work for you.
It has a very long half life and can make some people very sleepy the next day. Beady look at the treatment page on this website it give the list of meds for RLS, even tho its an American site we use almost all the meds here in the UK. It tells you all about Clonazepam. rlshelp.org sorry just corrected the link to the website
Thanks have just had a read it all gets 2 much for me then I start crying it is just ring doc and change yet another tab well I will see how it goes then I expect I will be phoning again, doc is nice though but they realy don't know do they,wonder how xmas will go there is one thing for certain I shallnt be on my own best wishes x
Aww, so sorry you get upset. I have been there myself. Have your tried Pramipexole, i cant remember. Sometimes taking 2 meds at low doses can work better. Like i take 2 of the lower dose Tramadols and then add a small dose of the Pramipexole. I am not saying you should try the same, but i found the 2 meds at low doses is working most of the time for me. Nothing works ALL the time it seems and we get bad nights. Its taken me a while to get to where i am with the meds, and i expect any day it will stop working. But i take each day at a time. So far i have had 3 months of reasonable relief, with some bad nights along the way. Or have your tried the Neupro Patch people have some good results with that. Hope you get some sleep tonight. x
Oh, my. I was on Clonazepam for sleep and restless legs and yes it helped both.I moved out of state and the new doc wouldn't write a script for it so I had to come off cold turkey. It was terrible and even though it helped, unless you are going to take it the rest of your life- be warned.
and sometimes the side effects go away after time. It all depends on the individual.
Every one's experience is different. We cant just say not to take a med because some one's experience was a bad one. Not everyone likes the dopamine agonists either, and will give their bad experience of those.
Sorry for late reply, just saw this. Unfortunately, oxycodone is the only thing that gives me any sort of relief. I'd be more than happy to discuss this further in a new thread if you'd like.
The range of severity of RLS is immense ranging from mild and occasional to very severe 24/7.The treatment depends where you are on the severity scale andcwhat worksvfor one doesn't work for another, .You may be surprised to know that many international RLS experts now regularlyregularly prescribe Methadone as a treatment that is how severe RLS can be.I also have degenerative disc disease , have had back surgery and looking at another one as the problem has mow reached my coccyx.I have arthritis and need knee surgery and I have Graves disease.The one that I hate the most ...restless legs.
Tramadol is a synthetic opiate, but like you said, it is weak for pain control. It was like magic for my RLS, but did nothing for my back and neck after 5 surgeries. For the record I had RLS before any of my surgeries.
And, sleep deprivation causes physical brain damage. I have seen many many brain scans and the brain damage form sleep deprivation shows up the same as the damage from Alzheimer's. The pain meds are the ONLY thing that stop my RLS and I have been on the same dose for over ten yrs. I tried every med known to man for RLS, and we always went back to the pain meds. The risks are no greater than if you are taking them for pain or for RLS. not sure I understand your point, when you are taking those same meds, Dan. I was taking them for pain, and we found that they are my "magic bullet" for RLS after much trial and error. So that is all I use. plus a sleep med for RLS and PLMD
There's only one thing worse than sleep deprivation and that's worrying about it. I can almost guarantee you that worrying about it will kill more brain cells than the act itself. How many brain cells do you think those meds you're taking kill? Life itself kills brains cells. Everything from aspartame, smoking, air pollution, anethesia, to pesticides will kill brain cells. Oh yes, and mountain climbing (think Himalayas) will kill brain cells from the lack of oxygen. And once again, the only thing worse than these substances and acts, is worrying about them. The brain is the most amazing organ in the body and we learn something new about it everyday. I for one no longer believe in "permanent" anything in terms of the brain. New neurons and connections are forged even in the face of some of the worst injuries imaginable.
But thanks for the heads up on that. No pun intended.
tcho,. all I was saying was is I saw the brain scans of several RLSer's and am speaking of sleep deprivation only on this thread. What meds are you on now? besides your iron. I am just saying that it does happen, and have seen the proof. Go google it. You will find more than you can read in one sitting, I promise you. I am not going to get into my meds with you again. I have not had a major RLS incident in a very looong time, so am happy with my meds, no panic attacks any more, etc. Also you have no idea of my entire medical history, so please stop telling me about my meds. I am a 2 time cancer survivor, so I survive very nicely with the regimen I am on now. We are all different, and that is VERY apparent here on this forum.
No drugs. No doctors now that my allergist retired. Iron for RLS as needed. Zinc carnosine (double the recommended dose) for IBS/bloating and mind over matter for interstitial cystitis and narrowing of esophagus due to Schatzki's ring (congenital webbing of esophagus that has gotten worse with age). I have to start to address overwhelming fatigue but have had it since childhood and have become accepting.
Sounds like neupro combined with morphine may stop morphine from losing effectiveness. So a little of this and a little of that may be the way to go for those unwilling to OD on potassium, tonic water, or iron.
Tons of evidence,l Dan, and severe RLS sometimes calls for "overkill" as you put it. I cannot take ANY RLS meds and now opiates are officially listed as treatment for severe RLS. ALL RLS experts discuss use of opiates now. If it was not for them, I would not be able to walk, and my RLS would have caused me to do desperate things over the last 12 years. Dopamine meds are hardly the only answer and we know now that they cause a lot of problems for a lot of people. I wish people would not generalize so much. Say what works for you, and what does not , but what is your "overkill" is MY "quality of life".
The licence was filed in April 2014,.The EU gave positve approval for Targinact for second line treatment of patients with severe to very severe RLS on october 14the full licence would take a further 2 months and according to my GP was December 16th . However he gave it to me off licence.
I think you have a problem with RLS sufferers taking opiates.Why is this? Do you have RLS as I have only seen you mention your mothers treatment. Why do you þhink it is ok for you to take opiates for your back problems but yet it is overkill for RLS? Infact my morphine is also for my back but works on my legs too.You have helped me on the pain forum before Dan so I cant understand why you are being like this about RLS .All I can think is you dont personally suffer with severe 24/7 RLS.
Does it matter? All's fair in love and war. This is war. RLS by day is annoying but intolerable at night. I would venture a guess that about 40% to 50% of the people on here would benefit and maybe completely rid themselves of RLS by switching out or dropping prescription meds such as Prozac, Tagamet, HRT, Statins etc. The list of bad for RLS medicines is becoming longer with each passing week it seems.
And about another 45% of the people on here are battling other conditions that lead to RLS. Just about any spinal/back injury that affects the nerves/CNS will lead to RLS. Even varicose veins (venous insufficiency) which press on nerves in the legs can be a culprit. Infections, bacterial or viral can lead to RLS. I believe this is because when our body is under attack it withholds the absorption and release of iron in an effort to starve out the critters. In the process our brains are denied iron. No iron to the brain means no release of dopamine which means RLS. Diabetes, obesity, kidney failure, MS all seem to be linked to RLS in those that are genetically predisposed. Diabetes is at epidemic proportions so is the use of statins, but there is not a corresponding epidemic of RLS so its just us special few that will have it triggered by these things. Finally, there's one or two percent of people on here that are not on any medications or supplements, have no disease or back problems or infections or obesity, and still have RLS.
We know that RLS brains are anemic and that we have plenty of dopamine kicking around up there, but our dopamine receptors are bad and getting worse with age. Those receptors are the gateway by which dopamine travels through-out our central and peripheral nervous system and quiet our legs and bodies. So the dopamine agonists, which temporarily shore up those receptors work!!! And as you know, substances like cocaine, amphetamines, cause a rush of dopamine everywhere in our bodies. I don't think these substances shore up the receptors exactly but somehow they cause a release of dopamine. I believe the same is true for the opiates...not agonists but are analgesics and facilitators of dopamine. So they too relieve RLS.
We really understand a lot about RLS but what we need are some leaders in the field to come up with benign substances that cause the release of dopamine but aren't so stimulating or addictive that they keep us awake and defeat the whole purpose. In experiments (not necessarily regarding RLS) researchers will use large amounts of potassium to simulate our brains on meth and then try to find substances that will stop the cascade of events that happen when there's an overdose. In other words, the researchers are looking for a substance that can be administered in the ER when someone is brought in with an over dose. But what does that experiment, which is unrelated to RLS tell us? It tells us that potassium triggers the release of dopamine and that's what we're looking for. Standing, walking, listening to music, orgasm, all cause the release of dopamine. But we can't do those things all night long and get some sleep.
I too am not a fan of the opiates or the agonists but until I find a reasonable alternative
or until you find one (Pleeeeeeeeeeeze find one) what choice do these people have? Why can't we put dopamine (L-Dopa) into some type of spinal pump thus bypassing the brain and bringing dopamine right to the CNS? Just a strange thought I've been having lately. There may be numerous reasons why that can't be done.
in reply to
Let's not forget quinine. It too, or at the very least, a derivative thereof, is a dopamine agonist. It's called quinolone and I see it used in experiments and it's also in a new anti-depressant called Abilify but it is far from benign and I put it in the opiate, agonist category. I'm not ruling out tonic water. But it sounds like it takes about a liter per day to give night time relief. My RLS is intermittent so it's hard to experiment with tonic water, otherwise I would. I would have to take melatonin, benedryl and Tagamet in the late afternoon wait an hour to feel the rush of RLS come on, consume a liter of tonic water before midnight and see what affect it has.
I am actually no longer on Targinact as it didnt suit me I am on zomorph.The Neurologist I go to prescribes Oxycodone for RLS .All the other treatments such as the Dopamine meds must have been tried and failed first, Yes I have back problems too , have had one surgery and facing another.I know there are risks and you have to weigh that up with quality of life, Suppose the difference in mild RLS and very severe RLS is difference in back ache and the severe back pain you must have to need opiates..Anyway I off to sleep now.Goodnight
This is the gòod thing Dan ,very tiny doses are beneficial ,the Neurologist prescribes just 10mg of oxycodone and it eliminates RLS in many of his patients.Unlike when used for chronic pain conditions it does not need to be increased for most patients and the tiny dose provides relief for years.Their are many in the states who have been on 10mg of Methadone for 10 plus years with no need to increase the dosage.I use a low dose combination of 3 meds which often works better than high dose of one thus enabling me to keep my opiate dose on the low end of the dosing scale.I take 2x20mg of slow release morphine a day so total 40mg,75mg pregablin at night and 1mg Neupro patch.This works for me 95% of the time.
This is the gòod thing Dan ,very tiny doses are beneficial ,the Neurologist prescribes just 10mg of oxycodone and it eliminates RLS in many of his patients.Unlike when used for chronic pain conditions it does not need to be increased for most patients and the tiny dose provides relief for years.Their are many in the states who have been on 10mg of Methadone for 10 plus years with no need to increase the dosage.I use a low dose combination of 3 meds which often works better than high dose of one thus enabling me to keep my opiate dose on the low end of the dosing scale.I take 2x20mg of slow release morphine a day so total 40mg,75mg pregablin at night and 1mg Neupro patch.This works for me 95% of the time.
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