Questions about transitioning to lower doses of Tramadol while on Pregablin (Lyrica)?

[Bganim1947]

Anyone know the standard dose of Tramadol that works well with Lyrica to eliminate RLS symptoms? I’m on 100 mgs Lyrica and 100 mgs of Tramadol 3 x a day. With that I am RLS free, but my doctor wants me to cut back to 50, 50 and 100.

I started titrating down last week to just 50 mgs with my morning dose, and found my RLS symptoms came back in my legs in two days. Doc thought I might go slower to eliminate withdrawal to 50 mgs every other morning for a month. Then when I stabilize, do the same with afternoon dose. That sounds reasonable, but I’m really worried about going through the withdrawal phase, and then being symptomatic while waiting for my body to stabilize to lower doses. Any suggestions from people who have actually done it?

[Pam34]

Hi Bganim

Just wondered why you were taking them 3 times a day? Do you suffer from symptoms all day?

Pam

[martino]

I am currently reducing my Tramulief (ER Tramadol) at the rate of 0.25mg a week. I have gone cold turkey in the past and my legs were all over the place within 2 days. Today is another 0.25 reduction but even though it is early days I think my legs are getting more restless at night. 2.00am yesterday morning and 4.00 this morning. I am not optimistic! I have asked Dr Mark Buchfuhrer for his opinion. He suggests Lyrica rather than the Gabapentin I am on and recommends Targinact or Methadone IF my Doctor will prescribe it

[John_naylor]

I’m on 3x400gm Gabapentin per day plus 2x50mg Tramadol per day and have tried to reduce my Tramadol to 1x50mg but struggled. I’d like to alternate between 50 and 100mg/ day as it became ineffective last year and hence the need to add Gabapentin. I may just reduce the Gabapentin if I don’t get anywhere. Good luck with reducing your Tramadol, stick with it as on such a high dose where do you go next if you reach Tolerance?

[involuntarydancer]

It is a conundrum. Reducing the opioid induces all over body restlessness in me that is very similar to rls. And it can last a long time so it becomes very difficult to establish what are withdrawals and what are underlying symptoms breaking through because of insufficient medication.

Madlegs has posted links to sites that help with opioid withdrawal and the big thing I took from them was to reduce at a rate of about 10% every 10 days. I applied this very successfully to withdrawing from lyrica which otherwise was extremely hard for me (I know some people discontinue it easily but I got terrible withdrawal symptoms).

I would think that reducing your daytime pills at a rate of about 10% every week or so will minimize withdrawal discomfort and allow you to assess how your underlying symptoms are coping with the reduced dose. I would check with a pharmacy but what I do is crush and dissolve the pills and Then use a syringe to measure out an exact dose.

HOWEVER, it is slooooow and there isn’t always time to do it that way. I am currently withdrawing from Kratom in a rush - I have a deadline - and the attendant restlessness is nearly as bad as rls - virtually no sleep possible. Luckily Kratom withdrawal symptoms don’t usually last long with me - not nearly as long as OxyContin which unfortunately is probably closer in profile to tramadol.