My mum has been taking tramadol for 10+ years. She initially took it for pain and then later when diagnosed with rls, she continued to take it.
7 weeks ago I took my mum to the gp as gabapentin was not helping any more, gp gave her pregabalin 75mg twice a day. After this she had an appointment with the nurse for pre op for knee replacement surgery. We discussed her rls and she checked her iron ferritin levels were 25, hence she prescribed her iron tablets. Mum had a good few days sleep and then she had her knee surgery. After the surgery once she came home, she wasn't sleeping well due to the pain and her rls came back and we thought it was because of the surgery and will settle given time, however 6 weeks later there was no improvement. She then was taking tramadol as well as codeine just so she can have some sleep but I was worried and thought it may be dangerous so I took her to gp again today and he said the neurologist has said to stop the tramadol as it can cause rls. The treatment plan is to wean of the tramadol and increase the pregabalin to 150mg twice a day.
She has been taking 2x50mg twice a day.
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Bejwo50
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Tramadol of itself definitely does NOT trigger or cause rls. It is actually a very effective reliever of rls.
I don't know where your advisors are coming from, but I'd be inclined to ask for a peer reviewed reference for that observation.
It verges on medical negligence, if it doesn't actually cross the line.
I am not a patient person. 🥺
Of immediate concern to you is your mum.
She needs to get her iron up to over 100. I would not change anything else before that, if she were my mum.
Then, weaning off the Tramadol should be done extremely slowly ( but first I would question the necessity for that action.)
Many people find Pregabalin very effective for rls, others, not so. Side effects can become an issue.
There is no shame or good reason to get off opiates if they are doing the job, with no major problems, other than ticking a Drs' box list for chopping a certain number of vulnerable patients for the sake of looking good with the Authorities.
Totally agree with Madlegs reply below. I have RLS and was prescribed Tramadol for pain relief after a hernia operation 2 years ago. While using the Tramadol my RLS symptoms completely disappeared so I believe Tramadol is actually very effective for RLS.
This is just one research paper on Tramadol and worsening of RLS. I have seen many references to augmentation from Tramadol, including from the RLS Foundation, an impeccable resource.
However, I do not know if this means Tramadol can cause RLS.
I just found this, and it was because of sudden stopping of the opiate. i do wonder if it had been tapered down the outcome would have been different. sleepmedres.org/journal/vie...
Also abrupt, but a young man treated short-term for pain.......
And perhaps you remember a few months ago, we had a young man who had been taking pramipexole off-label for sexual dysfunction of some sort and he ended up pretty rapidly with RLS. I felt really sad for him.
I take tramadol which is the only thing which helps my severe RLS never heard of it causing such a thing furthermore augmentation as I understand it is rare with tramadol and I have been under a neurologists care for many years and would have been alerted about a possibility.
Augmentation from taking Tramadol is rare, but it can happen. The actual Tramadol causing RLS, when you have never had RLS, plus other opiates, is explained in the links by myself and Parminter, its seems to happen when the opiates have been stopped cold turkey,.
I have been taking tramadol for rls for years. At first it was wonderful, then I started to augment, so have been trying to wean myself off it. My GP's are hopeless, so I am pretty much alone. I was only taking one tablet a day, and now I am pulling the capsule apart each day and taking out some of the powder, taking a little more each month. Then I will be taking nothing for this condition at all. If you stop the drug cold turkey you will get a rebound of symptoms, do it very slowly and carefully.
I’ve had a weird relationship with tramadol. It eases the RLS but it also stimulates serotonin which makes me quite sick and does seem to augment the RLS after a few days use. I can only take it occasionally but not repeatedly, and because of this, I haven’t been able to establish whether the augmentation is real or not, but I’m pretty sure. Johns Hopkins believes it can (there’s a video seminar on the use of opiates that could be of some help) and they are saying other opiates can be less serotonin stimulating and therefore better for those who are particularly sensitive. I am extremely sensitive to serotonin and it’s also common for the elderly to be more sensitive overall.
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