Augmentation from Tramadol

[Muftah36]

Hello fellow sufferers of RLS. I am just so discouraged. Since weaning off Ropinarole one year ago, with much difficulty , I have been taking codeine and Tramadol and with a very strict diet have managed my RLS fairly well with an episode once or twice weekly. For about a month now I have been having episodes nightly as well as evening , plus my legs kick me out of bed every morning at 6-7 am. I may have cheated a little on my food intake, but I am afraid to think maybe I am augmenting from Tramadol, How likely is that ? I can’t bare to think that Tramadol is causing this or that my condition may be worsening .

I am presently avoiding gluten, sugar, (although I love a sweet in the evening) caffeine and alcohol. Any thoughts on this and where do I go if indeed it’s the Tramadol. This is scary as I’m suffering almost all day now .

Thanks for any advice

[LotteM]

Hi Muftah, sorry to hear about your lack of control of symptoms. Hard to say whether it is the tramadol. It is possible. But it may also be worsening of symptoms. RLS tends to get worse with age. Or tolerance. How much tramadol do you take? And how much codeine? Codeine on its own or with paracetamol? Tramadol on its own didn't suffice to control your symptoms? And why dis you add codeine rather than take a higher dose of tramadol?

[Muftah36 in reply to LotteM]

Hi LotteM , thanks for your response. My family physician started me on Tramadol 3x50 at night plus 3x30 Codiene at bedtime after I had a horrible withdrawal from Ropinarole last year. I had been taking Tramadol SR at the same time But it didn’t touch my RLS , thus the Tramadol and codiene. They act in different ways so this was the combination at the time that he thought would work. I would really rather not increase these drugs unless I have to . I won’t see him again for several weeks if I’m lucky with all this pandemic stuff going on.

[Jumpey]

I'm sorry to hear you are suffering. What I can say is my experience of both tramadol and codeine is that after a period they stop working. When this happens I take a drug holiday of a month and then the meds kick in again. I must say I have never taken both drugs together. I rotate them. Good luck.

X

[Muftah36 in reply to Jumpey]

Hi Jumpey, Thanjs for your response. So I’m curious how you manage your RLS during your drug holiday. Do you mean that you take codeine or Tramadol in rotation? What dosage of them works for you? I have never done that , it may be worth a try. I really don’t want to think that they have stopped working and neither do I want to chalk it up to a worsening of the condition.

[Jumpey in reply to Muftah36]

I take 30mg of codeine and 50mg of Tramadol at night.I just put up with RLS symptoms when they occur in the evening by walki g around. keep doses low to keep side effects acceptable. I do get breakthrough symptoms at night so these doses don't always completely eliminate RLS. But most of the time they do.I'm prepared to accept this as a payoff.

I have taken Tramadol until it stops working then switched to codeine. This worked for a long time.Then they both stopped working. So I had a month off both.Complete RLS drug holiday.Then restarted Tramadol which started working fine again.And has been doing so for about 7 months again now. The month without anything was a challenge .I'm lucky I am retired.I took a sleeping pill about once a week to get a bit of rest.

Good luck.I hope you can find a way if getting relief. X

[martino]

I wish I knew an answer as I am in a similar situation. I use a Neupro patch and also use Tramadol and Pregabelin. All was well but as I age something is going wrong. My legs are getting more restless and sometimes it is only exhaustion that keeps me sleeping. The culprit may be the Neupro but I suspect my neurologist may want me to go from 2mg to 3. I have dropped the Tramadol but I struggled so have continued

[Muftah36 in reply to martino]

Thanks for your reply. I will revisit my diet and attempt to reduce or eliminate the Tramadol for a while in hopes of improvement.

Good luck to us both

[bill54321]

Tramadol is for pain NOT< NOT<NOT RLS. You need to talk to your Doc OR a MOvement Neurologist. Be aware, every one has opinions. Read my routine on posts, read others, and google. Very few people have it the same way. Are you jerking or mentally bothered by it. At night? Day? both. Other problems etc. Drink coffee in AM only. Research yourself. RLS is a Doctors parrot area. Not much new good research. Start studying "Brain Barrier".

[Joolsg in reply to bill54321]

Lots of drugs used for pain work on the same receptors in the brain responsible for RLS. Opioids at low dose and anti epileptics do work for RLS & are used at much lower doses.

The first recorded case of RLS was treated with morphine in England by Dr Willis in the 1600s. The disease is named after him and Dr Ekbom.

[Muftah36 in reply to bill54321]

Thanks Bill54321 for your response but I have researched RLS and treatment, Low Dose opioids are in fact recommended for RLS with fewer side effects than other drugs.