Currently I am taking 150-200 mg Tramadol throughout the night and it sort works, each dose for about 90 minutes of relief. I sleep usually 5 am to noon. Now I'm having greater issues. BTW, my flavor features arm involvement sometimes but not always.
I have been prescribed .5 mg naltrexone twice daily.
Any advice when to take the pills? The pharmacist suggested 6 pm and 6 am. However, I have read it should be taken at night after 10p, 2 hours after food. My neurologist said to continue the Tramadol, which I take usually at 10p, 12a, 2a, and sometimes 4a. I know this is counter-intuitive and so does she. The pharmacist said little is known if LDN impacts Tramadol totally or just somewhat.
Now I don't seem to be sleeping at all, maybe 3 hours late morning. This started before the LDN.
Anyone have thoughts on this from your own experience? I know advice cannot be given, however sharing your own experiences would be illustrative. I'm interested in when to take the LDN and how long it might take to show improvement.
Low Dose Naltrexone blocks opioids & is often used to get people off opioids so if you take it with tramadol, the tramadol will be less effective
Tramadol is the only opioid that causes an increase in severity of RLS & causes it to move to other body parts (Augmentation). Tramadol is worsening your RLS and is being blocked by the LDN.
LDN can be effective for RLS, so you could use it to help you off tramadol completely and see if it works alone for your RLS.
I know at least 2 members who switched to LDN alone after using it to get off Oxycontin
If LDN doesn't help the RLS once off tramadol, you could try Oxycontin, methadone or Buprenorphine but NOT while you're on LDN.
Correct me if I’m wrong (I’m not native English), but for me it seems this study from 2007 is about a single patitent, at least this sentence makes me think this: “We report clinical and polysomnographic accounts of a patient developing RLS augmentation after long-term treatment with tramadol”
There are lots of reports of tramadol causing augmentation. Dr. Buchfuhrer says it's 'rare' but anecdotally, from reading this forum for the last 6 years, it does happen quite a lot, particularly where the patient has previously been on a dopaminergic drug.
Thank you much for your salient reply. I would prefer to be on methadone, but I cannot find any provider in Florida to treat me as an RLS patient. There are pain clinics and addiction treatment centers, but no doctor will take me for methadone treatment of RLS. So sad.
I know someone in Florida who is seeing a doctor within the next week who follows the Mayo algorithm and has confirmed they will treat with methadone or Buprenorphine if appropriate. I'll message her to ask for the name. Also, someone on the Melatonin post is seeing a doctor at the Mayo Clinic in Jacksonville, and hopefully they will follow the Mayo algorithm to treat RLS.
As Jools says, LDN shouldn't be taken with Tramadol. I'm surprised your pharmacist/neurologist didn't raise this...
I know of some people on an LDN forum that seem to think if there's sufficient time between taking an opioid and naltrexone, then it's OK but from memory that was around 12 hours.
I have used LDN on and off for about 3 months. It helps considerably with daytime fatigue that i experience (most likely a result of the medication i take).
I do need to take it first thing in the morning as any later and it causes me insomnia.
This is why I like healthunlocked so much. You would think that the RLS Foundation Community Bulletin Board would be very active, but it's not. The participants here are wonderful and so knowledgeable. I am grateful for everyone's well-considered and prompt input. Lots of expertise here!
Continuing conversation about Tramadol and LDN: I have an idea. I cannot cannot use LDN because then Tramadol is ineffective and the suffering is intense, even if I dose the LDN once daily 12 hours before Tramadol. I understand that once you have augmented on ropinerole, you can't go back because the D2 receptors will remember and you'll be right back in the same situation. However, from my last RLS webinar, ropinerole can be used sporadically, for example, if one is traveling via airplane it could be used for the trip to avert symptoms and it works for a few times. How about I go back to ropinerole and get some relief while amping up the LDN? Then I would have relief without the Tramadol. Thoughts?
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