Hello. I am looking for some advice about Tramadol. For the last 4 months I have been on Tramadol for rls and Trazadone to help with sleep. I found 150mg Tramadol was needed to stop the rls. My Doctor also prescribed 225mg Pregabalin in August as he felt a low dose of Tramadol and a low dose of Pregabalin may be the best solution. The addition of the Pregabalin has stopped the heart palpitations caused by Trazadone. I sleep very well since adding the Pregabalin and have zero rls since starting Tramadol - not even a twitch. Tramadol is by far the most effective medicine I have taken over the last 20 years. The problem I have been having is exhaustion and nausea which begins creeping in around lunch time and gets progressively worse until I take the Tramadol and Pregabalin in the evening and then it stops. It felt like withdrawals to me so I tried splitting my Tramadol dose and taking 1 at lunch time and the exhaustion and nausea lifted. And it made no difference to the night time - still no rls. I am wondering if Tramadol needs to be taken at regular intervals?? This week I also had a few days when the nausea and exhaustion started when I woke up. I took a Tramadol and it lifted immediately. Does anyone have any experience with Tramadol dosage for rls and could advise me? Thanks and I am grateful for this supportive group.
Tramadol Advice: Hello. I am looking... - Restless Legs Syn...
Tramadol Advice
All opioids need to be spread out over the 24hrs to avoid mini withdrawals, as you have discovered!!
Tramadol has a very minor risk of augmentation, so do watch out.
Ok that explains it then. Any idea how regularly I would need to take it?
It's very much a personal challenge.
You need cover at nighttime, but also a minimal cover during the daytime.
Tramadol has a 24 hr tablet - the 100 mg dose. The 50 mg tablet is for 6 hrs, (I think) Check the leaflet.
And have a chat with your Dr.
Good luck.
From the NHS site. ------
When to take tramadolWhen to take it depends on the type of tramadol that you have been prescribed:
standard tablets and capsules – usually 3 to 4 times a day
drops – usually 3 to 4 times a day
slow-release tablets and capsules – usually once or twice a day
If you're 65 or over, or you have liver or kidney problems, your doctor may ask you to take tramadol less often.
You can take your tramadol at any time of day but try to take it at the same time every day, and space your doses evenly. For example, if you take tramadol twice a day and have your first dose at 8am, take your second dose at 8pm.
Interesting. I take 150mg Pregabalin, 150mg Trazadone and 5mg long release Oxycodone (slightly stronger than Tramadol) each night. If I don't drink too much red wine with dinner, my RLS is finally almost under control. I seem to have no side effects at all ... certainly no nausea, although I do feel a bit "sluggish" when I first wake up, but that soon clears. Hope this helps. As Madlegs says below, all opioids need to be long release or spread out.
Thanks for your reply - appreciated. So a similar regime to me bar for the different opioid. What are you taking Trazadone for? I was prescribed it for the terrible depression I encountered when I came off Pramipexole and also for the insomnia caused by Tramadol. I also experience brain fog and memory problems while on this combo. Have you experienced this?
Hi Gary. I am taking Trazadone depression brought on by menopause. One of those weird things. Never had PMT in my life, never had black moments ever. Then about eight years into menopause - hot flushes only, which went away with Estradiol patches - bang ... anger, tearful, the lot. Came as a bit of a shock really.
I was initially put on Citalopram - which just kicked off my RSL. Then got prescribed Setraline, which also kicked off my RLS. Finally, a few months ago, I went onto 100mg Trazadone. It did not affect my RLS, but I felt I needed to go up to 150mg, which I am now on. I honestly would like to go up to 200mg, because I still struggle in the afternoons, but I am going to give it 6 months and see if I can cope.
But on a combination of Pregabalin (150mg), 150mg Trazadone and 5mg long release Oxycodone, all taken at night, I have no nausea, no brain fog, no memory problems. Although I have to say that I have never had any power of recall. I am convinced it is because of the inherent lack of dopamine in my brain. I am very bright, just useless at exams etc because I cannot remember things. And that was from way back when I was in nursery school.
I took pregabalin for two years and initially it was amazing. Stopped my rls and I slept well. Gradually I had to increase the dose for effect and omce on 200mg I had very bad tinnitus. This was really bad. Like standing on a runway when a plane was landing. My balance was then affected, I put on weight and concentration levels bad. I gradually developed pains in my legs and feet. Rls got worse, I was doing housework, ironing, washing floors in the middle of the night just to get relief. My bladder then decided to stop working i.e i could not pee. I had to self catheterise which caused many UTI"s. My urologist could not find anything wrong! I was beginning to get suicidal.So I very gradually came off Pregabalin over one month or so and I am now taking two Tramadol, one at 1pm and the other at 5p.m. I'm also taking two magnesium tabs and one ferrous sulphate as my ferritin levels were 29.
My doctor will check my iron levels in a few weeks.
Tramadol has completely changed my life. I am sleeping well, my concentration is good, my balance is back to normal and most importantly my bladder is once again working well.
When something goes wrong doctors just think "oh what can a prescribe for this?'
They never think what medication can have caused this.
So please anyone who is reading this DO NOT TAKE PREGABALIN!! It will work initially but ruin your life forever.
You've scared the shit out me now. I started pregabalin 3 weeks ago and it's started working but after reading your post I'm terrified
My Dad and Mum have been on Gabapentin (similar to Pregabalin) for years and have been OK. I have found Pregabalin really helpful since I started it. I dont want to stop it as it is working.
Don't be scared. What happened to Avocadopal is terrible but it is very rare.
Many people manage well on pregabalin or gabapentin and don’t have the side effects you describe. It’s great that you worked out what was wrong and were able to access tramadol and are now much happier but given that dopamine agonists have serious issues the treatment options are pretty limited and while pregabalin can have side effects it’s also relatively easy to withdraw from and as far as I know has no long lasting effects. Therefore I’d say it still has to be an option rather than go straight to opioids which many Doctors will resist. Like you my tinnitus seemed to worsen when I took pregabalin but the same thing seemed to happen with cannabis oil so maybe there’s something else happening - a change in awareness? All that aside it is really useful to hear your experience and see what worked for you as others may end up in the same situation.
Gee that's a horror story. Sorry to hear about it. Thanks for sharing your story and for what is now working for you.
Avacadopal,
I think the warning here against Pregabalin is excessive. It is not listed as a common SE. But in some medications ie antidepressants it can be in 10% of people. Does your Urologist say it is definitely the Pregabalin or they just dont know why this has happened?
Is your urinary retention ongoing and for how long? If it has resolved - great, but terrible the you had to go through it. But does not = ruining your life forever. Not every medication suits every person, especially in RLS! Pregabalin however has been a virtually life saving medications for many people with RLS. Many have been on it for years and not had serious side effects develop. If people are using it successfully, your experience does not necessarily mean they should stop something that is working for them.
I hope you find something that works well for you.
The other medication may be responsible for nausea. Are you taking long acting Tramadol or normal one? Yes only Tramadol could stop RLS in my case. Patients settle down to 150mg. I thank my neurologist for prescribing the right medicine. (Beware - weaning off Tramadol is almost impossible)
Thanks for your reply. I am taking normal Tramadol - I am sure the nausea is mini withdrawals as it lifts when I take a Tramadol. I tried taking a Pregabalin and it did not lift the nausea - hence my conclusion that its the Tramadol. I ahve come off Tramadol once before and it was hideous. As bad as coming of Pramipexole - depression and anxiety at such bad levels. It seems we are all trapped having to use difficult drugs. What I do know, is I never want to go near Pramipexole again!
It's not impossible - it just needs to be done slowly. Luckily it is not like coming off a DA.
That is very encouraging to know!
In my 12 year experience with Tramadol I definitely noticed withdrawal symptoms if I didn't take it at regular intervals.
My symptoms got worse every few years and my Dr didn't know that Tramadol can cause augmentation and as my RLS got worse,he upped my dose until I was in the max dose. So I was taking 100mg every 4 to 6 hours. If I went any longer than 6 hours I would start to get withdrawal symptoms. Which for me were headache and a runny nose and just a general feeling of uncomfortableness.
Hi GaryHB,
After 40 years of unsuccessfully managed RLS, I'm going to ask my pain doctor for Tramadol. It's never worked for pain for me, but it sounds like a plan for RLS. I'll consider your experience when I speak with doctor and will let you know my progress. Thanks so much for sharing!
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