Is Tramadol effective right away?

[Marzipana]

After seeing a new neurologist late in April, I started on clonazepam at bedtime. After a week of not having any results other than being way groggier than ever during my walking sessions through the night, I was told to double the dose...still no lessening of my RLS symptoms. Yesterday I was switched to 50mg Tramadol a bit before bedtime. The pattern was the same: sleep an hour, up for an hour, etc, with a total of 4 hours sleep, broken up, between 10pm and 5am. Has anyone had success with Tramadol?

[ChrisColumbus]

You might find reading through some of these previous posts and replies helpful:

healthunlocked.com/rlsuk/se...

BTW, despite recent insistence from another poster that one doesnt augment on tramadol, you'll note various references to this in the chain linked above. RLS-UK says "Tramadol is the only opioid that can cause augmentation and worsening of symptoms should be monitored". Some may confuse augmentation with tolerance: NHS says "If you take it for a long time, your body can become used to it (known as tolerance). That means you need higher doses to control your pain over time".

[Marzipana in reply to ChrisColumbus]

Thank you for that information, Chris.

[SueJohnson]

You should have weaned off clonazepam.

[Marzipana in reply to SueJohnson]

I was only on Clonazepam for under 2 weeks

[Madlegs1]

What has your medication history been before all this?

Were you taking a Dopamine Agonist at any time-- Pramipexol or rotigotine or neupro patch?

[Marzipana in reply to Madlegs1]

I was on clonazepam back in the late '90s, bit my neurologist took me off it, as it was a "controlled substance" My RLS was mild back then. I was switched to Ropinerole and Gabapentin, which I was on for years, slowly increasing doses as augmentation escalated. Last year I saw sleep specialists at Mayo and was weaned off both Ropinerole and Gabapentin, while starting and gradually increasing Lyrica. I've always felt that even at the maximum dose of 300mg Lyrica, I was not having relief of my symptoms. I accidentally found Health Unlocked and found that 450mg Lyrica was safe, so I tried that awhile and still had no relief. It took me months to get an appointment with a new neurologist (not at Mayo), and that's when I started the clonazepam (only for a few weeks, as it wasn't effective), and now I'm on 50mg Tramadol. I have to wear a wrist device that tracks my sleep, as well as keep a 24 hour "graph" depicting my sleep, which seems stupid. I have to fill in tiny rectangles with marker every 1/2 hour that I'm asleep to see if it correlates with what the wrist device is tracking.

[nocturne]

I take Codeine-acetaminophen #3 at night as needed, which gives me about 3 hours of relief, and sometimes more if I'm lucky. When I took Tramadol instead, it gave me perhaps 4 hours of relief, so it wasn't that much better than Codeine. But while I can take a second Codeine pill when the first one wears off, I was warned against taking a second Tramadol pill (it can cause heart problems). So I took a codeine pill, which made me nauseous. So, no more Tramadol. I'm back on Codeine-acetaminophen.

[LotteM]

Your dose may be too low. Does your prescription allow playing with the dose? If you want to remain on an as low dose as possible, try adding 1/2 an extra tablet. After dopamine agonists, I was switched to tramadol too. And although usually a low dose of medicines suffice for me, even for me, 50mg was not enough to get me trough the night without symptoms. If you do add, build up slowly, it may help to avoid or better deal with side effects, as your body gets time to adjust.

[Marzipana in reply to LotteM]

Thank you, Lotte, I will check with my doctor to see if I can go up with the Tramadol. I was only given a small prescription to start.

[TheGiz]

I went through all the standard medication you have but didn't try codeine. I'm on Tramadol 50-100mg in the evenings and it's worked quite well in allowing me to sleep. I find 50mg is not enough to eliminate my symptoms 100mg does. Most likely you need to try 100mg. I take 2 50mg tablets about 4 hours apart in the evening for no particular reason but it works for me.

[Whippetmama]

I have been taking 200 mgs of tramadol in the late afternoon and again when I retire, usually 1-1:30 AM. I also take 900 mgs of gabapentin in the evening. Have been on that combo for over a decade. No adverse effects.

[Marzipana]

Oh, my goodness, that's a lot of Tramadol and Gabapentin! Last year, when I was still with Mayo, I was weaned off Gabapentin along with Ropinerole, but I'm not sure why, as I don't think it causes augmentation. Still, your 900mgs of it is way more than ever took! May I ask why you "retire" so late? (I love some of the language variations the British members of HealthUnlocked use!) 1-1:30am is definitely "middle of the night" for me!