Tramadol regimen

[ID158]

I'm interested to know if there are people here who largely control their RLS with tramadol. Actually, in doing a search, I can see there are some, but I'm also interested in what their regimen is: Dosage, timing, and anything else that seems relevant.

After trying nearly everything else for a few years (infusions, gabapentin, pregabalin, pramipexole and then tapering off of that, and so on), my neurologist now has me taking 100mg tramadol and 225mg pregabalin. I'm still working on the timing (currently pregabalin two hours before bed, tramadol 1 hour before bed), but it's looking promising. And I hope so, because the next stop would be methadone or buprenorphine.

Relatedly, is it true that, for some people, tramadol can eventually make RLS worse? I don't know if that would be via augmentation or what, but I had a different neurologist tell me that.

[Joolsg]

You can play around with the timing of both tramadol and pregabalin. There is no 'one size fits all'. I used to split my pregabalin dose and take 100 at 9pm and 50mg at midnight. And you can do similar. As long as you take both meds in the evening/at night you can see what works for you. You can also try taking 50mg tramadol around 9pm and 50mg just before sleep.There is one research paper that shows tramadol causes similar drug induced worsening of RLS to dopamine agonists, but many people seem to do well on tramadol. So, stay on it and it may continue to work.

If both stop working, then methadone and Buprenorphine work very well for many of us.

[Whippetmama]

I don't have a set time schedule. I do rely on tramadol to help control my RLS and I also take gabapentin. I take 900 mgs of gabapentin before I retire for the night and I take tramadol whenever I get "that" feeling. Sometimes I take 100 mgs but most time I take 200 mgs. That's probably not very helpful to you but I've been on this regimen for about 4-5 years and it works for me.

[GaryHB]

Hi there. I have been on Tramadol for over a year now and it has been the best treatment for my rls so far. I take 50mg at 7am, 50mg at 1pm and 100mg at 7pm and I have zero rls. I have been rls free now for a year. Hope this info is useful and all the best!

[Vivace in reply to GaryHB]

Do you take anything else with the Tramadol or is the Tramadol alone enough to end the rls? Were you experiencing RLS symptoms during the day, hence the daytime dosing? Does it make you tired during the day?

[GaryHB in reply to Vivace]

I only take Tramadol for the rls. It alone has stopped all the rls. I had previously been on medication that wasn't working, so my rls was a mess. I started with a single evening dose which was insufficient so went up to 2 tablets which stopped the rls. The problem I had was nausea and fatigue in the day which my Doctor thought may be mini withdrawals between Tramadol doses, so he introduced a morning and lunch time dose. To be honest I am not sure if the nausea and fatigue was withdrawals between Tramadol doses, or withdrawals from the previous medications I had stopped. I don't mess with it as it is working. I am having an ongoing problem with nausea and fatigue which I am not sure what the cause is. I was prescribed Trazodone for sleep and I understand that the 2 are not recommended to take together, so it may be that which is causing the fatigue and nausea. I don't know if Tramadol alone causes fatigue? Maybe someone else here would know?

[707twitcher]

look for DesertOasis’ posts a few months back about Tramadol. She is convinced that Tramadol doesn’t cause augmentation, it just loses its effectiveness for some after a while. But it could possibly help heal dopamine receptors. So definitely use it while it’s effective for you, but be prepared for possible switch to buprenorphine or methadone later. Unfortunately Tramadol didn’t work for my RLS, so I’m on buprenorphine.

[Jerry57]

I've been taking tramadol for over 2 decades, and along with iron, my RLS is under control. Currently I take 100 mg at 3 pm, and another 100 mg at 9 pm along with 1 or 2 ferrous bisglycinate tablets. A while ago I mistakenly thought I was augmenting on the tramadol, but it turned out I had to adjust my iron intake. Too little or too much seems to aggravate my RLS. Hope this helps.

[Vas1963]

I’m experiencing the same situation as you! My sympathies because it’s a pain to deal with. Im taking 50 of tramadol around 3-4 pm and the 100 around 8-9pm and has been working very well. Also no caffeine after 3pm . Been sleeping great with some occasional rls that goes away after a few minutes of stretching. Good luck

[Rosyrestless1]

I have mostly used only tramadol 20+ years starting with 50 MG and now taking 300mg but as it is unfortunately in my brain now I will be increasing or changing soon.

[johannasuar]

hey there. I’ve been in Tramadol for over 12 years with great success. I do not use any other drug and I haven’t had augmentation once I adjusted my dose in the first two years. Just remember that what’s good for the goose isn’t always good for the gander.

My dose is 100mg split in two 50 mg tablets. I learned that my RLS starts around 7PM and tramadol takes close to two hrs to kick in so I have a set timer for 5:30 to take my first 50mg dose, then I take the second 50mg tab at 10:30 pm and I’m good to go till the next day. What tramadol causes is a bit of insomnia which I’ve learned to tolerate because every third day I’ll get a full nights sleep. It’s better than having RLS . The big trick is to medicate before the RLS starts or you’ll have to wait those two hrs to get relief, I’ve been very lucky because my dose has been perfect for me. As we all know, alcohol is a no no. But when we go out to dinner I do enjoy a cocktail and consequently I have to pay the price but what I do is take another tab split in 1/2 which is 25 mg more. As for tramadol making RLS worse, not for me, I think that’s a toss up question, some say yes, others say no, I’m a NO person. Constipation is another problem but easy to take care of. I hope I helped some. Another issue is that some say tramadol causes augmentation but again, it hasn’t for me and like I said. I’ve been on tramadol for over 12 yrs, Good luck. You’ll get a lot of different answers here, you need to experiment to find what gives you relief. At first I was given Gavapentin which did NOTHING for me except gain a tremendous amount of weight which came off as soon as I got off that med. good luck.

[ID158 in reply to johannasuar]

I have also found that taking it pre-emptively is key. I know it's going to happen--it's every night. It's no longer if, it's when, so there's no point in waiting for it to start.

[ID158]

Thanks everyone. This has been super helpful. Clearly one size does not fit all! But we are certainly used to that.