Morning all. I wanted to ask if anyone has any advice for me regrading Tramadol and sleep issues. The background: Coming off Pramipexole was a guddle and I ended up on Tramadol, Pregabalin and Trazodone. The Trazadone at least was mis prescribed by my GP. In order to take as little meds as possible and since Tramadol was controlling the rls and not the Pregabalin, I successfully came off the Pregabalin. Since the Trazodone was mis-prescribed I then set about trying to come off that too. I was on 90mg and I am now down to 35mg. It has been SO hard. I experience at least 3 weeks of depression and anxiety after each reduction. My last reduction was 6 weeks ago and my sleep is regularly terrible. I sleep only a few hours and have insomnia, which has always been the case for me with Tramadol. Its clear that Trazadone was helping the sleep and now that I am reducing it, it no longer works to help me sleep. It would appear from online info that Trazodone is a safer option than sleeping tablets, so do I increase the Trazodone and stay on it? Any tips or advice would be appreciated before I consider a trip to my Doc. Thank you to everyone who contributes to this form - what a great service.
Tramadol and sleep issues: Morning all... - Restless Legs Syn...
Tramadol and sleep issues
Trazodone and wellbutrin are both RLS safe anti depressants. Trazodone helps opioid induced insomnia and will help post DA withdrawal depression.So, as you have both, it makes sense to stay on the trazodone for now and to take the minimum dose that covers both. So increasing now to that minimum effective dose makes sense.
And perhaps in several months, you can very slowly start reducing trazodone to see whether the insomnia/ depression have improved.
Hi Joolsg. Thank you for your reply. You have no idea how comforting it is to read those words. With such little confidence in GPs to manage this condition, we end up 2nd guessing everything! One of the other reasons why I wanted to reduce the Trazodone was because of continuing 24/7 heart rhythm problems which I was worried was too much serotonin. However, in spite of the reduction they are persisting, so I am thinking it may be the Tramadol.
Opioids can definitely cause racing heart for many people.I'm one of them. A sedating med usually helps. Trazodone is sedating.
But if you have heart rhythm issues- definitely insist on an ECG and tests to ensure your heart is fine.
Thank you - I had an ECG and the Doc said my heart was fine - no issues, again it is a comfort to know that it is likely an opioid issue. One last question, do you think Pregabalin would be a better sleep aid than Trazodone?
Hard to say. Pregabalin is often given as a sedating med to counter opioid induced alerting/insomnia.Trazodone is more of a mood stabiliser.
In your case, you have both alerting AND depression.
Pregabalin won't help mood- in some cases it causes anxiety/suicidal tendencies.
Discuss fully with your doctor.
If Trazodone is helping you sleep, stopping the insomnia AND settling the depression, then it would make sense to stay on that.
I don't know how long off of Pregabalin you are, but it is notorious for causing heart palpitations. I had severe, 24/7 HPs even until a few weeks after my last dose. My doctor prescribed bisoprolol (anti heart arrhythmia) for relief. I only had to take it a couple of times. One dose would last several days.
Hi and thanks for your reply. I had my final does at the end of May last year, so that's 8 months ago?? I still have ongoing heart issues. I'm encouraged to hear about bisoprolol?
Ok, that was a long time ago! But yes, talk to your doctor about bisoprolol or something similar. They are crazy-driving, aren't they?
They are!
If you do get the bisoprolol, you only need a very small dose. I took half of a 2.5mg tab and it totally stopped it. So if they prescribe you a larger amount, try the lowest dose first.
Great, thank you, I will remember that!
bisoprolol make RLS worse There are safe ones if you want to know them
Thanks Sue - which are the safe ones?
Bisoprolol is a beta blocker used for high blood pressure and most make RLS worse.
Propranolol (Inderal, Hemangeol, InnoPran) a beta blocker that may help RLS, Discuss this with your doctor.
Thank you.
bisoprolol makes RLS worse.
Thanks Joolsg, that is very helpful. Much appreciated. Last night after waking up after 2 hours sleep and being wide awake for hours, in desperation I took another 5mg Trazodone and I got back to sleep for a few hours - and no low feeling this morning. So what you say stacks up with my experience.
With the huge help of Health Unlocked, having suffered afternoon as well as nighttime RLS partly because of a lumbar injury 30+ years ago, and the ready agreement of my GP, I have over the last 3 months reduced my Pramipexole intake from 0.27mg to zero, alongside increasing Pregabalin from 100 to 200mg and (at GP's request) come off Tramadol. This process has proved relatively painless, and my RLS has actually subsided. The process has been accompanied by poor sleep, though, and I'm still struggling with this.
wish I could help but you’ve done good advice on here, I am on tramodol for shoulder but try not to take it, my sleep pattern is not good anyhow, good luck x
Thank you.
hi tramadol cause insomnia, when I take it for fibro is only in the morning or early afternoon, every time I have taken before bed time I wouldn’t sleep at least until 4-5am my husband took it and couldn’t sleep all night, so I would say definitely stay away from tram for the bed time
I have had a lot of issues with anything that increases serotonin (that includes Tramadol), and coming off them is a nightmare for me as well. There is a a counter reaction where I get this wakeful fright, it can be mild to terrifying. I also get depression and fatigue from these meds.
And so it has become clear to me that the meds are making my insomnia worse but then coming off them it’s even worse. I think it’s worth coming off them and see where the baseline is. You may not have as much insomnia as you think because these meds are tripping you up or having a paradoxical effect. It could be that it’s the combination that causes problems also. You can get symptoms of serotonin syndrome when you take more than one of these drugs.
You may be right! That makes sense. Thank you.
I had to stop tramodol and try a different RLS med because it kept me awake. It felt like I just had a few cups of coffee every time I took it. And it did very little for my RLS. Great for cleaning the house but not so much for sleeping. I know a couple of people who take it specifically to stay awake. Have you considered asking for a different opioid like methadone? It still has some insomnia problems but not half as much as tramadol for me. And it seems to work better for RLS.
Thank you for your message - the Tramadol amazingly controls the rls 100% - I rarely have rls which after decades of hit and miss with Pramipexole is amazing. I would be loath to mess with it tbh.
My third laugh of the day - Great for cleaning the house 🤣🤣🤣
Tramadol kept me awake as well (although it made my RLS go away like magic), so I only took it a few times. I eventually ended up on Gabapentin. Luckily for me, it takes very little Gabapentin to work on my RLS, which is moderate. And, I feel like Gabapentin has made my sleep more restful (although it could, of course, be the mitigated RLS -- just a feeling and not proven). I imagine Gabapentin has been explored for you since it's a common first med these days. But, I'm just bringing it up since I don't see it in the comments above.
Before I ended up on Gabapentin, I found Xanax to work too. That definitely helps with sleep, although I do find myself a little groggier in the morning when I take Xanax and I learned that it's not recommended to take Xanax every day (my RLS specialist recommended only taking Xanax 5 of 7 days per week if I'm going to take it). But, to be clear, I eventually moved from Xanax to Gabapentin and find that much better.
I wish you the best as you wrestle with this.
Thank you for your message. Appreciated. When I stopped Pramipexole, Gabapentin did not work, nor Pregabalin, but Tramadol did. Tbh I am not sure they work on me. Opiates are very effective for me.
I have severe RLS in my whole body all day. I take a high does of Pregabalin -500 mg spread throughout the day, plus Neupro patch, and 50mg Tramadol at night plus a sleep gummy. If I don't take the Tramadol the RLS keeps me awake and I need the gummy to help me sleep. It takes about 1.5-2 hours for everything to kick in, so I am trying to take earlier in the evening. Finally got an appt with a good RLS specialist and will discuss getting off all current meds and switching to methadone or buprenorphine. This Board has been very helpful, thank you everyone.
That's strange about Trazodone. I was on it for many years just as a sleep aid, and I took a very low dose (20mg I think) since Trazodone supposedly has a "paradoxical" effect: if you take a low dose (around 30mg or less) it will induce sleep and not act as an anti-depressant, but if you take a high dose (30mg or higher) it will act as an anti-depressant and have an energizing effect and you will not put you to sleep. 90mg should be acting as an anti-depressant and not be putting you to sleep, but maybe your body reacts differently. 35mg is kind of a gray zone between sleeping and energizing so you are probably not getting either the AD effect or the sleep effect, I would guess. Talk to your doctor.
Thank you for your message. I saw my Doc today, they said Tramadol should not cause insomnia. They wondered if other factors were contributing to the insomnia??
I think you are confusing trazodone with tramadol.
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