Is it a good idea to take Tramadol as and when needed for RLS 1 - 2 times a week?

[MrCrow]

My symptoms vary quite dramatically on a day to day basis. When it's bad, it's painful and all over my arms, legs, back and shoulders. On other days they can be mild. I was wondering if the proposed regimen is ok to take and doesn't result in tolerance or dependence (or even augmentation).

This is the only opioid quite readily available where I live (India). In many places you can buy this OTC.

[Joolsg]

Yes. It should be fine. Tolerance rarey develops. The Massachussetts Opioid study has confirmed that.If you use it daily- then you will become dependent on it & will suffer withdrawal symptoms when you stop it. And the most common withdrawal symptom is RLS.

But using it as and when needed is a good plan.

There are people who have taken it every day for years successfully.

[ChrisColumbus]

The Mayo Algorithm specifically mentions tramadol for intermittent RLS: "Intermittent use of low-potency opioids usually before bed can be effective. Doses of 30 to 90 mg of codeine, in combined preparations with acetaminophen, or 50 to 100 mg of tramadol can be taken before bed or during the night. Constipation or nausea may occur. Tramadol can rarely induce seizures and is the only nondopaminergic drug associated occasionally with the development of augmentation."

Both tolerance and augmentation get mentioned occasionally, the latter very rarely. As Jools says, some have taken it regularly for years without problems.

[Wordsworth99]

As Chris wrote, it can cause constipation. I suggest that you be very careful to avoid that happening, as it can then lead to bacterial overgrowth such as intestinal methanogen overgrowth (IMO), which then leads to worsening RLS overtime. That’s what happened to me.

[Cluaran]

I have had a prescription for 3 years for one 50mg Tramadol daily for severe RLS. However, I only take it as needed at night or during the night when my symptoms are severe.