Augmentation from tramadol

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Werbers
Posts: 5
Joined: Sun Mar 17, 2019 12:21 am

Augmentation from tramadol

Postby Werbers » Thu Mar 21, 2019 8:19 am

Good morning all. It’s 2:00 AM which seems like an appropriate time to discuss augmentation which is currently driving me nuts!

I’m new to this group. I’m 68 years old and have had RLS as long as I can remember. I have taken a combination of tramadol 100mg in the afternoon and oxycodone 10mg at bedtime for the past 20 years with GREAT success. Almost complete relief for the first 10 years. I began having symptoms so I added ropinorole 1 mg at bedtime which helped for about a year but then experienced augmentation. I got through that horrible experience which lasted 2-3 weeks by taking a bit more oxycodone and when the augmentation subsided, went back to just the 10mg of oxycodone and 100mg of tramadol. That worked reasonably well until about 6 months ago when the augmentation returned. I wasn’t even aware that tramadol could cause augmentation until I listened to Dr Buchfuhrer’s webinar but then it all made perfect sense. I tried tapering the tramadol but finally decided cold turkey was the best approach. My last dose was 21 days ago. Needless to say the augmented symptoms were severe at first but are gradually getting better. I’m currently getting by with 20-30mg of oxycodone through the day, most of it at night. I have an appointment with my physician tomorrow and the plan will most likely be a ferritin level (was 99 2 years ago) and starting Lyrica. I tried gabapentin briefly a couple of years ago with zero benefit.

My questions for the group are:
1. Any idea how long augmentation from tramadol will last?
2. Since tramadol is not a dopamine agonist, will I be able to use it again any time in the future?

Thanks for your thoughts.

ViewsAskew
Moderator
Posts: 15598
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Augmentation from tramadol

Postby ViewsAskew » Thu Mar 21, 2019 9:40 pm

Tramadol is great for many...but that pesky augmentation! Doesn't happen often, thankfully...but that doesn't help you, does it?

I honestly don't know how long it lasts - hopefully someone else will be more up on that. In most cases - very generally - augmentation lasts between 3 days and a month before it starts to subside. Yours is subsiding, so that is good. When I augmented on pramipexole, I started to see diminished symptoms around 3 weeks, but it was very slow. Mine actually decreased over about ten years. Sure, the craziness went away in a month, but I still had increased symptoms. I had 24 hr symptoms that eventually went to 20 hours, then 18, then 12, etc. I am medicated, so cannot be sure, but seems to me that I am down to about 10-12 hours these days. Infusions helped, too.

My guess is that while there are averages, this hits each of us somewhat uniquely and not sure why. Ferritin would seem to be part of it, but I don't think any studies have been done on it.

So sorry you're going through this. I know how nasty it can be.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

ViewsAskew
Moderator
Posts: 15598
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Augmentation from tramadol

Postby ViewsAskew » Thu Mar 21, 2019 9:42 pm

Oh - forgot the can you use it again question.

Many of us have used DAs again. I waited a few years, others only a few months. As long as my ferritin is high (for me that means REALLY high - like over 275), I have no issues using a DA. But, I don't know if they know why tramadol causes it and if whatever happens in the brain can be reversed. Not much help today, am I!
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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