Is Tramadol continuing my Mirapex augmentation?

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Polar Bear
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Polar Bear » Mon Oct 07, 2019 1:33 pm

I actually replaced .25mg ropinerole plus 30 mg Codeine with 2 grams /1 level teasp Kratom. It was my 3am dose and it was a straight swop.
I have not replaced the codeine completely, just that one dose which is one of my lower codeine doses. It is my intention to get rid of the ropinerole not the codeine.

I started with 1/4 teasp which was insufficient, then next night 1/2 teasp which was also insufficient. Third night settled on 1 level teasp.
On the first two nights when it was insufficient I ended up taking the codeine after an hour, but not the ropinerole.

Some nights I give it a miss and use the codeine to break the Kratom pattern.

This helps my symptoms and urge to move but does not promote sleep. I understand higher doses may promote sleep but that's for another time.
Betty
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Icantsleep
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Icantsleep » Tue Oct 08, 2019 7:57 am

So ...

In a nutshell I'm now addicted to tramadol after using it for 8 weeks.

I woke up this afternoon following 3 or 4 fragments of decent sleep
I believe only 1 , maybe 2 awakenings caused by RLS, likely attributed to the tramadol IR wearing off.
For me, this was actually well above average quality, however it took me nearly 2 hours to get out of bed because of my mood/drive etc .
I suppose this 2 hours includes going to the bathroom with my new acute IBS in all its glory (I've lost at least 10 pounds in the last 8weeks ... I'm actually thinking I withdraw from IR tramadol every day about noon , and thus causes this )

Anyhow, I pulled myself together and got downstairs as I was starving , but soon was nearly overcome with anxiety and agitation, and just an overall awful mental state until 945pm

I took a mere 0.5g of Red Bali kratom (my first experience with kratom) at 930pm , and seemed to have these feelings eased .

I then took only 25mg or tramadol at 1230am instead of 50mg , even though those same withdrawal symptoms were returning
I then went through another hour of anxiety etc while I waited for my first tramadol dose of the "day" to kick in .
This anxiety was likely enhanced due to the internet telling me that tramadol and kratom dont go well together, in that kratom can override the tramadol (and leave me feeling like I didn't even take the 25mg at all)

Anyhow , I've calmed down , but only because the tramadol kicked in, and I'm counting down the minutes for when I can take another 50mg

I'm also not planning on taking kratom until I reduce tramadol from approximately 125mg daily to perhaps 75 or 50mg
Bear in mind, right in the middle of this I'm taking 0.75mg clonazepam as well (and high THC FWIW)

Long story short , I plan on eliminating tramadol and replacing it with kratom
Plan A was to only take tramadol to come off of mirapex anyway (which I did 6 weeks ago )

I'd sooner go back to 0.0625mg of mirapex than continue tramadol

Tramadol is not for me
At least not yet in this lifelong battle


Edit
*** This was my second night not taking tramadol ER after taking it for 3 nights , and I felt the same withdrawal yesterday, but it was quickly solved by taking 25mg tramadol IR 4 hours earlier than planned .
.... perhaps this "type" of withdrawal is related to the ER cessation (?) ***

Sorry if this doesn't appear to be a continuous coherent thought
Im sure most of you can relate to being on drugs (or withdrawing from them) combined with minimal sleep .

badnights
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby badnights » Mon Oct 14, 2019 7:13 am

Interesting that you might have (do have?) IBS. There is a much higher incidence of WED/RLS among IBS patients (also Chrohn's patients) and it's thought to be because absorption of iron is impaired. I would suspect, though, that it;s more complex than that, because absorption of everything is impaired. If you could magically fix one thing and one thing only, choose the IBS. Neurological and psychological issues can be caused by gut issues, so everything youve got going on might conceivably be fallout from gut issues: the circadian mess, the WED/RLS, the anxiety, even in a way the previous drug abuse if it was a form of self-medication.

From what you say, I would guess you're dependent on tramadol, not addicted. Addiction is when you crave more of a drug for a direct effect on your mood, and use ever-increasing amounts of it in attempts to satisfy the craving. Having withdrawal is not a sign of addiction, it's a sign of dependence. Dependence is the state of your body being so used to the drug that it gets sick without it, at least until some time has passes and the body resumes its former state of non-dependence. You can be addicted and dependent; you can be dependent without being addicted.

Tolerance is also not to be confused with addiction - it's a state in which more of a medication is needed to achieve the same effect.

Possibly the heightened anxiety and mood disturbance is something you'll experience until the Tramadol withdrawal is over. Kratom seems to be well tolerated among the people on this board who use it, so hopefully you'll get relief without side effects.
Beth - Wishing you a restful sleep tonight
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Icantsleep
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Icantsleep » Mon Oct 14, 2019 9:53 am

badnights wrote:Interesting that you might have (do have?) IBS. There is a much higher incidence of WED/RLS among IBS patients (also Chrohn's patients) and it's thought to be because absorption of iron is impaired. I would suspect, though, that it;s more complex than that, because absorption of everything is impaired. If you could magically fix one thing and one thing only, choose the IBS. Neurological and psychological issues can be caused by gut issues, so everything youve got going on might conceivably be fallout from gut issues: the circadian mess, the WED/RLS, the anxiety, even in a way the previous drug abuse if it was a form of self-medication.

From what you say, I would guess you're dependent on tramadol, not addicted. Addiction is when you crave more of a drug for a direct effect on your mood, and use ever-increasing amounts of it in attempts to satisfy the craving. Having withdrawal is not a sign of addiction, it's a sign of dependence. Dependence is the state of your body being so used to the drug that it gets sick without it, at least until some time has passes and the body resumes its former state of non-dependence. You can be addicted and dependent; you can be dependent without being addicted.

Tolerance is also not to be confused with addiction - it's a state in which more of a medication is needed to achieve the same effect.

Possibly the heightened anxiety and mood disturbance is something you'll experience until the Tramadol withdrawal is over. Kratom seems to be well tolerated among the people on this board who use it, so hopefully you'll get relief without side effects.


Totally with you regarding the importance of fixing the acute IBS
And yes, I have become increasingly aware of the heightened incidences
My IBS is not chronic, and only has been present a few times in the last 5 years (and never prior)
Each time it occurred it was directly related to a very stressful event, which in turn led to very little sleep

I have now had it for 9 weeks straight

SLEEP is the common denominator in my opinion
(........... if of course, the IBS isn't related to tramadol or the actual rapid removal of mirapex )

Either way, sleep itself is paramount

I literally moved three bags to my parents house 2 nights ago (one including my new weighted blanket)
I left my wife and 2 daughters temporarily in the hope I could get more sleep in my parents basement .

I come back to my house overnight
.... in fact , although there was no butter, no gravy, no cranberry, I did just go to town on my wife's Thanksgiving turkey
It was actually a very bland meal, but larger than my recent chicken noodle soup and crackers I've been so accustomed to lately

I put my foot down on the sleep and skipped out on the rest of the family while they had Thanksgiving at my house
(I should definitely add that my wife is fully supportive)

Addiction wise :

You appear to be bang on with your breakdown

I felt the craving
I knew what it was and yes, I felt it
I had quit the 100mg ER the night before and for the first time in my life I craved an opiod

I had never done opiates/opiods , but I felt a nice little high when I took the tramadol
I knew there would be a potential for me to want to chase that high (like so many others do)

... I've had heroin explained to me for what its worth ...

I have yet to feel that high again
.... I did feel relief once I took more tramadol , but never that high
And I dont want to because it is not sustainable.
I would need to take more and more in order to sustain it.

When I said I was addicted to tramadol, I was expressing my profound craving
It has since decreased significantly over the past few days to the point I barely feel it .
(I speculate it had to do with the ER variety of tramadol leaving my body, but I'm just guessing there
.... although I never felt the craving feeling prior to taking the ER variety , which I only took for 3 days, then went back to tramadol IR)

Kratom helped alot and I continue to use it

Anyway .... I'm going to work on sleep
A bit more kratom and a bit less tramadol for a couple days
Or likely a switch to codeine, but I only have a script for 60 mg ER or a bottle of 15mg that is nearly 3 years old (I'm unsure if it's potency might be affected ?)

....plus I'm not sure if I'd do a straight swap in one night (25/50/25 tramadol to 15/30/15mg codeine )

Back to the turkey I ate couple hours ago ... I think that was a mistake

Frunobulax
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Frunobulax » Fri Oct 18, 2019 12:14 pm

QyX wrote:b) you augment under Tramadol. Tramadol is the only opioid where this can happen. One way to test for it would be to slightly increase the dose, let's say from your current 100 mg / day to 150 mg / day. When you have more symptoms afterwards, you certainly have some form of augmentation and when your symptoms improve, then most likely your dose is not high enough.


I agree with the rest of your post, but I'm not sure about this one. In augmentation, raising the medication will usually give relief for a while until symptoms return and get worse than before. It certainly worked that way for me with Ropinirole, which has a similar half-life (roughly 6 hours).

So if you increase the dose it may take a few weeks or more until symptoms get worse.

Frunobulax
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Frunobulax » Fri Oct 18, 2019 12:24 pm

Icantsleep wrote:I do really wish I had low iron

My blood iron was the only recent concern with my bloodwork in that it was too high

It's been a little too high for quite some time apparently


Are we talking about Ferritin or Transferrin%? Ferritin is an inflammation marker. There are studies (with rats I think, but may have been human blood) where introducing inflammatory agents would raise Ferritin reliably. In humans Ferritin can be elevated a lot during actual infections. Thus, a low Ferritin is a reliable indicator for low iron, but high Ferritin is no indicator for anything, you can still be deficient in iron.

Icantsleep wrote:Transferritin 2.1 Normal 2.1 - 3.6 (on the low side)


There we go. My guess is you're low in iron (ignore the Ferritin) and have silent inflammation. Did you have your antioxidants checked (vitamin D, alpha-lipoic acid, coenzyme Q10, glutathione)? If they are low, and/or inflammation parameters like TNF-alpha or IL6 are high, then you may have a lead how to fix your RLS :)
(See these threads: http://bb.rls.org/viewtopic.php?f=20&t=10588 and http://bb.rls.org/viewtopic.php?f=5&t=10599)

stjohnh
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby stjohnh » Fri Oct 18, 2019 3:44 pm

Frunobulax wrote:
Icantsleep wrote:I do really wish I had low iron

My blood iron was the only recent concern with my bloodwork in that it was too high

It's been a little too high for quite some time apparently



Icantsleep wrote:Transferritin 2.1 Normal 2.1 - 3.6 (on the low side)


There we go. My guess is you're low in iron (ignore the Ferritin) and have silent inflammation. Did you have your antioxidants checked (vitamin D, alpha-lipoic acid, coenzyme Q10, glutathione)? If they are low, and/or inflammation parameters like TNF-alpha or IL6 are high, then you may have a lead how to fix your RLS :)
(See these threads: http://bb.rls.org/viewtopic.php?f=20&t=10588 and http://bb.rls.org/viewtopic.php?f=5&t=10599)


I cannot interpret these values. There is no test called "transferritin." Likely the original post had a typo and was meant to say "transferrin." Also the units are not specified and the range given does not match standard USA reporting of transferrin levels. Transferrin by itself is not very helpful. The usual clinical measure is Transferrin Saturation, given as a percentage.
Blessings,
Holland

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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Icantsleep » Fri Oct 18, 2019 4:13 pm

I cannot interpret these values. There is no test called "transferritin." Likely the original post had a typo and was meant to say "transferrin." Also the units are not specified and the range given does not match standard USA reporting of transferrin levels. Transferrin by itself is not very helpful. The usual clinical measure is Transferrin Saturation, given as a percentage.


You are correct
Typo ment to say transferrin

I believe as indicated in this thread my "saturation" was was 0.5 .... with 0.2 - 0.5 being normal

I'm not sure if that's a percentage

The info on page 1 of this thread was essentially a copy of my test results (except my typo of course)

There is nothing more elaborate that I left out
I have a hard copy of my own
With that said , I'm sure more detail could exist

stjohnh
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby stjohnh » Fri Oct 18, 2019 4:56 pm

error. please delete.
Last edited by stjohnh on Fri Oct 18, 2019 5:10 pm, edited 1 time in total.
Blessings,
Holland

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Re: Is Tramadol continuing my Mirapex augmentation?

Postby stjohnh » Fri Oct 18, 2019 5:07 pm

stjohnh wrote:
Icantsleep wrote:
I believe as indicated in this thread my "saturation" was was 0.5 .... with 0.2 - 0.5 being normal

I'm not sure if that's a percentage

The info on page 1 of this thread was essentially a copy of my test results (except my typo of course)

There is nothing more elaborate that I left out
I have a hard copy of my own
With that said , I'm sure more detail could exist


If the saturation you reported is transferrin saturation (could be iron saturation, not transferrin saturation), and the reported values are a ratio, the normal reported, (0.2-0.5) expressed as a percentage would be 20-50%, which IS an accepted normal range for transferrin saturation. If all that is true, a transferrin saturation of 50% suggests you may have too much iron in your BLOOD, not too little. The combination of a high ferritin and high transferrin saturation suggests excess iron, not inflammation, but these tests are not very good at distinguishing between the two. We already know you have too little iron in your BRAIN because you have RLS.

The overall significance of this is that you do not qualify for IV Iron infusions based on current guidelines.
Blessings,
Holland

QyX
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby QyX » Fri Oct 18, 2019 6:48 pm

Frunobulax wrote:
QyX wrote:b) you augment under Tramadol. Tramadol is the only opioid where this can happen. One way to test for it would be to slightly increase the dose, let's say from your current 100 mg / day to 150 mg / day. When you have more symptoms afterwards, you certainly have some form of augmentation and when your symptoms improve, then most likely your dose is not high enough.


I agree with the rest of your post, but I'm not sure about this one. In augmentation, raising the medication will usually give relief for a while until symptoms return and get worse than before. It certainly worked that way for me with Ropinirole, which has a similar half-life (roughly 6 hours).

So if you increase the dose it may take a few weeks or more until symptoms get worse.


Yes, you are not wrong. Personally, I always augmented very fast and could tell within a few days, sometimes even the next day that there was an issue.

Icantsleep
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Icantsleep » Tue Oct 29, 2019 10:55 pm

So ... a bit of an update

The whole addiction/severe withdrawal (and even extreme numbness) all seemed to be attributed to the ER/XR variety of tramadol

With that said, while using the "normal" IR tramadol spaced out in two or three doses, I've seen a significant worsening of symptoms.
Is this tolerance.... or is this augmentation?

Over the past week I'm leaning more toward augmentation, as I've now been getting rls in my arm every night
This was a key indication of my mirapex augmentation

Once I stopped mirapex, I did not have rls in my arm for 8 solid weeks
... now it seems to happen nightly as I continue tramadol IR

I am going to skip my evening dose and rely on THC until my usual 50mg bedtime dose
... then if I have a problem overnight into the morning, I'll substitute that tramadol dose with kratom

By tomorrow or the next night , I will begin codeine slowly , with tramadol being completely eliminated

stjohnh
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby stjohnh » Tue Oct 29, 2019 11:14 pm

Icantsleep wrote:So ... a bit of an update

The whole addiction/severe withdrawal (and even extreme numbness) all seemed to be attributed to the ER/XR variety of tramadol
...
I am going to skip my evening dose and rely on THC until my usual 50mg bedtime dose
... then if I have a problem overnight into the morning, I'll substitute that tramadol dose with kratom

By tomorrow or the next night , I will begin codeine slowly , with tramadol being completely eliminated


Sounds like a reasonable plan to me.
Blessings,
Holland

Icantsleep
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Icantsleep » Wed Oct 30, 2019 6:39 pm

So I had what I'd best describe as rebound rls from about 8pm until 5am
Arm then leg then hip etc
THC didnt do much
Usual 50mg tramadol did kick in for a short while but didn't last
Usual clonazepam 0.75mg did very little

Woke up 5 times with rls
It wasnt until I took 1 gram kratom at 5am where I saw about 3 solid hours of sleep (and the rls disappear )

Tonight I plan to do a mere 7.5mg codeine for evening dose with thc vape when rls occurs
15mg codeine at bedtime with bedtime indica
Clonazepam 0.75mg hopeful at least a few hours later
... then kratom 1gram if (when) rls wakes me up again

Will see how that goes and make adjustments accordingly for next night

Icantsleep
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Re: Is Tramadol continuing my Mirapex augmentation?

Postby Icantsleep » Wed Oct 30, 2019 11:08 pm

stjohnh wrote:
Everything QyX said sounds about right to me. One possibility, if you are augmenting on tramadol, is to switch to kratom if conventional opioids are unobtainable. Kratom works similarly to a weak opioid, and while definitely not potent enough for people that require strong opioids, it may be enough for someone who only needs lower dose tramadol. Doubly true if you plan on trying tiny dose Mirapex again. That is exactly what I did for a year or so after augmenting on Mirapex. After getting my dopamine receptors reset by getting off Mirapex for a few weeks and using kratom instead but not getting sufficient relief, I added tiny dose Mirapex. The combination worked very well to control urge to move. I subsequently added low dose gabapentin and THC to improve sleep.


How often did you use the kratom on it's own?

As in .... what time(s) of day and how many grams ?

I had just been using kratom in the early afternoon to alleviate the overall crappy feeling the meds and lack of sleep left me from the night before

I did use only 1 gram around 430am and it was like magic for about 3.5hours

I'm trying to devise a plan that involves kratom/clonazepam/THC and the least amount of codeine possible

Tonight will be my first night without tramadol

Perhaps the plan for the next few days may differ from a longer term plan
I believe I'm going to take 15mg codeine momentairly as my evening dose to see how I react then go from there


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