Restless Legs Syndrome (RLS) Discussion Board

I've been on (only) Tramadol for about 2 years, 50 mg twice nightly. I think I'm augmenting. Doesn't really work anymore and now my arms are involved. Has this happened to anyone? Can I quit cold turkey? I did that with gabapentin which didn't work at all for me. It was a rough couple days, but I didn't lose my mind.

ratfancy wrote: ↑

Sun Nov 22, 2020 9:00 pm

I've been on (only) Tramadol for about 2 years, 50 mg twice nightly. I think I'm augmenting. Doesn't really work anymore and now my arms are involved. Has this happened to anyone? Can I quit cold turkey? I did that with gabapentin which didn't work at all for me. It was a rough couple days, but I didn't lose my mind.

I've read it can happen. I would not quit cold turkey. You likely are dependent on it - you could get quite sick. Reduce slowly and see what happens would be what I would do.

And, so sorry this is happening. Glad you had two years of it working, though!

Augmentation on tramadol is unusual, but it does happen.

Can I quit cold turkey?

DO NOT quit tramadol cold turkey!!!

Tramadol is not only an opioid, it is also an SNRI anti-depressant. You can quit opioids cold turkey from a dose like yours and only experience a bit of withdrawal for a few hours. Quitting an anti-depressant cold turkey will cause a different type of withdrawal AND can leave you with something called SNRI Withdrawal Syndrome or Serotonin Withdrawal Syndrome (I will call it SWS for simplicity). SWS will leave you with nightmares, can cause migraine-like headaches, very brittle emotions and something that is essentially PTSD. I know because I was forced to quit tramadol abruptly (I was on 200mg for 10 months). I experienced the classic opioid withdrawal for about 90 minutes and then severe RLS restlessness for the next eight. That was last Christmas and the experience is still causing me depression that requires therapy and occasional nightmares.

However, you may find that your doctor is not familiar with the dual nature of tramadol. Many of the doctors that I have spoken with over the last 11 months think of it only as an opioid. My RLS specialist neurologist even said "well it isn't used for that", meaning as an anti-depressant. If your doctor needs convincing, ask him/her why there is an FDA black box warning about giving tramadol and anti-depressants at the same time. You can also suggest that (s)he look at the chemical structure of tramadol and Effexor on Pubmed. Tramadol is essentially the same chemical as Effexor (an SNRI anti-depressant) except it has a second branch that contains the opioid chemistry.

Very helpful information! Thank you!

I used to be on tramadol before the restless leg diagnosis. My primary physician took me off tramadol so I could begin pramipexole for RSL.(at that time) She said the two meds conflict. I didn't have any problem when I stopped.

I have no idea what your doctor was thinking because there is no conflict between tramadol and pramipexole. I have been taking both of them at the same time for years. My doctor keeps suggesting that I get completely off of the pramipexole, but when I did that I found that I needed more tramadol. So she agreed that the combination was right for me. Maybe your doctor just wanted to stop writing tramadol scripts since it is an opioid.

What tramadol is not compatible with is anti-depressants since it is one in its own right even though that is not used as one.