Tramadol ER
Tramadol ER
I sure wish DAs did not cause augmentation or impulse control disorders! Pramipexole worked so well for me for years - until it didn't - and then it was horrendous. Had already tried gabapentin, neurontin, and clonazepam. Switched to Neurontin but couldn't get off the pramipexole, then tried Lyrica which worked for my RLS but caused a profound depression and weight gain. Then on to 150 mg Tramadol. Woke consistently 3 hours after taking it (at bedtime) with "need to move" symptoms, plus had symptoms in early evening. Had a sleep study at Mayo to make sure I did not have any other respiratory issues that might be waking me - nothing! Switched to 100 mg Tramdaol ER and am still waking 3 hours after taking it. Vaping with 4:1 CBD:THC controls the "need to move" symptoms but with all the negative health reports about vaping, I am uneasy about continuing it, even with medical marijuana. I have tried a tincture of 5:1 CBD:THC but it doesn't work as well. So, I climb my stairs. I have only been on the Tramadol ER for 2 weeks so I will be calling my doctor on Monday to see what her opinion is - up my dose, try another drug? My ferritin is close to 200. Any suggestions?
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Re: Tramadol ER
It would seem to me that you (and your doctor) have two options at this point. Increase the dose of Tramadol ER to 200mg or switch to something like methadone where the starting dose would be 5 or 10 mg.
Steve
https://www.mayoclinicproceedings.org/a ... 0/fulltext
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.
https://www.mayoclinicproceedings.org/a ... 0/fulltext
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.
Re: Tramadol ER
Another possibility is adding a tiny dose of pramipexole to your current meds. Several people have found, me included, that after augmenting and getting off the DA for several weeks, that they can take a small dose with very good results, and no resumption of augmentation or impulse control issues... as long as the dose is kept VERY low (0.0625-0.125 mg, IE 1/2 or 1 of the smallest sized tablets).
Blessings,
Holland
Holland
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Re: Tramadol ER
I augmented in about a week. Stopping it was truly hell. When I finally was off the DA, I found nothing else worked except strong opioids - 18 different drugs alone or in combo. But,after a year or so and with tolerance occurring, I had to have another solutions. I decided to try pramipexole every other day - I knew I wouldn't augment that way. That wasn't perfect for many reasons, so I kept trying a better way. I used pramipexole in different ways - but never more than 2-3 days in a row, for a few years.stjohnh wrote:Another possibility is adding a tiny dose of pramipexole to your current meds. Several people have found, me included, that after augmenting and getting off the DA for several weeks, that they can take a small dose with very good results, and no resumption of augmentation or impulse control issues... as long as the dose is kept VERY low (0.0625-0.125 mg, IE 1/2 or 1 of the smallest sized tablets).
Eventually, I had iron infusions. After my second one, the serum ferritin stayed over 100 for quite awhile. So, I experimented even more with pramipexole.
I took it 3 days, then 4, then 5, then 7 - all with a 2-3 day break in between. it was OK - no sign of augmenting. Then I tried 2 weeks - it was OK. Then I tried 3 weeks. And so on. Over 2-3 years, I eventually worked up to 6 months - no augmentation. That was a few months ago. I stopped for 2 weeks, then went back to it. I use it with the opioid so that I keep the pramipexole dose low and the opioid dose low. I also find I need slightly less when I do that. It takes 6 parts opioid to control the RLS through the evening and night. It takes 5 parts pramipexole to control it alone. But, together it only takes 2 parts pramipexole with 2 to 2.5 parts opioid.
I am not advocating that everyone try this - I just know it worked for me. And, without the increase in the serum ferritin, I would never have attempted it. Once I tried Neupro (a DA patch) and I augmented in about a week - this was prior to any infusion and my serum ferritin was terribly low.
If it took years to augment, my guess is that it might work to take it for at least a few months at a time. Of course, you mentioned the impulse control issues - and if that was a problem for you, I cannot imagine you would want to try again!!!
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.
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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Re: Tramadol ER
If I was the the OP (brossman) , I would consider thisViewsAskew wrote:I augmented in about a week. Stopping it was truly hell. When I finally was off the DA, I found nothing else worked except strong opioids - 18 different drugs alone or in combo. But,after a year or so and with tolerance occurring, I had to have another solutions. I decided to try pramipexole every other day - I knew I wouldn't augment that way. That wasn't perfect for many reasons, so I kept trying a better way. I used pramipexole in different ways - but never more than 2-3 days in a row, for a few years.stjohnh wrote:Another possibility is adding a tiny dose of pramipexole to your current meds. Several people have found, me included, that after augmenting and getting off the DA for several weeks, that they can take a small dose with very good results, and no resumption of augmentation or impulse control issues... as long as the dose is kept VERY low (0.0625-0.125 mg, IE 1/2 or 1 of the smallest sized tablets).
Eventually, I had iron infusions. After my second one, the serum ferritin stayed over 100 for quite awhile. So, I experimented even more with pramipexole.
I took it 3 days, then 4, then 5, then 7 - all with a 2-3 day break in between. it was OK - no sign of augmenting. Then I tried 2 weeks - it was OK. Then I tried 3 weeks. And so on. Over 2-3 years, I eventually worked up to 6 months - no augmentation. That was a few months ago. I stopped for 2 weeks, then went back to it. I use it with the opioid so that I keep the pramipexole dose low and the opioid dose low. I also find I need slightly less when I do that. It takes 6 parts opioid to control the RLS through the evening and night. It takes 5 parts pramipexole to control it alone. But, together it only takes 2 parts pramipexole with 2 to 2.5 parts opioid.
I am not advocating that everyone try this - I just know it worked for me. And, without the increase in the serum ferritin, I would never have attempted it. Once I tried Neupro (a DA patch) and I augmented in about a week - this was prior to any infusion and my serum ferritin was terribly low.
If it took years to augment, my guess is that it might work to take it for at least a few months at a time. Of course, you mentioned the impulse control issues - and if that was a problem for you, I cannot imagine you would want to try again!!!
.... in fact, I'm considering it for myself
Congrats to both of you for finding your personal safe and sustainable mirapex limits !
I'm still going to give a very small dose of gabapentin or lyrica a shot first
I also have kratom on it's way in the mail
Tramadol ER (XR) 100mg with a boost of 50mg of regular tramadol before bed works for me in that it keeps me asleep with a consistent dose
NO rls and sufficient sleep for the first time in recent memory.
However , I have a HUGE problem with certain areas of my body going numb
regular tramadol doesn't seem to last long enough to keep me asleep
brossman , you might want to determine the quality of your vape pen , mostly for its contents, but also for its delivery efficiency
Do you have access to true medical marijuana?
Ideally you want to be ingesting THC/CBD flower and not some sort of synthetic concentrate in a vape pen .
Even "street weed" or weed from a dispensary would probably be much better .
You should invest in a quality vaporizer that effectively heats the flower, but cools it before it hits your mouth .
The Mighty and Crafty vaporizers among others do this very well
They are pricy, but if vaping is going to be part of your regime, I would suggest not cheaping out in this area .
Also, I find if I'm on my fifth or sixth vape session of the night (or early morning by this point ) THC/CBD might even worsen the symptoms
Try to stick to only 2-4 sessions daily , with the first just being merely 2 draws from the vape .
If you wake up from an actual period of sleep after your 4th session, give up, get up , walk around , eat maybe a tiny meal quickly, get back in bed .
Do not touch the vape again
Just go back into the sleep you were just experiencing before rls woke you up , or at least try .
Re: Tramadol ER
Thanks for all the replies and suggestions. Yes I do have access to true medical marijuana. However, the plan beginning tonight is to try 200 mg Tramadol ER and see how my sleep is. Hopefully I won't need to vape anymore. Stay tuned!
Re: Tramadol ER
Good luck with the Tramadol. Just keep in mind that Tramadol can be quite stimulating and cause insomnia as a side effect itself.
When it comes to severe RLS & insomnia, marijuana seems to be by far the most reliable and best option when opioids are not working.
I also like the mood uplifting properties some strains have on me. Today I woke up feeling really tired and depressed, even though I slept 9 hours straight. So before not getting out of bed at all, I vaped a small amount of Red No. 2 and Bedrocan and I came back to life.
When it comes to severe RLS & insomnia, marijuana seems to be by far the most reliable and best option when opioids are not working.
I also like the mood uplifting properties some strains have on me. Today I woke up feeling really tired and depressed, even though I slept 9 hours straight. So before not getting out of bed at all, I vaped a small amount of Red No. 2 and Bedrocan and I came back to life.
Re: Tramadol ER
Well, 200 mg Tramadol ER did nothing for me, even when combined with a 50 mg immediate release tab. In fact the increase in dosage was worse than before! Augmentation? My doctor is changing me to oxy, starting very low dose 5 mg which she is sure that I will have to increase, but wants to start out low.
Re: Tramadol ER
Tramadol is simply not a good opioid for RLS because of its serotonergic properties.
Oxycodone should work much better. I've been taking it myself for 7 years now.
Good luck!
Oxycodone should work much better. I've been taking it myself for 7 years now.
Good luck!