Stopping tramadol after 2 months

[Icantsleep]

So I'm going to get off tramadol

I started it to get off mirapex , and well, I completed that wonderful (sarcasm) experience about 7 weeks ago .

I should have done it sooner, but the initial plan is to ween down from 50mg evening, 50mg bedtime, 25mg when RLS wakes me up a second time (following taking clonazepam the first time rls wakes my up) to nothing over 9 days by removing 25mg every 2nd day

I am now on night 3, and night 1 of 25/25/25

I have kratom, cannabis, clonazepam, and a new clonidine Rx to help
Ill use some or all of these to combat my RLS during and after I'm done with the tramadol, but first things first .

I've taken a gram of Kratom neatly 3 hours ago
About to eat a big(ish) meal then take 25mg tramadol.
(Then 25mg 2 more times in spaced out doses)

Any suggestions as to how to make this experience a bit more bearable with all medications considered ?

[QyX]

I would simply go by feel and reduce as fast as you tolerate the reduction. Opioid receptors seem to be able to reset a bit faster than other receptors. When I discovered Carbamazepine, which was highly effective for my RLS symptoms at the time, I was able to stop Hydromorphone within 2 weeks.

So as long as I had my RLS symptoms covered, it was quite easy to stop opioids.

You have to consider that Kratom is basically stimulating the same opioid receptors as Tramadol. So is your plan to stop Tramadol and replace it with Kratom or do you want to use Kratom only for a short time while stopping Tramadol?

What you have to keep in mind is that as long as you replace Tramadol with Kratom, you are not really changing too much in your brain chemistry. But since it is probably easier to dose Kratom and make finer adjustments, it might maybe easier to completely switch to Kratom and then stop it.

But just in general: 75 mg Tramadol per day is not that much. I would guess it will mostly depend on your RLS symptoms. I as an example would never be able to stop opioids because my symptoms simply would be so bad, that I would not tolerate a withdrawal.

Clonidine is historically used to help with opioid withdrawal. I tried Clonidine in the past and it wasn't effective for me. Also the doses required for it to be effective are maybe higher than what you have been prescribed.

I guess you just have to try and see what works for you, experiment and maybe stop with the reduction or go back a step when the RLS symptoms get to troublesome.

[Icantsleep]

I would simply go by feel and reduce as fast as you tolerate the reduction. Opioid receptors seem to be able to reset a bit faster than other receptors. When I discovered Carbamazepine, which was highly effective for my RLS symptoms at the time, I was able to stop Hydromorphone within 2 weeks.

So as long as I had my RLS symptoms covered, it was quite easy to stop opioids.

You have to consider that Kratom is basically stimulating the same opioid receptors as Tramadol. So is your plan to stop Tramadol and replace it with Kratom or do you want to use Kratom only for a short time while stopping Tramadol?

What you have to keep in mind is that as long as you replace Tramadol with Kratom, you are not really changing too much in your brain chemistry. But since it is probably easier to dose Kratom and make finer adjustments, it might maybe easier to completely switch to Kratom and then stop it.

But just in general: 75 mg Tramadol per day is not that much. I would guess it will mostly depend on your RLS symptoms. I as an example would never be able to stop opioids because my symptoms simply would be so bad, that I would not tolerate a withdrawal.

Clonidine is historically used to help with opioid withdrawal. I tried Clonidine in the past and it wasn't effective for me. Also the doses required for it to be effective are maybe higher than what you have been prescribed.

I guess you just have to try and see what works for you, experiment and maybe stop with the reduction or go back a step when the RLS symptoms get to troublesome.

I definitely hit the point where rls became troublesome last night , and likely will tonight
I have a massive headache from the strain of simply not sleeping
I am actually planning on moving to my parents house for a good week starting tomorrow.
I have a 1 and 3 year old that can disturb any sleep I actually get .

Kratom has so far been used the last 4 days to ease withdrawal and also more specifically slow down my bowels (sorry but it's been a problem since the removal of mirapex or the start of tramadol)
It has not been used to replace a tramadol dose.

I might need to do that when I remove a 25mg dose (which I was going to do tomorrow)

It would be nice to reach a baseline rls with just cannabis and a bit of clonazepam ..... but without mirapex or opioids in my system, as you said, I'm not sure it will be possible
As far as I know , I'm going to need to replace the tramadol with something
I guess I'd like to do it with kratom first , then perhaps add 0.0625mg mirapex if rls is unbearable

I do have codeine and a script for codeine ER .

I believe I'll try a quiet house , the same 25/25/25 , then go kratom/25/25
.... then if I run into massive rls, up the kratom

Then if that doesn't work, see what 0.0625mg mirapex does (gasp) ?

To be clear, I'm stopping tramadol because of side effects , not because it was ineffective
I don't do well with SSRIs , and also like to feel my midsection
... I'm not sure if going on codeine would see similar numbing of my midsection

Either way , and above all else, step 1 right now is to find some sleep right now !

[Icantsleep]

I took a step back and just took 50mg tramadol
That will bring me back to 25/50/25 for at least tonight

Sleep has now become the primary goal .
My decision was based on that

Although I will miss the hell out of my children (and miss Thanksgiving on Sunday which we are hosting), ill have better sleep settings starting tomorrow at my parents

My sleep schedule has drifted to a 6am bedtime over the past numerous weeks
I need to get back aligned with the world (and my kids)

Perhaps better decisions regarding a new medication will be made in a better and more "normal" setting

[QyX]

Wow ... when your sleep is so messed atm ... I wouldn't even think about reducing or stopping Tramadol.

Opioids are just the best medication for RLS. When you are under no pressure to reduce or discontinue Tramadol, I would just continue taking it.

Oh and I know that so well ... only being able to sleep at 6 am.

I had phase while I was still taking Carbamazepine and I was at least able to sleep every day at around 6 to 8 am .... so at least I was able to make plans and schedule things. But at the moment it is almost unpredictable ....

Eh, and I would fill the Codeine. I am convinced those classic opioids are much better suited to treat RLS than Tramadol. I especially believe in Codeine, Dihydrocodeine and Morphine.

Codeine is kinda Morphine anyway since Codeine needs to be metabolised into Morphine to have any relevant analgesic properties. When some patients react well to Codeine, you can be 100% sure that Morphine will work, too.

I always liked those extra hypnotic effects of Morphine which Hydromorphone and Oxycodone don't have. They always had stimulating effects.

So the Tramadol you take can sometimes have quite significant stimulating properties. For me it was always quite bad. Codeine is just as potent as Tramadol. So you could replace Tramadol at night with Codeine and see if you get better sleep.

Unfortunately those special hypnotic properties of Codeine / Morphine ... I developed a tolerance to them after about 3 months but it was a good time, when it worked.

[Icantsleep]

The pressure to reduce is self imposed

I cant tolerate the idea of losing function of my body between my navel and my thighs , combined with a constant need to pee
It only got that severe at with the 100mg ER plus 50mg IR boost at bedtime
I went up that high cause any lower hadn't done anything yet for rls
I also felt what it was like to crave an opiod for the first time in my life when I quit the ER and dialed back to 50/50/25

Scary

.... and then there's the apparent effect on my bowels

It does really help with the rls .

My concern with codeine is that I take 0.75 mg clonazepam at some point overnight
I actually tried codeine first, but it seemed to affect my breathing, certainly more than tramadol
Not a dealbreaker though

I would need to consider differences between regular and ER
It seems very brief lasting, but I'm not even sure I'd need minimum dose ER
(I didn't react well to tramadol ER , plus I dont need the drug like I'm treating constant pain or constant rls
I only need it to work at night and especially through sleep.

Also ..... maybe I could kratom first ?
Once I get to new location I may swap one of the 25mg tramadol doses
I already take a little over a gram in about the middle part of my day to help with withdrawal and I'm interested in taking more at other points

[QyX]

Tramadol is chemically related to an antidepressant called Trevilor (Venlafaxine). That's why it can have such a wide range of side effects because it also works in some way as antidepressant (serotonine & noradrenaline reuptake inhibitor). That's also the reason why Tramadol can cause augmentation.

If you can get Codeine or maybe even better Dihydrocodeine on a regular basis, I would take this instead of Tramadol and most likely you will have way less side effects.

Once you are used to Codeine, it is possible to combine opioids with Benzodiazepines, but eh, that's something you should talk with your Dr.

Tramadol was the first opioid I got for RLS. It never did much good for me and the effects were rather poor compared to classic opioids.

But when side effects of opioids are too problematic for you, I would just see how much can Kratom do for you. But since I never tried it, I have no idea how many mg of Tramadol or Codeine you can replace with it. But that would be something quite interesting to know.

[Icantsleep]

Try it ?

You might be able to reduce all your opioids

I assure you, I'm no expert though

Worth looking into at the very least
I'm sure you've seen the threads
I tried it a few days in a row and the effects were subtle but positive and no adverse effects

And ya ... I believe it's the SSRI / SNRI aspects that are most problematic
I've taken a small handful of SSRIs years ago and I would feel the same sort of numbness as I do now

Hate it

[QyX]

I take Morphine (90 - 120 mg/day), Oxycodone (20 - 30 mg) and Hydromorphone (4 - 8 mg), so approximately 180 mg - 220 mg in Morphine equivalent or about 2.000 mg Tramadol / Codeine. There is no way I can ever replace this with Kratom. I am way to deep into opioids, managing opioid tolerance for quite a few years now. With Cannabis it became much easier but there is no way to replace my opioids with Kratom.

From time to time I try to cut my dose to reduce tolerance a bit but it is always super hard and never lasts long.

[Icantsleep]

Well certainly not to replace of course , but to possibly just reduce a bit here and there

As you mentioned, it's all sort of the same thing in terms of receptors though ...
Your doses are very tedious and specific
You might have a fluctuation here or there , but perhaps in a positive manner (?)

[QyX]

For me there is not really a point to reduce some of my opioids and take Kratom instead. In the end they technically stimulate the opioid receptors in a very similar way and after 7 years I basically have no more side effects from opioids while with Kratom I have no idea how it could possibly interact with my current regime. For the most part I am very happy with how effective opioids still are, even after 7 years on a higher than average dose.

I also learned over time that it doesn't really matter if I take 180 mg Morphine or 220 mg or 250 mg a day as long as I don't rocket up over 300 mg and can't get down anymore. I'm having the same average dose for about 4 years now. There would be no benefit to taking a little bit less opioids.

It is unfortunately quite obvious that I will forever need them (or we get some crazy new therapy options).

In my experience and compared to other drugs opioids are by far the drugs I have the least side effects and the biggest medical advantage.

But without access to opioids, I would have tried Kratom long ago.

[Icantsleep]

I suppose that's terrific you tolerate them so well

I agree they work very well to stop rls
Me .... I don't tolerate them so well though

For me I had side effects for 2 days with mirapex, then never again
My equlibruim was screwed, and I had the most intense spontaneous nasal congestion
Then poof .... nothing . Totally straight
It worked very very well to stop rls for quite some time
Years in fact
then I either progressed to much or my augmentation began

And yes BTW
I'm also sorta holding out for that new therapy you mentioned lol

[Icantsleep]

Ok so I have to try this again ....

Myself, GP and pharmacists all agree it's the tramadol that's causing my bowels to be excessively speedy

I did 25mg evening followed by approx. 40mg bedtime last night then clonazepam 0.75 overnight (with brief THC vaped to get to sleep)
Going to do codeine 15mg evening followed by 35-40mg tramadol (3/4 of a pill) tonight and likely same tomorrow

The last time I tried a straight swap tramadol to codeine and got massive rls rebound , so I'm going to try and go slower
I'm not terribly worried about withdrawal symptoms when compared to rls symptoms

I know that mirapex at a low dose may need to come back into the picture

I have kratom as well

[Icantsleep]

So quick update

This time a mere 15mg codeine early evening slowed down insides significantly
Still took 50mg tramadol around 11pm because I was exhausted all day and wanted to sleep by midnight (ya right)
I had mild rls twice between these doses, which is uncommon lately, but had no rls symptoms for many hours overnight (which has occured for a handful of nights straight)
.... only problem is, I was unable to sleep until after 5am, likely due to my N24 circadian rhythm disorder
I basically rested/lay there for 5 hours
Then I fell asleep for an hour
Then I basically had rls 5 different times until I gave up at 11am
This made getting out of bed at noon on a snowy November day nearly impossible.

Tonight I'm taking same codeine/sativa/tramadol/indica/clonazepam/indica, but all an hour later, and will attempt to actually sleep no earlier than 1am

Codeine helps with tramadol's worst side effect .
Hopefully a later tramadol dose covers my overnight RLS better

Cause I gotta sleep

[Icantsleep]

So much of the same last night, except some moderate rls accompanied my hours long insomnia

I had slept so little and was having so much rls wake me up every 20 minutes that by 9am I took another 25mg tramadol
I then had the best 90 minutes of sleep I've had in a few nights

I go from trying to get off tramadol to adding more in 2 nights
Somehow either the codeine or the elimination of whole wheat toast to start my day has drastically reduced my IBS , which allows me to continue tramadol for now ...

Good thing , cause codeine seems to do very little for RLS symptoms, and I'm trying to go another month before possibly reintroducing low dose mirapex

I think I'm going to go back to 25mg tramadol evening/50mg tramadol bedtime / 0.75mg clonazepam overnight and another 25mg tramadol mid morning if needed
See where that leaves me and my bowels tomorrow