Stopping tramadol after 2 months

Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.
QyX

Re: Stopping tramadol after 2 months

Post by QyX »

For somebody who is used to opioids even a little bit, 15 mg of Codeine is barely anything. In your situation you would need 200 - 300 mg of Codeine to have relevant effects imo.

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

QyX wrote:For somebody who is used to opioids even a little bit, 15 mg of Codeine is barely anything. In your situation you would need 200 - 300 mg of Codeine to have relevant effects imo.
15mg of codeine can help slow down my bowels
Codeine gives me the usual constipation
Tramadol does the complete opposite to the point I'm losing weight and nutrients

I just confirmed again in the last hour that tramadol has this very unusual and adverse effect on my intestines

Shouldn't 50mg tramadol be about the same as 30mg codeine ?

.... or do you mean I would need to use that much codeine to cover initial tramadol rebound ?

If i get decent results from 25/50 or 25/50/25 tramadol for rls symptoms, wouldn't 200-300 mg codeine be very excessive ?

QyX

Re: Stopping tramadol after 2 months

Post by QyX »

50 mg of Tramadol equal to about 50 to 70 mg of Codeine. It is a difficult to give a precise estimate. There are some people who metabolise Codeine very fast and for them 50 mg of Tramadol could equal 100 mg Codeine.

But on average it is a 1:1 conversation ratio.

I would either take Tramadol or Codeine but not both. If you want to replace Tramadol with Codeine, you have to take as much as you need to cover your symptoms. This is not a perfect science.

When you take 100 mg of Tramadol per day, I would assume you need something between 100 and 150 mg of Codeine on average.

Again, there is no real way to well before you haven't tried it. Doctors can only give an estimate based on previous data and experience.

Overall Codeine is a very weak opioid, only 1/10 as potent as Morphine.

Also for some people Tramadol can be more effective because it has those serotonergic and noradrenergic properties. Those are responsible for you losing weight under the influence of Tramadol.

Constipation normally improves once patients are more used to opioids like Codeine.

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

Gonna see new neurologist to discuss new options tomorrow
Would be neat if codeine could cover my symptoms like tramadol

.... cause I'm a bit concerned about taking something stronger for my urge to move that keeps waking me up

I have a feeling neurologist will want to put me back on mirapex before giving me a strong opioid
I'd only go for that if very low dose and in combination with something else very low dose as well .

Perhaps me being clonazepam dependant might play a role in my options

I'll revisit here or my other post tomorrow night with an update

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

So he wanted to put me on Neupro patch

Just following protocol


Needless to say I'll need to wait for the next specialist

I'm considering something radical like major dietary changes or traditional Chinese medicine

Square 1 right now while I take tramadol with some codeine and clonazepam and THC

I do have kratom, which originates not far from China

Fml

QyX

Re: Stopping tramadol after 2 months

Post by QyX »

Potent opioids would be the best option because it would allow you to get rid off Clonazepam and Dopamin-Agonists altogether.

But as long as this is not an option: I would simply combine Tramadol with Codeine and Kratom. And THC can give an extra boost to the opioids.

Neupro patch would just be going down another rabbit hole.

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

He did say monitor the patch very closely for augmentation


He had so few options cause old specialist still hadnt sent my file over
He wasn't comfortable monitoring me on a stronger opioid based primarily on his limited expertise .
He was going to refer me right there
(I'm talking to him tomorrow as well)

With that said, perhaps this was my wake up call (no pun intended) to examine a few more natural remedies to perhaps lessen the severity of my RLS and to also promote sleep

I gotta remember I still have my non 24 hour circadian rhythm disorder that I really need to fix
Also, I split my sleep in 2 when my internal clock is backwards
.... this has now become the norm for my sleeping at any time for the last 3 years

It started with the clonazepam
Years ago (and apparently still to this day ) I would take it to start my day
Now if I wake up at 3am after going to bed in the early evening , I take clonazepam, and I cant stay awake
Then 3am becomes 9am , and I cant stay awake because i just took my clonazepam
.... soon I'm waking up at noon , taking clonazepam, and then going back to sleep

I need to change when I take my clonazepam
I need to take it BEFORE my desired sleep time, not after

.... the problem is I currently take my strongest dose of opioid about a hour before desired sleep .
I need to be able to take my clonazepam soon after that

I suppose I need to remind myself that my symptoms are less severe now than they were during augmentation (and definitely during mirapex withdrawal )

QyX

Re: Stopping tramadol after 2 months

Post by QyX »

You can split your Clonazepam into two doses for the start. This will make it easier changing it completely.

In severe cases of RLS, the only "natural" remedy is treatment with iron infusion. I tried all kinds of alternative treatments and changed my diet million of times. Nothing ever made a difference. Only potent medication had an effect for me.

I mean, there is no harm in trying the Neupro patch. Maybe augmentation will not quickly and you will get good relief for several months and when you finally augment, it will only strengthen your case for treatment with stronger opioids than Codeine and Tramadol.

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

Gonna need to split that clonazepam dose

Or something, cause I stopped breathing after finally falling asleep
Might need to do neupro patch until I taper clonazepam a bit .

My log for the "day" :

Vitamin D 3000iu 430pm
2 draws sativa 1115pm
Codeine 15mg 1145pm
Nap 130-230am (?)
Codeine 22.5mg 445am
3 draws sativa 530am
Rls left arm moderate and right hip/leg severe 8am
Moving to trunk and thigh .. moving rapidly left side of body 810am
4 draws indica 810am (worked VERY WELL)
clonazepam 0.75mg 9am
Rls in back of left hand then shooting up arm 930am severe
Rls left ankle to left hip 935am moderate
Rls left arm left arm left arm left leg 10am
Get relaxis
Rls top of right foot up shin to thigh (left arm continues) 1005am ... must get up
Rls left arm and Extreme left leg 12pm
Codeine 22.5mg 12pm
Massage rub 1215pm
Fall asleep 1-2pm
Stopped breathing 2pm !??!?!??!?!?
TERRIFIED from lack of oxygen
... took an hour to calm down
Lie in bed until 6pm

Tramadol gives me unbearable shits

Codeine/clonazepam mix depresses my breathing to the point its VERY dangerous

Any suggestions as to what I do now ?

Neupro patch
Try Lyrica ?

..... or at the very least , space out my current meds more???

QyX

Re: Stopping tramadol after 2 months

Post by QyX »

I've taken much higher doses of opioids (around 100 mg of Oxycodone, equal to about 2.000 mg of Codeine) in combination with Clonazepam for several months, Clonazepam in doses up to 4 mg. I never had any breathing issues for the amount of time you are taking Clonazepam, the relatively small dose of opioids should not cause relevant CNS depression.

I suspect that there are some other factors at play but you would need a sleep study to have this properly investigated. If you really had breathing issues due to CNS depression, you would experience them while being awake, too.

It would be extremely uncommon for someone who has been taken Clonazepam for such a long time than you have, to experience respiratory depression due to interaction of Benzodiazepines and opioids in the doses you are taking those medications. It is not impossible but rather unlikely.

badnights
Moderator
Posts: 6259
Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

Re: Stopping tramadol after 2 months

Post by badnights »

I have a bit of advice that I think is important. Don't take clonazepam unless your symptoms are controlled (or you expect them to be controlled) by codeine, Tramadol, kratom, Neupro, or something else. Some of your bad symptoms in your example day came after the clonazepam when nothing else was in your system, yet you took clomazepam. WED/RLS is brought on by relaxation, physical and mental - particularly the relaxation that comes with sleep. This means that clonazepam can actually trigger the WED/RLS sensory symptoms.

Think of the clonazepam as a sleeping aid, not as an aid for RLS/WED symptoms.

Tramadol, opioids, kratom, and DAs like Neupro (and perhaps some strains of marijuana) treat the WED/RLS sensory and urge-to-move symptoms. So make them work together properly. Treat the sensory symptoms, then help yourself sleep.

When you have (or preferably, expect to have) WED/RLS symptoms, take the opioid or whatever. But not clonazepam. When your body is still, or preferably when you expect it to be still after taking opioids or whatever, only then do you take clonazepam. Aim for them to take effect at the same time.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

I take clonazepam for a few reasons

1. I am completely dependent
Distant 2. It helps me sleep
Distant 3. It helps with my anxiety
I do not take it for rls symptoms
I actually was already on clonazepam 2 years before I ever noticed an rls symptom

If I thought I could stop taking it I would
I've had this attitude towards it for years.

It is the one and only drug I am truly dependent on
(Or addicted to?)
Whatever the case I'm sure really bad stuff would start to happen to me if I stopped taking it

The logged day above is a depiction of what happens lately if I don't take tramadol .
My rls symptoms are only this severe when I dont take medication (or apparently if I take codeine)
With that said I suppose I should wait until I am awake for the day to take some or all of my clonazepam .
I will likely split my dose somehow moving forward

Also , I should mention that I have diagnosed upper airway resistance syndrome
I found this out by chance during an rls sleep study .
I have had handfuls of similar episodes where I'd stop breathing in my sleep, but never as severe a couple days ago .

They stopped occurring after I lost some weight a couple years ago , plus I've lost further weight using tramadol, so I didn't think it would be a factor.

It seems neither tramadol nor codeine on their own will be sufficient/tolerable , unless I treat the tramadol with something like imodium.

Codeine can cover the early onset for a while , but tramadol is what covers peak symptoms
Therefore until I go on neupro etc ... I take codeine, then 5 hours later I take tramadol an hour before I plan to sleep .
( and once I wake up from that chunk of sleep I take clonazepam.... for now)

I welcome advice , especially lately ....
Thank you for taking the time

Icantsleep
Posts: 216
Joined: Sun Oct 16, 2016 6:07 am
Location: Ottawa Canada

Re: Stopping tramadol after 2 months

Post by Icantsleep »

You're totally right btw
... not that we both didnt know that already

Here I am 2 hours after falling asleep with tramadol and sativa thc
Rls wakes me up from DEEP sleep
I guess my hope is a different indica thc will help cover rls until i can take a bit of codeine to cover the tail end of my sleep window.
That's what I do lately if necessary

Saving the indica until this point worked great yesterday to the point more codeine wasnt even needed.

Cause now is the usual clonazepam dose (basically for avoiding withdrawal )

QyX

Re: Stopping tramadol after 2 months

Post by QyX »

Brrr ... waking from deep sleep with heavy RLS is just the worst. This sometimes happens to me when I fall asleep and haven't taken enough opioids to make it through the night.

Normally I try to take some opioids in the final 30 minutes before I fall asleep. But it is not always that easy to predict. So sometimes things go wrong...

Post Reply