Narcotics...How Do They Work?

Kwazylegs · Post by **Kwazylegs** » Sun Sep 17, 2006 5:37 am

Josh,
Thanks for your help...I'll ask for Ultram to begin with. You mentioned that this medication also has some antidepressant qualities, and that it can increase RLS symptoms. I've tried most marketed antidepressants in the past 15 years, and the SSRI's make my RLS go nuts. I'm trying to keep my mood up despite the chronic sleep deprivation. I've also tried the tricylic AD's like elavil and doxepin, as well as atypical meds like Serzone, Effexor, etc. Most of these meds either keep me awake, give me panic attacks, jack up my RLS, or make my hands/legs tremble. I'm currently taking Wellbutrin XL 300mg, and this doesn't seem to be messing me up like the other AD's. Do you know if Ultram's antidepressant effects derive from a potentiation of serotonin, or one of the other neurotransmitters like norepinepherine, or dopamine? I know I'm asking a lot of questions, but I might not get too many chances to get an RX from my MD...and so I'm trying to choose and ask for one that might be more effective for me and yet have few adverse effects. Thanks again. ---Andy

FidgetBoy · Post by **FidgetBoy** » Sun Sep 17, 2006 4:15 pm

Don't worry about asking me questions... it's what I do for a living. :wink:

I just hope folks reading this thread aren't sick of me yet.... Ultram, in addition to its narcotic qualities, weakly inhibits the reuptake of norepiphrine and serotonin. Its weak antidepressant activites are thought to actually enhance the drug's ability to treat pain.

As an aside, when I looked on Ortho-McNeil's website this morning, I just realized they make ultram in a once-a-day long-acting formulation. That might be a great option for those who need all day relief but don't necessarily need a stronger opioid.

Post by **ViewsAskew** » Sun Sep 17, 2006 6:21 pm

Josh, it that available in the US? I vaguely remember a post about that on another board - can't remember if it's available here and not Canada or vice versa.

FidgetBoy · Post by **FidgetBoy** » Mon Sep 18, 2006 2:41 am

I found this online but I'll check tomorrow when I get to work... I have to say, if it's used here, it isn't used often.

"Once Daily Ultram ER Extended-Release Tablets Now Available in the United States

New formulation provides option for patients who suffer from moderate to moderately severe chronic pain

RARITAN, NJ, and TORONTO, CANADA -- February 21, 2006 -- A new prescription option is now available to the more than 50 million Americans who suffer from moderate to moderately severe chronic pain.

Ortho-McNeil, Inc. and Biovail Corporation today announced that once-daily Ultram(R) ER (tramadol HCl) extended-release tablets are now available by prescription in the United States.

Ultram ER is the first extended release tramadol product approved in the United States for relief of moderate to moderately severe chronic pain in adults who require around-the-clock treatment of their pain for an extended period of time. Ultram ER is available in once-daily dosage strengths of 100 mg, 200 mg and 300 mg tablets."

Post by **ViewsAskew** » Mon Sep 18, 2006 5:07 am

Sounds like this might be worth looking into for may RLSers. What a great option - once a day! Of course, it may not work well - not sure why, but these meds can be weird :shock:

Thanks for finding that for us, Josh. I think if I were you, I'd sometimes not want to share what I do with people - it might make them unintentionally (or intentionally) take advantage of your willingness to help. So, I hope I didn't do that and thanks for ignoring it if I did.

BeanieLee · Post by **BeanieLee** » Wed Sep 20, 2006 2:22 am

Just wanted to add a quick note in relation to all of this Ultram talk. I tried Ultram a long time ago for pain and it made my rls worse and made me jittery and spacey. I've taken it every once in a while since then out of desperation, when I ran out of hydrocodone, thinking maybe it would help but it has always worsened my rls symptoms and caused the same negetive effects. I don't mean to scare anyone away from it though as I've heard lots of terrific anecdotes about how much it has helped several people with their symptoms. I'm just sharing my experience. I've taken a mild antidepressant in the past and the side effects were very similar to those I experienced on Ultram. So the similar effects that antidepressants and Ultram have don't work well for me. I have heard that it was the wonder drug for some people with RLS though so I say it's worth a try and you should be able to tell pretty quickly if it's going to benefit you or not. Good luck! If it's not useful I'd suggest a low potency narcotic like vicodin or something.

yogitiad · Post by **yogitiad** » Thu Sep 28, 2006 11:42 pm

Hi all, am new to this site. I am a 37 year old female, an rn, and a sufferer of rls! hate it! Actually think I have more of plm than rls. Just reading your posts on ultram which are very interesting. I tried ultram for a different reason, joint pain, a year or so ago, and it seemed to cause pvc's, Josh, is this common? I do know they were pvc's due to easy access to heart monitors at work!!!! just wondering, I have had other meds do that to me ie. Bextra, every few minutes!...before they took it off the market, great for pain, but not for my heart rate/rhythm! I am on requip 1mg qhs. Worked great for a while, now wearing off! I also am a distance runner...who also has joint pain...not r/t running, however I was wondering if there are any other runners out there and how running affects their rls. Does it make it better or worse? I refuse to stop running, it is one of my favorite things to do, but sometimes after a hard, hilly run the nite is hell with my legs moving!

FidgetBoy · Post by **FidgetBoy** » Fri Sep 29, 2006 3:51 am

y- I found a vague listing for "palpitations" when I checked the tramadol package insert. It's very rare- < 1%. In my practice, however, I have found that younger women, such as yourself, tend to have more of the palpitation issues with drugs.

ps.. I can't exercise at all anymore since my legs have gotten worse in the last few years.... if I ran, my legs would lock up and jerk all night! I don't know how you do it!

BeanieLee · Post by **BeanieLee** » Fri Sep 29, 2006 2:04 pm

I'm with Josh on that. I fell in love with the eliptical machine and it works out the tightness in my legs wonderfully but I can imagine the brutal, tight cramps that would probably result from running. My calves are always way too sore to even think about any kind of high impact leg excersize like that. If anyone is looking for a good excercise for rls, I highly recommend doing an eliptical machine for a half hour or so. No impact at all and it really stretches the calves nicely. : )

blastme · Post by **blastme** » Wed Oct 11, 2006 8:22 pm

Only Tramacet is available in Canada not Tramadol.

rfishburn · Post by **rfishburn** » Wed Oct 11, 2006 11:26 pm

FidgetBoy-
Just wanted to run something past you, ultram for me is a bit stimulating and I have heard other on here say that. Any insight on that one?

Anonymous · Post by **Anonymous** » Wed Oct 11, 2006 11:49 pm

Post by **ViewsAskew** » Wed Oct 11, 2006 11:52 pm

Em, mine is sometimes very sedentary, sometimes very active. I have three "jobs". Two of them involve sitting in from of a computer all day, or sitting with trainees all day. But, either way, I don't get up and move much.

My third one requires me to be on my feet for many hours at a time.

I tend to ride my bike to the one were I stand forever - so on those days, I get a LOT of activity. One the computer days, I roll out of bed and walk 20 feet to the computer, or walk 1 block to public transportation.

For me, the Methadone solves all situations - no varying dose.

BeanieLee · Post by **BeanieLee** » Wed Oct 18, 2006 1:21 pm

Emily,
I'm along the same lines as Ann. I have a desk job and I don't excersize often. I'm not a total bum but I'm certainly not a real active person. The narcotics help me completely and are the only thing that's helped me completely. I have a very high tolerance for pain medicine so I have to take a stronger dose - 4mg of dilaudid every 4-6 hours, but this has helped my symptoms like nothing else has. My doctor is trying to get me a Requip starter kit to try so I may be trying that soon. Right now I'm also on Lyrica and while it helps me sleep really well it's not the miracle I was hoping for regarding the the urge to move and the pain. If it weren't for the narcotics that I take I would probalby be in tears all day and night.
I really hope you find your miracle drug.