# Anyone have experience taking mirtazapine and tramadol?



## SnakeEyes (Jun 27, 2012)

My doctor was first going to give me soma (carisorodol) for my nightime backpain then later came back in and changed it to tramadol because they thought that the soma might be too sedating. Having done my research on tramadol in the past I voiced my concerns about tramadol interacting with antidepressants I ended up walking out with neither. 

I went to talk to the pharmacy at my p-docs office and they gave me the go ahead on the tramadol but I'm still not sold on it. How strong is the serotonin syndrome possibility compared to other antidepressants? If I do take it it would be only a couple days a week because I don't want to become dependant on it and weightloss seems to be a pretty common side effect, I'm a 135lb male who struggles with weight despite being on mirtazapine for the past year.


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## istayhome (Apr 4, 2012)

I think it's a safe combo, I don't think you have to worry about Serotonin Syndrome. The combination CAN increase the risk of SS but it's rare. Start out with a low dose of tramadol and take it from there, SS would be dose dependent.


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## jim_morrison (Aug 17, 2008)

Mirtazapine and tramadol combination will not cause serotonin syndrome.



> Clarification: This review originally cautioned against combining tramadol with mirtazapine because of an increased risk of adverse effects due to serotonin toxicity. *Subsequent expert advice suggests that combining tramadol and mirtazapine is very unlikely to cause serotonin toxicity.* Although adverse events due to serotonin toxicity are unlikely to occur, there are case reports of adverse events in people using both medications.


http://www.nps.org.au/health_professionals/publications/nps_radar/2008/december_2008/tramadol_xr

Mirtazapine is a 5-HT2 serotonin antagonist, just like Cyproheptadine; a medication which is actually used to treat serotonin syndrome.


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## istayhome (Apr 4, 2012)

jim_morrison said:


> Mirtazapine and tramadol combination will not cause serotonin syndrome.
> 
> http://www.nps.org.au/health_professionals/publications/nps_radar/2008/december_2008/tramadol_xr
> 
> Mirtazapine is a 5-HT2 serotonin antagonist, just like Cyproheptadine; a medication which is actually used to treat serotonin syndrome.


Yes, thanks for adding the important information. Like I mentioned in another thread, drugs.com interaction checker says everything has major interactions. It said combining tramadol and mirtazapine can be life threatening and should be avoided at all costs. If one were to follow all possible drug and food interactions to the letter they would be unable to ingest anything besides water.


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## SnakeEyes (Jun 27, 2012)

^^ lol very true. I figured people on here would know for sure because I know there are many that are on combos that drugs.com has listed are major drug interactions. Thanks


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## jim_morrison (Aug 17, 2008)

istayhome said:


> Yes, thanks for adding the important information. Like I mentioned in another thread, drugs.com interaction checker says everything has major interactions. It said combining tramadol and mirtazapine can be life threatening and should be avoided at all costs. If one were to follow all possible drug and food interactions to the letter they would be unable to ingest anything besides water.


Agreed, I think those interaction checkers are over the top and nondiscriminatory to the point where it's hard for the average person to discern the serious interactions from the bureaucratic ones.


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## CailinGaelach (Aug 28, 2012)

Yeah, I wouldn't put too much stock in those online interaction checkers -- think they're too general... I've taken both Tramodol and Tridural (long-acting Tramadol) with anti-depressants for years (I have fibromyalgia) and I've never had a problem. I think you just need to be vigilant about your body's response when you start any new combination. I'm a firm believer that we know our bodies best.

Best of luck!


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## SnakeEyes (Jun 27, 2012)

Well I went back today and the same doctor wouldn't give me either he told me to take extra strength Tylenol and apply topical gel which is something that I've already been doing nearly everyday (the tylenol not the gel). I get if I'm lucky 4 hours of sleep a night other than the one to two nights a week that I take my temazepam. God I hate the health_care_ here. :sigh


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## CailinGaelach (Aug 28, 2012)

SnakeEyes said:


> Well I went back today and the same doctor wouldn't give me either he told me to take extra strength Tylenol and apply topical gel which is something that I've already been doing nearly everyday (the tylenol not the gel). I get if I'm lucky 4 hours of sleep a night other than the one to two nights a week that I take my temazepam. God I hate the health_care_ here. :sigh


Not trying to be smart, but I'm assuming when you say you 'hate the health care here', you live in the U.S.? Just trying to figure out if I could offer any advice along that line. I'm in Canada and I've got three docs, presently: my GP (family dr), my psychiatrist, and my pain specialist. I was going to say that if the dr you saw wasn't a pain specialist, they can be pretty useless. They just don't get how incapacitating acute or chronic pain can be. Only my pain doc gets it. Tylenol and OTC topicals - Yeah, right! :roll

But that is what I would suggest -- find a pain specialist, unless it's a money/insurance issue; that would really suck.


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## SnakeEyes (Jun 27, 2012)

My backpain isn't bad enough to be in pain management nor does it require strong or daily narcotics but sleeping is a real problem. I've tried Flexeril and when taken with my mirtazapine either gives me anxiety and keeps me up or puts me into a panic attack. I have stomach damage from the 800mg ibuprofen that I'm currently trying to heal so I can't take any NSAIDS at the moment so that only leaves tylenol which doesn't help at all. Pot helps a lot but my psychiatrist doesn't want me to do it so I try to limit my usage to only a couple times a month although that may change soon because I can't keep working like this. 

I'm 37 and low income (almost poverty) I don't have insurance and have spent so much of my savings this past year on various health problems, chiropractic, physical therapy, etc. and other than my p-doc prescribing my temazepam and this doc with the flexeril once I have gotten no other help because I don't have paperwork showing that I have back problems yet I can't get the needed tests because they are insanely expensive. 

It's sad that you go to the doctor and all they do is check your blood pressure and weight, talk to you for 5 minutes and tell you to take OTC this and that and walk out leaving you with another doctor bill and still no help.


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## istayhome (Apr 4, 2012)

keep bugging your doctor if finding a new doctor is too bothersome or costly. Just keep complaining and explaining all of the issues as to why OTC options are useless and how much this is affecting your ability to function and maintain your quality of life, etc. They have to do _something for you, tramadol isn't even scheduled, I don't see their issue. Retarded doctors._


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## SnakeEyes (Jun 27, 2012)

They didn't give me a reason this time for the muscle relaxers but for the tramadol they said they had patients that had issues combining it with mirtazapine which I think is BS because the last time I was in there when they WERE going to give it to me he seemed like he hadn't even heard of it before. I even mentioned that my psychiatrist office said that it was fine to take but apparently that doesn't matter.


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## istayhome (Apr 4, 2012)

What about codiene or hydrocode? other mild relievers that don't interact with mirtazapine?


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## SnakeEyes (Jun 27, 2012)

Hydrocodone I don't have a chance of getting. Codeine although a weak opiate it's still a narcotic and if they aren't willing to give me a decent muscle relaxer I can't see them giving me codeine. The DEA has doctors so scared to prescribe any narcotic medication because of what happened with OxyContin.


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## istayhome (Apr 4, 2012)

crap man, you're in legitimate pain that makes it so you can't sleep and the doctor won't do anything? what the hell! I really feel your pain man, I'd be up in arms, this is seriously f-ed up.


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## SnakeEyes (Jun 27, 2012)

Yeah it sucks. :|

I need to go back to my psychiatrist and see if I can get some more temazepam but crap that's another $100 and no guarantee that I'll even get them. I'm afraid to tell him how I'm really feeling because I don't want to lose any possible benzo script that I may get because at this point in time the temazepam (even if only a couple days a week) is the only way I can get a good nights sleep. I don't want to resort back to getting baked every night because my anxiety is finally under control.


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## istayhome (Apr 4, 2012)

Have you considered buying phenibut online? It is a good muscle relaxant, helps you sleep and relieves anxiety, just a thought.

If you are familiar with it and want some or haven't tried it yet, read about it and want some then I'll just mail you some for free. I used to use it and sell it but I don't anymore so I have a kilo of pure phenibut sitting around. I'm happy to help someone out and better it get used than sit around indefinitely. PM me if you're interested.


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## UltraShy (Nov 8, 2003)

SnakeEyes said:


> The DEA has doctors so scared to prescribe any narcotic medication because of what happened with OxyContin.


In 1999 the media told every junkie what to ask for by name when robbing pharmacies at gun point. None of the junkies asked for MS-Contin or MS-IR, as the media forgot to tell these morons MS = Morphine sulfate (i.e. the good stuff). These dim bulbs forgot to ask for the entire locked cabinet of C-IIs, including amphetamines. Hell, even if a particular junkie only likes downers, they should know enough that uppers can be traded for downers or sold to junkies that have different preferences.

How could it be that with the whole wonderful world of C-IIs before they they asked for only one drug by name :stu:

http://www.mapinc.org/drugnews/v01/n794/a04.html


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## CailinGaelach (Aug 28, 2012)

I researched Phenibut online and it sounds like an amazing drug! U.S. probably has a problem with it because it was first discovered in Russia - lol. And the Canadian Drug Federation is probably more strict than the American. Other than withdrawal warnings, sounds like it might be helpful for now.

Again, wish I knew more about the U.S. drug system -- I don't suppose you can get Tylenol-1 OTC there? They only have 8mg of codeine per tablet, but they help a lot more than plain Tylenol.

Also, if your back pain is consistently affecting your sleep, then I disagree; I think you've crossed that barrier and should be in pain management. You're not going to be able to function much longer without sleep. Hasn't this doctor heard of Preventative Medicine?? Stupid question, I guess, 'cause the system can just keep trying to get more money the sicker you are. And Obamacare sounds like a drop in the bucket, though I suppose it's a start; but I don't get how everyone is supposed to buy insurance if they can't afford it! 

So sorry you're going through all this, SnakeEyes. I hope the Phelibut helps if you decide to try it. Keep posting to let us know how you're doing. ATB


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## istayhome (Apr 4, 2012)

CailinGaelach said:


> I researched Phenibut online and it sounds like an amazing drug! U.S. probably has a problem with it because it was first discovered in Russia - lol. And the Canadian Drug Federation is probably more strict than the American. Other than withdrawal warnings, sounds like it might be helpful for now.
> 
> Again, wish I knew more about the U.S. drug system -- I don't suppose you can get Tylenol-1 OTC there? They only have 8mg of codeine per tablet, but they help a lot more than plain Tylenol.
> 
> ...


The U.S. doesn't allow any product containing codeine to be sold OTC. Like 8mg of Codeine would be effective anyways.

The US has no problem with Phenibut, I forgot that Canada was trying to limit it's importation.


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## CailinGaelach (Aug 28, 2012)

istayhome said:


> The U.S. doesn't allow any product containing codeine to be sold OTC. Like 8mg of Codeine would be effective anyways.
> 
> The US has no problem with Phenibut, I forgot that Canada was trying to limit it's importation.


Yeah, like I said, I don't know enough about the U.S. system, and I didn't even know about Canada's stand on Phenibut, but it doesn't surprise me. Bottom line is people like SnakeEyes suffer unnecessarily while our gov'ts tie things up in red tape, etc., keeping helpful drugs out of reach. (Don't know how many times my own drs have said, there's this promising new drug ... but we probably won't get it for another 2 yrs...)


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## CailinGaelach (Aug 28, 2012)

Holy crap, SnakeEyes. Just read this thread on Phenibut -- maybe you should do a little more research first:

http://www.socialanxietysupport.com...uys-phenibut-is-making-me-hallucinate-206396/


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## SnakeEyes (Jun 27, 2012)

Thanks guys sorry it took a couple days to get back. The doctor wants me to get back xrays ($500-$600 which I can't afford yet I make too much for gov assistance) :roll which I already had done when I did chiropractic less than a year ago so I somewhat already know what it's going to show and MRI's are over 3k, f*** my life lol. 

I did manage to source some relief for myself but I know this is isn't sustainable (or smart) but at this point playing by the rules has left me broke and in no better shape so screw it. It's messed up that heroin addicts can get put on methadone for "maintenance" for those who don't know it's an synthetic opiod stronger than morphine yet people like me can't even get codeine/tramadol. :blank


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