# tramadol/ultram for anxiety and depression



## RockiNToM (Jun 15, 2009)

Hi all,

I've been a spot of bother recently with my stomach troubles, but they have now found out what's wrong with me. I seem to have a cyst as found by a recent scan of my abdomen. Anyway, long story short, I've been given tramadol for the pain I've been experiencing that recently put me in hospital. When I took it I really wasn't expecting anything other than it to take the pain away, but my god!! my mood is the best it's been in years, EVER.

I knew I heard of tramadol before but couldn't remember why so I looked it up, and sure enough, its anti-depressant like properties with the ruptake of serotonin and norepinephrine explain everything. I know it also works at the opioid receptor too; making it good for pain relief (while still not officially an 'opioid'). I also think the key thing to note with this medication is it works fast. It doesn't need to be taken for 2-4 weeks to for it to be in the system before it works. So because of that fast action relief, this is probably the best mood elevator I have taken for my depression.

Thing is, as you've probably already gathered is that there is that possibility of addiction. From what I've read from other users, if it's used at relatively low doses now and then, rather than high doses all the time, tolerance levels should remain pretty low still and your body doesn't have to face horrible withdrawals when you suddenly stop taking it. But this is just what I've read, it isn't by any means totally accurate.

So inevitably because my mood is elevated my anxiety has dropped and I feel more confident, happy and generally better in my own skin. I'm not sure it's fair to say the effect is like a 'high' because it doesn't really make me feel euphoric or anything, it just makes me feel how I used to feel when I was happy.

A lot of people give tramadol some stick because it's not as confidence boosting as say Ritalin or Adderall, but I think that's ok for me. Subtlety is all I need - I don't need big confidence boosting effects or euphoria. On top of this though, if there is no 'mood' to correct or fix because you have no problem with your mood, then you may find it will do absolutely nothing.

The biggest problem of all is that Tramadol is not licensed for depression or anxiety, it's used for pain relief. However there are cases (from where I've scouting the net) where it has been used off-label for depression, anxiety and ocd and found to be pretty effective. But finding a doctor/psychiatrist who will prescribe it for those things is going to be extremely rare and difficult. I can only hope this changes in the future.

The best thing of all that I like about tramadol is the minimal side-effects. No sexual dysfunction, no apathy, or that 'dumbing' down that I experience usually with anti-depressants on cognitive function. The side-effect I get is a bit of dizziness, nothing else at all. But there is a bit of a seizure warning, but these seem to be at really high abused doses. I only take 50 mg.

All in all for me this has been a godsend, but for how long? I know I probably won't be allowed this after my op to remove my cyst, which is the down side. I just wish it was approved more for other things than just pain relief so others out there can have some relief from their symptoms of anxiety and depression - rather than going through the motions of having to wait ages for a med to work and suffer from side-effects.
*

The information I have given is my own experience, and is not something to be taken as medical advice. *


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## Saqq (Dec 1, 2008)

It worked on me better than anything I've been on (including parnate) -- GL getting a prescription to it though with it being a synthetic opiad. 200mg worked the first few times, but then I had to double up to 400mg (which is pretty much the Max you should take for medical reasons). 

I also think its OTC in Canada (but mixed with Acet. and only 37.5mg/pill -- not sure if cold water extraction works, possibly)

Although who knows these days with people getting adderall scripts, etc -- 

next time I'll ask for Tramadol + Adderall + Xanax and see what kind of reaction I get (Parnate ain't doing ****) -- neither does a boatload of benzos.

meh natural tolerence = lame.


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## crayzyMed (Nov 2, 2006)

If you want to use opiates you should get memantine (or another nmda antagonis), ulra low dose naltrexone and proglumide to block tolerance.

If you dont you will develop a dependency and tolerance.


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## RockiNToM (Jun 15, 2009)

Interesting, but isn't Tramadol a synthetic opiate? I don't think it's ever been classed officially as an 'opiate'.

I think the addictive side to this med more than anything, is the anti-depressant effect on how fast it works on people's mood - just like how fast acting benzos can be for reducing anxiety I suppose.


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## crayzyMed (Nov 2, 2006)

RockiNToM said:


> Interesting, but isn't Tramadol a synthetic opiate? I don't think it's ever been classed officially as an 'opiate'.
> 
> I think the addictive side to this med more than anything, is the anti-depressant effect on how fast it works on people's mood - just like how fast acting benzos can be for reducing anxiety I suppose.


Those strategies work for other synthetic opiates like hydrocodone etc, i'm pretty sure it would also work for tramadol. If tramadol did anything for my anxiety i would probebly use it daily with the meds i posted about.

I think the most addictive thing is the euphoria, altough for anxious ppl feeling normal could be even more addictive.

With the right precautions its possible to use opiates as treatment tough


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## UltraShy (Nov 8, 2003)

Ultram is useless, at least that was my experience. I have access to literally thousands of tablets of tramadol from excess my mother doesn't use.

I've tried it a number of time. Once I stayed on it for something like 6-8 weeks at 400 mg daily and I didn't notice any effects at all (good or bad).

Since that didn't work, I have tried it at single doses of of up to 800 mg at once. That would be 16 pills. Don't try that at home, boys & girls. Dosage is limited due to risk of seizures at excessive doses and that would clearly be excessive. Still zero effect even at that sky high level.

Seems to work OK for a back ache, but sure doesn't do anything for any mental issues.

I've never had to deal with the toxic Tylenol in Ultracet. I have access to pure tramadol, not that adulterated garbage.


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## StPatrick317 (Dec 4, 2008)

The deal with this is rapid tolerance. Of course if Opiates worked indefinitely they would be fantastic for Depression. Im on Suboxone, which is a partial Opiate. I have very resistant depression, but its been the 2nd most effective med I've tried out of 30+ ones. It still works 8+ months later. I remember Ultram fading quickly.

Oxycodone, Morphine etc who knows, it's kind of gambling because if they stop working then you have to withdraw & that will be difficult. I'm not going to outright say they are useless for depression, there are studies that show they work in some people who respond to almost nothing. But Ultram, I doubt it. Maybe your one of the few people who don't get tolerant.


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## RockiNToM (Jun 15, 2009)

UltraShy said:


> Ultram is useless, at least that was my experience. I have access to literally thousands of tablets of tramadol from excess my mother doesn't use.
> 
> I've tried it a number of time. Once I stayed on it for something like 6-8 weeks at 400 mg daily and I didn't notice any effects at all (good or bad).
> 
> ...


But can I just ask, you don't have any problems with your mood no? If your problems don't stem from your mood (I mean from what I've read you only take benzos for anxiety) then of course you're not going to feel a great deal of difference - there is nothing to fix.

For me it fixed my mood; made me happier, brighter, less negative, more optimistic, which then impacted my anxiety too, for me.


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## crayzyMed (Nov 2, 2006)

StPatrick317 said:


> The deal with this is rapid tolerance. Of course if Opiates worked indefinitely they would be fantastic for Depression. Im on Suboxone, which is a partial Opiate. I have very resistant depression, but its been the 2nd most effective med I've tried out of 30+ ones. It still works 8+ months later. I remember Ultram fading quickly.
> 
> Oxycodone, Morphine etc who knows, it's kind of gambling because if they stop working then you have to withdraw & that will be difficult. I'm not going to outright say they are useless for depression, there are studies that show they work in some people who respond to almost nothing. But Ultram, I doubt it. Maybe your one of the few people who don't get tolerant.


Yes suboxone is a very good antidepressant and hasnt much tolerance issues compared to other opiates. Its also a kappa receptor antagonist.


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## Vini Vidi Vici (Jul 4, 2009)

i got addicted to Tramadol, even a low dose can be really addictive and hard to get off of, like 3-5 50mg pills a day. Tramadol has so many random pharmacologic actions...alot more than just its weak opiate properties. Id take it for as short a time as possible.........it did help me a ton with nearly all my problems like OCD, depression, anxiety, insomnia, and chronic pain, but when i had to stop it was worse. its a very useful drug if it didn't cause so much dependence......it looks like it actually is, besides a weak opiate, an SNRI, and an NMDA antagonist...so it could prevent some of its own tolerance...


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## ippa (Jul 21, 2009)

Tramadol worked for me too, its a very good drug against sa, when i was talking with friends about tramadol they said they wanted to do good things under it like working on something, doing something in the house, talking more polite with people, and what good is with this drug is that it doesnt have psychedelic properties, so u feel less sa while your thinking is clear and not changed in bad way like it can be with many other drugs, but the problem is the people think its very bad drug very addictive and people die from it constantly, i think its more bull**** then truth.


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## euphoria (Jan 21, 2009)

People's reports of tramadol use are scary. Some of them increased their dose to large amounts over time, and got seizures (apparently a common risk if dose gets high enough).


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## meyaj (Sep 5, 2009)

Opiates definitely make you feel good and not depressed, but as someone with both social anxiety and LOTS of experience with opiates, I have trouble seeing how it will help SA.

Keep in mind this is strictly anecdotal, the experience may be different for others (who may or may not be honest with themselves), but when I'm high on opiates, other people IRRITATE the hell out of me. It's no longer social anxiety, I just very easily annoyed.


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## RockiNToM (Jun 15, 2009)

Well, for me personally, I think my SA root cause stems from my mood. If my mood is bad, like I'm feeling down, seeing things generally negative, my SA is much worse. But I can understand for a lot of people who just have SA that their mood would be unaffected.

So far I'm pretty sensible with my tramadol, I only take 1x 50mg a day of Tramadol, nothing more and this is what I've been prescribed for my pain by a doctor (my doctor actually prescribed me to take it 2x a day). The effects of it reducing my pain have been pretty great but the added bonus is it helping my mood.

I understand it is addictive but I have no intention of going up the dose - I feel great where I am. However, I do fear that when I've had my op to remove the cyst they will stop prescribing me tramadol. I kinda wish they hadn't given me it, because it helps so much more than just treating the pain. I just don't know what will happen when the time comes when I have to come off, will I be able to just come off or will I be facing horrendous withdrawals that won't allow me to? On top of all that, the time between now and my op is quite a wait, there isn't even a date for my op yet... We could be talking over a month or two. But I suppose it could be worse, they could have given me a proper opiate to take and be addicted to.


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## crayzyMed (Nov 2, 2006)

RockiNToM said:


> Well, for me personally, I think my SA root cause stems from my mood. If my mood is bad, like I'm feeling down, seeing things generally negative, my SA is much worse. But I can understand for a lot of people who just have SA that their mood would be unaffected.
> 
> So far I'm pretty sensible with my tramadol, I only take 1x 50mg a day of Tramadol, nothing more and this is what I've been prescribed for my pain by a doctor (my doctor actually prescribed me to take it 2x a day). The effects of it reducing my pain have been pretty great but the added bonus is it helping my mood.
> 
> I understand it is addictive but I have no intention of going up the dose - I feel great where I am. However, I do fear that when I've had my op to remove the cyst they will stop prescribing me tramadol. I kinda wish they hadn't given me it, because it helps so much more than just treating the pain. I just don't know what will happen when the time comes when I have to come off, will I be able to just come off or will I be facing horrendous withdrawals that won't allow me to? On top of all that, the time between now and my op is quite a wait, there isn't even a date for my op yet... We could be talking over a month or two. But I suppose it could be worse, they could have given me a proper opiate to take and be addicted to.


Take a few days off once in awhile, you can avoid addiction by doing that.


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## Dangerous (Oct 21, 2009)

One warning about the tramadol, it's very easy to have a seizure taking it. You can tell I am not a medical doctor that is pretty obvious..lmao But, my neighbor was in pain and she took four all at once and had a seizure on the ground and was shaking like ozzy Osbourne. This is not the first time I heard of this happening. Also, I took it before and over a long period of time, even though it's a pretty weak opiate, the withdrawal were similar to other opiates. (if taken over a period of time)


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## RockiNToM (Jun 15, 2009)

The seizure thing is I must admit pretty scary, but luckily I am only taking 50mg, I have been told to take upto 100mg a day. I suppose if I keep my dose as low as possible I should be ok, but for how long? How long until it stops working and I have to go higher? I hope that doesn't happen.

The problem also is, if I go back to my doc and say "the tramadol isn't really for me" I will probably be given something more addictive for example like Dihydrocodeine. Either way I guess I'm screwed because none of the over counter pains meds work for my type of pain.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> The seizure thing is I must admit pretty scary, but luckily I am only taking 50mg, I have been told to take upto 100mg a day. I suppose if I keep my dose as low as possible I should be ok, but for how long? How long until it stops working and I have to go higher? I hope that doesn't happen.
> 
> The problem also is, if I go back to my doc and say "the tramadol isn't really for me" I will probably be given something more addictive for example like Dihydrocodeine. Either way I guess I'm screwed because none of the over counter pains meds work for my type of pain.


honestly, this might sound extremely stupid....but maybe, it might be a better idea to just go and get a real opiate... something that doctors recognize as being "addictive" of course its a horrible thing to be addicted to opiates....nevertheless...if you do develop tolerance/dependence, then the doctor will recognize it for what it is. you could possibly get treatment for dependence on a real opiate...however, if you tell a doctor your dependent on tramadol, there is a chance that they wont beleive you...theyll just say that tramadol isn't addictive. many people react differently and have different amounts of withdrawal syndrome....but when u take tramadol, you are taking an opiate....50 mgs isn't very much though. but i still had withdrawal from half a pill a day. and tramadol withdrawal can last alot longer than withdrawal from other opiates, especially the psychic symptoms such as depression


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## meyaj (Sep 5, 2009)

lol... Dihydrocodeine is kiddy stuff as well, I wouldn't be too scared of that

opiate dependence takes quite a bit of use to develop. I was on pretty hardcore opiates (100mcg/hr fentanyl patches + 8mg hydromorphone for breakthrough pain) 24/7 (literally, because of the patches) for over a month and had zero problem stopping use cold turkey.

Opiates are so demonized because people find them really enjoyable/rewarding leading a LOT of people to compulsive use, and so the media sensationalizes it as an epidemic because it's a popular drug of abuse. It's not that the physical dependence is particularly serious (although long-term, high-dose addicts have it much more difficult), withdrawal is not life-threatening and at worst is comparable to a very bad flu. 

In my opinion, pain relief is pretty much ALWAYS worth this trade-off, and if you're particularly concerned about seizures I'd say stronger/more addictive opiates are the lesser two evils.


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## Vini Vidi Vici (Jul 4, 2009)

lol im happy somebody besides me recommended real opiates. lol i thought everybody might think i was a complete idiot for saying its better to take a stronger opiate than a weaker one.....but tramadol is a really dirty drug....if u get addicted, and have to stop, you have more than just opiate withdrawal...it can be really confusing and scary...and doctors wont be able to help cuz they dont believe there is such a thing as tramadol dependence.


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> lol im happy somebody besides me recommended real opiates. lol i thought everybody might think i was a complete idiot for saying its better to take a stronger opiate than a weaker one...


I also agree that a "real" opiate would be better but only when also taking an NMDA antagonist + Ultra low doses of naltrexone otherwise you are asking for trouble.
I've also seen reports of ppl getting full blown withdrawal of just taking opiates as prescribed, so it can definatly cause trouble.
Taking breaks of a few days is also a must.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> I've also seen reports of ppl getting full blown withdrawal of just taking opiates as prescribed, so it can definatly cause trouble.


If you're taking them as prescribed, you really should not be getting "full blown withdrawal" because you should constantly have a proper supply (...as prescribed), and if/when you're ready to get off the narcotics, you can taper with the help of your doctor if you've reached the point where withdrawals are going to be serious (which takes a quite a while.) I know there are sometimes extenuating circumstances but for the most part you should be able to avoid this. Especially for someone with severe chronic pain, a few brushes with withdrawal is still going to be more than worth it when you consider the pain relief you're getting the other 99% of the time.

Also, the polypharmacy is totally unnecessary and probably not going to be of significant benefit.

Only thing I have to add to OP is stay away from Demerol. The doctors here like to prescribe it as a sort of moderate-strength opiate and that stuff is just awful and toxic. It also tends to mix horribly with antidepressants.


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## RockiNToM (Jun 15, 2009)

Well in regards to the dihydrocodeine that was just an example of a med I know they prescribe for pain in the UK. I'm sure there are other stronger alternatives but I personally am not aware since I don't have much experience with strong pain killers.

Here in the UK I don't think they even use Vicodin or Hydrocodone, but I'm sure again there are alternatives that are just as addictive. 

When I had an op before on my leg, they gave me tons of dihydrocodeine but I didn't really need to take them all since the pain quickly sorted itself out and went away - so that's how I only know about dihydrocodeine because of my own experience.

I think one of the reasons I was given tramadol is because of my stomach issues, and giving me something that's got codeine in it will bung me up and pretty much cause me possible more issues on top. So naturally tramadol I think from my doc's point of view was the one that made sense, which is perfectly understandable. But given what everyone says here it seems it's not going to help me in the long run when they eventually aren't going to prescribe it to me anymore.

The thing is as well, right now my cyst is at a bit of a peak with the pain right now. Over the last few weeks I've been in and out of hospitals because the pain has caused my body to go into shock (hence the prescription of tramadol) and I can't NOT take any. So I have to take it everyday along with paracetamol to curb the pain just to function, but it also means my body is becoming addicted to a real harsh medication on the brain. 

You all raise some good points, and although Tramadol has been a godsend for my mood as well as my pain, I think you're all right it's time to take control and be put on something that will allow me to come off easier when it's time to come off. Problem is, if I'm taking an opiate the same way I'm taking tramadol won't that be just as much of a problem?

This is all so frustrating because there is no confirmed date for my surgery and they are just making me pop pills until that date - which could be as long as 2 months, but I soo hope not!


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## crayzyMed (Nov 2, 2006)

meyaj said:


> If you're taking them as prescribed, you really should not be getting "full blown withdrawal" because you should constantly have a proper supply (...as prescribed), and if/when you're ready to get off the narcotics, you can taper with the help of your doctor if you've reached the point where withdrawals are going to be serious (which takes a quite a while.) I know there are sometimes extenuating circumstances but for the most part you should be able to avoid this. Especially for someone with severe chronic pain, a few brushes with withdrawal is still going to be more than worth it when you consider the pain relief you're getting the other 99% of the time.
> 
> Only thing I have to add to OP is stay away from Demerol. The doctors here like to prescribe it as a sort of moderate-strength opiate and that stuff is just awful and toxic. It also tends to mix horribly with antidepressants.


I'm not convinced at all that you can use opiates without a tolerance building to the anxiolotic effects, thats where the naltrexone comes in play it prevents tolerance from building en is even capable of reversing it.

Just my opinion, i tried oxycodone in the past and i started getting very small withdrawals after 2 weeks (itching, not able to sleep,..) but i was using it for euphoria so things can be differend when keeping very low doses. I do find GHB much easier to manage tough, i used for months without any tolerance.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> I'm not convinced at all that you can use opiates without a tolerance building to the anxiolotic effects, thats where the naltrexone comes in play it prevents tolerance from building en is even capable of reversing it.


Well first off, it's being used as an analgesic (as it's supposed to), so I'm not sure why you bring up anxiolytic effects.

Second of all, naltrexone only prevents tolerance because it's an opioid antagonist. Depending on the relative affinities, naltrexone is either going to be useless or is going to block the effects of the drug, which is obviously not something you want, and can be just as easily accomplished with the same results by using a LOWER DOSE.

BTW, itching is a side effect of opioids, probably the most common, in fact (along with nausea), as they cause massive histamine release. It's not a withdrawal symptom. And certain opioids, particularly codeine/ the *codones, can make it difficult to sleep for a lot of people. I seriously doubt you were experiencing withdrawals.

Oh... and also. Asking a doctor for an opioid antagonist (as pointless as it is) is just going to make the doctor think you're abusing opioids and are looking to get a hold of an antidote in case of overdose.


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## meyaj (Sep 5, 2009)

RockiNToM said:


> You all raise some good points, and although Tramadol has been a godsend for my mood as well as my pain, I think you're all right it's time to take control and be put on something that will allow me to come off easier when it's time to come off. Problem is, if I'm taking an opiate the same way I'm taking tramadol won't that be just as much of a problem?


Well for one, you'll only have an opioid withdrawal to deal with, which may make it easier, and if you just want a painkiller, I would strongly suggest switching.

But really, your main concern should be about effective pain management. What good is it to be dependence-free if your pain makes you unable to function properly?

If you're that worried about eventual withdrawals (how long do you expect to have this pain for, anyways? very important question), talk to your doctor about it the next time you see him/her and make sure that when the time comes, if you need it, they will help you come off the drug slowly rather than just cut you off immediately. Sometimes doctors do the ******* thing and force people to stop cold turkey, but if you express your concerns well beforehand, it will help them understand that your needs are legitimate.


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## crayzyMed (Nov 2, 2006)

meyaj said:


> Well first off, it's being used as an analgesic (as it's supposed to), so I'm not sure why you bring up anxiolytic effects.
> 
> Second of all, naltrexone only prevents tolerance because it's an opioid antagonist. Depending on the relative affinities, naltrexone is either going to be useless or is going to block the effects of the drug, which is not something you want, and can be just as easily accomplished with the same results by using a LOWER DOSE.
> 
> ...


Well this thread is called "tramadol/ultram for anxiety and depression" so id say it is about anxiolotic effects and not analgesia.

Ultra low dose naltrexone doesnt block the effects of opiates at all, i'm talking about extremely low doses, i've seen a report of a guy mixing it with hes heroine and hes tolerance went in reverse. There's also a studie showing this effect.


> Anyway, the past 7 days I have been doing ULD naltrexone with each shot of heroin. I have also gotten 3 of my friends (also daily users) to do the same. I'm still experimenting with dosing but so far I (as well as my 3 friends) have had INCREDIBLY SUCCESSFUL results with using ~1-2mcg with each shot of heroin. Here are effects I have noticed (each of my friends claim to get these same effects):
> 
> TOLERANCE
> I had gotten up to at least $20 #4 per shot to even feel slight effects from heroin. I was up to about 3-4 shots per day. AS SOON as I starting adding 1mcg naltrexone to my shots I have been catching extreme nods (like never ever before) from $8 of #4 per shot.
> ...





> Queen's Researchers Discover Paradox Of Pain Control; Morphine Effectiveness Restored To Between 80 And 90% Of Original Amount
> 
> (Kingston, ON) -- A surprising discovery by researchers at Queen's University could lead to the development of more effective pain-killing drugs, with fewer side effects, for terminally ill patients or people suffering from chronic diseases such as cancer or severe pain due to nerve damage.
> In a paper that appears in the February 2002 Journal of Pharmacology and Experimental Therapeutics, a Queen's team led by Dr. Khem Jhamandas of the Dept. of Pharmacology and Toxicology reports the "paradoxical" findings of their research on opioid drugs such as morphine. The usefulness of these powerful drugs can diminish dramatically after their prolonged use: a phenomenon described as drug tolerance.
> ...


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## meyaj (Sep 5, 2009)

To the first quote, you're using the single anecdotal report of a junkie who has no way of knowing the potency of their product. Not reliable.

To the 2nd quote, I respect that med school and live very close by, but those are *very preliminary* results and no doctor in their right mind is going to use this method and prescribe naltrexone along with an opioid. I mean, it really makes no difference arguing this point simply because of this fact. Ask for it along with your oxycodone or whatever, you're not going to get it.

Also... you should always be careful about jumping to conclusions when you see a sentence like this: "The next step in this investigation will involve clinical trials to determine if the same results that have been shown in *laboratory rats can be produced in people*."

You could be on to something, it's obviously impossible for me to say this for sure. But if we took every result we've managed to see in rats and skipped the whole human trial process, pharmaceuticals would be absurdly dangerous.

There's simply not nearly enough evidence for it yet to be stating it as fact, let alone recommending it to people.


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## crayzyMed (Nov 2, 2006)

meyaj said:


> To the first quote, you're using the single anecdotal report of a junkie who has no way of knowing the potency of their product. Not reliable.
> 
> To the 2nd quote, I respect that med school and live very close by, but those are *very preliminary* results and no doctor in their right mind is going to use this method and prescribe naltrexone along with an opioid. I mean, it really makes no difference arguing this point simply because of this fact. Ask for it along with your oxycodone or whatever, you're not going to get it.
> 
> Also... you should always be careful about jumping to conclusions when you see a sentence like this: "The next step in this investigation will involve clinical trials to determine if the same results that have been shown in *laboratory rats can be produced in people*."


Well its kinda strange then the guy suddenly has street heroine that doesnt develop a tolerance.

There are alot more anecdotal reports of using NMDA antagonists for this purpose tough, imo thats the best option as nmda antagonists also seem to prevent tolerance to amphetamines.

Its true that no doc is going to prescribe those things with opiates but there also wont be any doc prescribing opiates for social anxiety in the frist place. In my opinion its way to risky to use opiates every day on their own for anxiety.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> Well its kinda strange then the guy suddenly has street heroine that doesnt develop a tolerance.
> 
> There are alot more anecdotal reports of using NMDA antagonists for this purpose tough, imo thats the best option as nmda antagonists also seem to prevent tolerance to amphetamines.
> 
> Its true that no doc is going to prescribe those things with opiates but there also wont be any doc prescribing opiates for social anxiety in the frist place. In my opinion its way to risky to use opiates every day on their own for anxiety.


Yes I agree there's more evidence for NMDA antagonists. I recall more than one study about reducing doses and tolerance of opiates with co-administration of ketamine. But as much as that might work, you'll have a very hard time getting your doctor to structure and prescribe such a regimen for you, and personally I'd be worried about my doctor labeling me a drug for asking for it, which raises the possibility that your pain is going to be under-treated.


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## RockiNToM (Jun 15, 2009)

So guys, given that here in the UK doctors don't prescribe anything like Vicodin or Hydrocodone, only stuff like dihydrocodeine, what are the alternatives?

I want to prepare myself for the stuff my doctor might switch me to. So atleast I have some idea of what I might be getting myself into. For example if I had known about tramadol being so damn harsh to withdraw from and the seizure risk I would have probably refused.

It's a damn shame tramadol is the only med that has helped me feel less depressed and socially anxious in a long, long time. Maybe me going back on an anti-depressant while I'm on an a new pain med will be better for me? not sure about interactions though.


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## crayzyMed (Nov 2, 2006)

DXM is availible OTC.
I just think its better safe then sorry, here are a few anecdotal reports of ppl doing well on opiates for depression:
http://opioids.com/antidepressant/opiate.html

But on the other hand i saw some stories of ppl that started using opiates for anxiety or depression and ended up as complete trein wrecks.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> DXM is availible OTC.
> I just think its better safe then sorry, here are a few anecdotal reports of ppl doing well on opiates for depression:
> http://opioids.com/antidepressant/opiate.html
> 
> But on the other hand i saw some stories of ppl that started using opiates for anxiety or depression and ended up as complete trein wrecks.


Yeah I can say for myself that opiates make me even more withdrawn.

And yeah, DXM is available OTC, but it's a very dirty drug. By that, I mean it activates many different receptors, the number of which increases with the dose (hence the recreational "plateaus"). If I'm not mistaken, to get any significant NMDA antagonism you have to take a pretty hefty dose. It can also cause very bad interactions with antidepressants, including tramadol. If I were to use the NMDA antagonist strategy, I'd still rather obtain ketamine illegally and use instead.

But then the problem is that you're self-medicating and appropriate combinations of the drugs are complete guesswork. Doctors don't spend so much time in school and training for nothing.


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## crayzyMed (Nov 2, 2006)

meyaj said:


> Yeah I can say for myself that opiates make me even more withdrawn.
> 
> And yeah, DXM is available OTC, but it's a very dirty drug. By that, I mean it activates many different receptors, the number of which increases with the dose (hence the recreational "plateaus"). If I'm not mistaken, to get any significant NMDA antagonism you have to take a pretty hefty dose. It can also cause very bad interactions with antidepressants, including tramadol. If I were to use the NMDA antagonist strategy, I'd still rather obtain ketamine illegally and use instead.
> 
> But then the problem is that you're self-medicating and appropriate combinations of the drugs are complete guesswork. Doctors don't spend so much time in school and training for nothing.


True, altough i think with doing some research you can find out what meds will and won't interact and what combo's are safe. And yeah tramadol and DXM are both very dirty drugs.


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## RockiNToM (Jun 15, 2009)

That article is very interesting about opiates and depression. I know I'm not really the same as those people (who have a history of opiate abuse) but whenever I'm not on an anti-depressant I don't feel normal - I don't feel like my mood is stable. This goes way back to my early teens, at around 13 when I think my depression started to set in - that's when I started to feel different and I haven't felt the same ever since. Before that, I experienced happiness, although I still had SA, my mood wasn't really a problem. It seems that all changed when I reached my teens and it never settled down.

So given my personal history, it's odd that I only start to feel somewhat normal or able to experience happiness like I did before I reached me teens when I'm on something that changes my brain chemicals. Tramadol has been the only med I've taken that made me instantly remember happy memories of my childhood I thought I had totally forgotten. Paxil was very good as well, but not anywhere near as profound as Tramadol. All the other anti-depressants have helped somewhat, but not anywhere near as good as my experiences with Tramadol or Paxil. Very frustrating because when I went back to Paxil a few years ago, it didn't work and this apparently happens to a lot of people who have had success then have it poop out on them, take a break, and go back to it only to find it still doesn't work.

While I've been taking tramadol I've been doing things I used to love doing but gave up doing for the first time again in years, and I'm just basically enjoying my life more than I think I've ever done. Why is it with people like us everything is so overly complicated? Why do we always have to find our cures/solutions in the most difficult ways? If opiates/tramadol wasn't such a big no,no in terms of treating mental illnesses such as depression and anxiety nobody here would be worried about taking them. But, because there is, and there's always those out there who will abuse them, cause themselves hospitalization or harm to others, etc, these options are eradicated.

Sorry for my venting.


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## Vini Vidi Vici (Jul 4, 2009)

dude i totally understand what you mean by feeling normal on tramadol....when i was on tramadol, i could almost function at a normal level, and i wasn't severely depressed and OCD and stuff. it was pretty awesome....thankfully, there are some antidepressants that function similiarly to tramadol....it would be a really good idea to take an antidepressant wether or not you take an opiate. i really hope that in the future buprenorphine or some other opiate is approved for treatment-resistant depression....it really does stink. some people (like me) i believe actually have a deficit in natural endorphins/enkephalins...and an excess in pain and glutamate neurotransmission...so these people will actually need opiates to feel normal. i mean parnate is helping me...but it would be so much more helpful with an opiate.


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## jim_morrison (Aug 17, 2008)

Vini Vidi Vici said:


> dude i totally understand what you mean by feeling normal on tramadol....when i was on tramadol, i could almost function at a normal level, and i wasn't severely depressed and OCD and stuff. it was pretty awesome....thankfully, there are some antidepressants that function similiarly to tramadol....it would be a really good idea to take an antidepressant wether or not you take an opiate. i really hope that in the future buprenorphine or some other opiate is approved for treatment-resistant depression....it really does stink. some people (like me) i believe actually have a deficit in natural endorphins/enkephalins...and an excess in pain and glutamate neurotransmission...so these people will actually need opiates to feel normal. i mean parnate is helping me...but it would be so much more helpful with an opiate.


Tramadols related compound venlafaxine in addition to mirtazapine are purported to have some opioid activity.

http://www.springerlink.com/content/2kx87825w7017h47/

" Summing up the various interactions of venlafaxine and mirtazapine with opioid, noradrenergic and serotonergic agonists and antagonists, we found that the antinociceptive effect of venlafaxine is influenced by opioid receptor subtypes (μ-, κ1- κ3- and δ-opioid receptor subtypes) combined with the α2-adrenergic receptor, whereas the antinociceptive effect of mirtazapine mainly involves μ- and κ3-opioid mechanisms. This opioid profile of the two drugs may be one of the explanations to their efficacy in severe depression, unlike the SSRIs and other antidepressants which lack opioid activity. "


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## meyaj (Sep 5, 2009)

jim_morrison said:


> Tramadols related compound venlafaxine in addition to mirtazapine are purported to have some opioid activity.
> 
> http://www.springerlink.com/content/2kx87825w7017h47/
> 
> " Summing up the various interactions of venlafaxine and mirtazapine with opioid, noradrenergic and serotonergic agonists and antagonists, we found that the antinociceptive effect of venlafaxine is influenced by opioid receptor subtypes (μ-, κ1- κ3- and δ-opioid receptor subtypes) combined with the α2-adrenergic receptor, whereas the antinociceptive effect of mirtazapine mainly involves μ- and κ3-opioid mechanisms. This opioid profile of the two drugs may be one of the explanations to their efficacy in severe depression, unlike the SSRIs and other antidepressants which lack opioid activity. "


Interesting, tried both of them and never noticed any subjective opioid effects. Which is really odd because I even notice the opioid signature from endorphins every time I take a big dump :lol


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## jim_morrison (Aug 17, 2008)

meyaj said:


> Interesting, tried both of them and never noticed any subjective opioid effects. Which is really odd because I even notice the opioid signature from endorphins every time I take a big dump :lol


I'd assume that you'd need to take a higher than average dose, as the doses they give these rats per kg of bodyweight in these sorts of trials is usually pretty phenomenal, but considering that venlafaxine and mirtazapine have a unique ability to potentiate eachother (hence how the clinical observations of california rocket fuel came about), makes you wonder if taking the two together might be touching on this mechanism.


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## Vini Vidi Vici (Jul 4, 2009)

maybe that would explain why cymbalta and effexor are sometimes helpful in fibromyalgia and chronic pain and stuff.....but ive seen reports on erowid, where people who take effexor will not get high and won't get the associated dopamine rush/release when taking opiates. RocknRoll found this study that showed that 5ht2a and A2, i can't quite remember which, but it was 5ht2a and some adrenergic receptor that were both synergistically responsible for dopamine release from opiates and psychostimulants. Antagonize either or both of them, or downregulate them (presumably) would lead to no euphoria from opiates. maybe since effexor would activate both of those receptors, it might potentiate the bodies natural opiate activity or something....dunno, but its interesting


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## Vini Vidi Vici (Jul 4, 2009)

crayzyMed said:


> I also agree that a "real" opiate would be better but only when also taking an NMDA antagonist + Ultra low doses of naltrexone otherwise you are asking for trouble.
> I've also seen reports of ppl getting full blown withdrawal of just taking opiates as prescribed, so it can definatly cause trouble.
> Taking breaks of a few days is also a must.


Suboxone sounds like that...well minus the NMDA antagonism. but its already a partial agonist/antagonist, and it comes with added in naltrexone


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## meyaj (Sep 5, 2009)

Vini Vidi Vici said:


> Suboxone sounds like that...well minus the NMDA antagonism. but its already a partial agonist/antagonist, and it comes with added in naltrexone


I believe it's naloxone, which is similar but not the same as naltrexone, and the reason it does that is to prevent abuse. It precipitates withdrawals in opiate-dependent users _when injected_, making it really unpleasant, but if taken like they're supposed to, it will work like it's supposed to. This makes it great for weaning addicts off opiates.

The other half of suboxone, buprenorphine, is perfect for this because it has such an unbelievably high affinity for the μ opioid recepter that using other opioids is pretty much useless and, if you're high on something else at the time like oxycodone or heroin, for instance, it's going to knock that drug right off the receptors and again, precipitate withdrawals. Which is a pretty effective method of keeping addicts on a strict dose schedule when prescribed unless they're somehow getting their hands on more than they should be either off the street or by doctor shopping.

It also happens to make it extremely dangerous in overdose though because that high affinity means it outcompetes any opiate antagonists which would normally be used as an antidote.

If you're an opiate-naive individual being prescribed Suboxone though, taking it as you're supposed to, and no other opiates, the naloxone is not going to prevent or even so much as slow down tolerance or dependence.


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## jim_morrison (Aug 17, 2008)

Vini Vidi Vici said:


> maybe that would explain why cymbalta and effexor are sometimes helpful in fibromyalgia and chronic pain and stuff.....but ive seen reports on erowid, where people who take effexor will not get high and won't get the associated dopamine rush/release when taking opiates. RocknRoll found this study that showed that 5ht2a and A2, i can't quite remember which, but it was 5ht2a and some adrenergic receptor that were both synergistically responsible for dopamine release from opiates and psychostimulants. Antagonize either or both of them, or downregulate them (presumably) would lead to no euphoria from opiates. maybe since effexor would activate both of those receptors, it might potentiate the bodies natural opiate activity or something....dunno, but its interesting


Dual serotonin/noepinephrine meds alone are enough to deal with neuropathic pain like fibromyalgia, which is why cymbalta and TCAs are sometimes prescribed for these conditions, and as far as I know cymbalta and the TCAs have no affinity for the opioid receptors.
As for the dopamine release mediation, that was co 5ht2a and A1 agonism that I believe rocknroll was referring too. On the other hand 5Ht2c receptor antagonism is said to also mediate the release of dopamine from opiates, psychostimulants etc, and as such drugs which are 5HT2c antagonists are noradrenaline and dopamine disinhibitors, which owes greatly to prozacs atypical 'activating' effects when compared to most of the SSRI's.


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## Dangerous (Oct 21, 2009)

_I got a bottle of a partial opiate suboxone. Yeah, it may be used to treat addiction, and its worthless after you take it for awhile. But take a 8mg subby with no tolerance to any opiates and you will be puking your guts out. It pound for pound way stronger than vicoden. In the UK they give like a super low dose like 2mcg, and we have 4 and 8 mg..haha. If anyone wants it they can have it because I dont take the crap anymore..hahha just kidding._


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## RockiNToM (Jun 15, 2009)

jim_morrison said:


> Tramadols related compound venlafaxine in addition to mirtazapine are purported to have some opioid activity.
> 
> http://www.springerlink.com/content/2kx87825w7017h47/
> 
> " Summing up the various interactions of venlafaxine and mirtazapine with opioid, noradrenergic and serotonergic agonists and antagonists, we found that the antinociceptive effect of venlafaxine is influenced by opioid receptor subtypes (μ-, κ1- κ3- and δ-opioid receptor subtypes) combined with the α2-adrenergic receptor, whereas the antinociceptive effect of mirtazapine mainly involves μ- and κ3-opioid mechanisms. This opioid profile of the two drugs may be one of the explanations to their efficacy in severe depression, unlike the SSRIs and other antidepressants which lack opioid activity. "


That's very interesting, but for me Effexor gave me way too many side-effects, and that stuff did to my blood pressure while only on 75mg was just not normal. Mirtazapine on the other hand, gave me a great deal if suicidal tendencies which I'm sure may have been resolved over time but I couldn't get past that stage.

The combination may probably be more worthwhile (californian rocketfuel) but I must admit after my experiences of trying each one, I'm very reluctant to try either of them again, certainly together.

So let's say for a minute, a SNRI is what I need (diregarding Effexor) what would be the best one to take? Also please bear in mind I've taken a NRI before on its own called Roboxetine/Edronax and that gave me extremely bad anxiety (the worst I'v ever had). But perhaps the serotonin as well will help calm that effect I don't know. Certainly though, I did feel slightly stimulated with the NRI which probably would help with the fatigue from the serotonin.


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## jim_morrison (Aug 17, 2008)

RockiNToM said:


> That's very interesting, but for me Effexor gave me way too many side-effects, and that stuff did to my blood pressure while only on 75mg was just not normal. Mirtazapine on the other hand, gave me a great deal if suicidal tendencies which I'm sure may have been resolved over time but I couldn't get past that stage.
> 
> The combination may probably be more worthwhile (californian rocketfuel) but I must admit after my experiences of trying each one, I'm very reluctant to try either of them again, certainly together.
> 
> So let's say for a minute, a SNRI is what I need (diregarding Effexor) what would be the best one to take? Also please bear in mind I've taken a NRI before on its own called Roboxetine/Edronax and that gave me extremely bad anxiety (the worst I'v ever had). But perhaps the serotonin as well will help calm that effect I don't know. Certainly though, I did feel slightly stimulated with the NRI which probably would help with the fatigue from the serotonin.


Well if you can't take effexor then the main other SNRI is cymbalta. Both effexor and cymbalta have relatively short half lives so I wouldn't be expecting cymbalta to be much better in terms of withdrawl. Plus cymbalta has some whacky liver problems associated with it, although these are rare. So might be worth trying I guess, and then theres also pristiq which is the active metabolite of effexor, but it's generally regarded as being less effective than effexor and cymbalta for some reason.


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## RockiNToM (Jun 15, 2009)

Damn!

Can someone clear up something for me. What is it in tramadol exactly that is making me feel less depressed? Is it the fact it's a synthetic opiate or is it the serotonin and norepinephrine reuptake inhibition? I'm more inclined to believe it's the serotonin and norepinephrine because of it's apparent "mild and delayed μ-agonist activity" but I could be wrong.

From what I've read, Venlafaxine/Effexor is the closest medication in terms of chemical structure, but obviously Effexor is absent of opioid effects. Thing is, I've been on Effexor before and I know what it's like, the side-effects abo****ely SUCK! I was only on it at 75mg though. But surely going higher wouldn't improve that? All I know is, is Effexor gave me a damn hard time side-effect wise. My adrenaline felt fatigued, my blood pressure was all screwed up, I had major sexual dysfunction, my vision kept going blurry from all the dryness it caused my body to have, I had daily headaches, the list goes on... BUT (and this is a big but) it did quite well for my depression, much better than Zoloft, Prozac and Celexa - but not as good as Paxil.

I think the major issue here is, I've now had a taste of what happiness is and I want to feel it more often. When I'm not on medication I feel things again, I'm less apathetic, but I'm overly emotional, depressed, anxious and I am generally unhappy.. A lot of anti-depressants seem to fix these problems but they don't make me 'happy' - they make things manageable. What Tramadol and Paxil both did was actually make me happy. 

Why are things so screwed up? lol


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## Vini Vidi Vici (Jul 4, 2009)

its everything, most likely. weak SNRI action, weak NMDA antagonism, weak Opiate effects, possible Muscarinic acetylcholine M1 receptor antagonism, and possible 5ht2c antagonism, which by itself can be a potent antidepressant. I can't find out exactly how strong of a 5ht2c antagonist Tramadol is. But it does play some role in the antidepressant effects. If you antagonize the opiate effects, some of Tramadol's antidepressant effects will go away, but not all. I think alot more of the antidepressant effects can be attributed to O-desmethyltramadol, the active metabolite. It is 200x stronger as an opiate agonist, and posesses the 5ht2c antagonism. Tramadol is just a huge combination of various weak actions, which all posses weak antidepressant effects...combined with the opiate agonism, which has a strong antidepressant effect. when you add all the different mechanisms together, you get the strong antidepressant effects associated with tramadol, along with the unpredictable and unique withdrawal syndrome that some users get. the only way to replicate tramadol would be to get medications that posess the same mechanisms...and combine them together. oddly, paxil, zoloft, and tramadol are the only things that ever actually worked for me. paxil quit working, zoloft didn't help enough, and i had to discontinue tramadol. thankfully for those who like using tramadol, its not scheduled, and easily available to purchase online. i dunno if this is a good or a bad thing.


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## RockiNToM (Jun 15, 2009)

The only thing I will admit I dislike about tramadol is this one side-effect I've started to get, where it makes me feel a bit motion sick sometimes, which isn't very pleasant and convenient.

Whatever the case really, I need to get off it. It's just not practical being on something that you describe as having so many complicated actions on the brain, for when I decide to come off.


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## jim_morrison (Aug 17, 2008)

RockiNToM said:


> Damn!
> 
> Can someone clear up something for me. What is it in tramadol exactly that is making me feel less depressed? Is it the fact it's a synthetic opiate or is it the serotonin and norepinephrine reuptake inhibition? I'm more inclined to believe it's the serotonin and norepinephrine because of it's apparent "mild and delayed μ-agonist activity" but I could be wrong.
> 
> ...


My guess is that your experiencing the euphoria rush of it's opioid effects, ask anyone on this board whos taken both a narcotic painkiller and an antidepressant (on seperate occasions) to tell you which worked best for their depression lol.

With that said, your correct tramadol is structurally related to venlafaxine, however tramadols SNRI effects are much weaker than venlafaxines, just as venlafaxines (puported) possible opioid activity would be presumably much weaker than tramadols.


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## UltraShy (Nov 8, 2003)

RockiNToM said:


> But can I just ask, you don't have any problems with your mood no? If your problems don't stem from your mood (I mean from what I've read you only take benzos for anxiety) then of course you're not going to feel a great deal of difference - there is nothing to fix.
> 
> For me it fixed my mood; made me *happier, brighter, less negative, more optimistic,* which then impacted my anxiety too, for me.


I think you'd be hard pressed to find many people more negative, less happy, less bright, and less optimistic than myself. I'm the lord of negativity. There is a relative lack of people more negative than me because many of them are dead.

While anxiety is IMO the root problem, it results in severe depression for me.


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## RockiNToM (Jun 15, 2009)

I just find it odd, that given you say your depressed as well because of the anxiety you aren't treating your mood as well with something. But that's your call and your own business.


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## RockiNToM (Jun 15, 2009)

Question, how long would it take to withdraw from tramadol after taking it for a month (1x 50mg daily) or would there be any withdrawal at all?

I'm hoping in a month's time all will be sorted with my cyst.


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## meyaj (Sep 5, 2009)

RockiNToM said:


> Question, how long would it take to withdraw from tramadol after taking it for a month (1x 50mg daily) or would there be any withdrawal at all?
> 
> I'm hoping in a month's time all will be sorted with my cyst.


After using it for just a month it's conceivable that you won't notice much in the way of withdrawals at all


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## Medline (Sep 23, 2008)

UltraShy said:


> I think you'd be hard pressed to find many people more negative, less happy, less bright, and less optimistic than myself. I'm the lord of negativity. There is a relative lack of people more negative than me because many of them are dead.
> 
> While anxiety is IMO the root problem, it results in severe depression for me.


No offense, but do you think your life will get better if you don't change anything? I know you have tried many drugs, but you haven't tried MAOIs. You probably know that they can work very well even (or especially) when all other drugs (mostly reuptake inhibitors) fail. The risks of MAOIs are way overrated and for sure lower than the potential risks of severe untreated depression. Your Pdoc also mentioned stimulants, and altough something like Adderall may help you well, you won't get it if you don't see your Pdoc for ~ one year.


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## RockiNToM (Jun 15, 2009)

meyaj said:


> After using it for just a month it's conceivable that you won't notice much in the way of withdrawals at all


Well that's good to know. I really hope I don't have to take it much longer for my own sake.

Also, has anyone heard of a med called *Dosulepin/Prothiaden*? Apparently it's a TCA anti-depressant it has NE reuptake inhibition and 5-HT reuptake inhibition and from the little amounts I've read it seems quite promising. I can't seem to find much info on it though.


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## UltraShy (Nov 8, 2003)

Medline said:


> Your Pdoc also mentioned stimulants, and altough something like Adderall may help you well, you won't get it if you don't see your Pdoc for ~ one year.


1. I brought up the subject of stimulants. Up till that point my pdoc said nothing about amphetamines at all.

2. You will notice there is a very nasty catch 22 here. If seeing docs didn't scare the hell out of me, I'd see him and have had amphetamines way back last spring. Unfortunately, I suffer from severe SA that prevents me from eagerly running to my doc. I suspect many with severe SA have noted a similar problem in their own life.


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## Medline (Sep 23, 2008)

UltraShy said:


> 1. I brought up the subject of stimulants. Up till that point my pdoc said nothing about amphetamines at all.
> 
> 2. You will notice there is a very nasty catch 22 here. If seeing docs didn't scare the hell out of me, I'd see him and have had amphetamines way back last spring. Unfortunately, I suffer from severe SA that prevents me from eagerly running to my doc. I suspect many with severe SA have noted a similar problem in their own life.


As you have quite a stash of Xanax (correct me if I'm wrong ) - couldn't you take a somewhat higher dose ox Xanax on the day you have an appointment with a (P)doc to calm your nerves down.


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## UltraShy (Nov 8, 2003)

Medline said:


> As you have quite a stash of Xanax (correct me if I'm wrong ) - couldn't you take a somewhat higher dose ox Xanax on the day you have an appointment with a (P)doc to calm your nerves down.


I already do take a considerably higher dose that day.

But you're forgetting weeks of anticipation leading up to that day.

I could be calm I suppose, but I think it's deemed bad to bring a bottle of wine to your doctor's office.


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## RockiNToM (Jun 15, 2009)

Jeeez UltraShy, how do you manage with other things like work, seeing relatives, going to the dentist etc?


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## UltraShy (Nov 8, 2003)

RockiNToM said:


> Jeeez UltraShy, how do you manage with other things like work, seeing relatives, going to the dentist etc?


Work: I haven't done anything since college graduation in May 1995. Yes, that's 14.5 years that have been wasted.

Dentist: Last visit was March 2005, so 4.5 years there.

Relatives: Very rarely see any. Never had many to start with and most of them are dead. Last month I, for the very first time, met one of my aunts. My mother hadn't seen this sister in the last 40 years. Seeing how I'm 36, she never met me before. I've never yet met my only uncle and don't expect I ever will.

I only met one out of 4 grandparents, with my paternal grandmother living with us till her death in 1986 when I was 13. My paternal grandfather was dead by 1948, so no chance to meet him. Never met my maternal grandparents who survived till I was a young adult. Never met my great grandfather who died a year before I was born. Since my father was an only child, I have no aunts or uncles from his side of the family.

I have no nieces or nephews and never will, given that one brother is dead and the other is 56.


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## RockiNToM (Jun 15, 2009)

Wow that sucks UltraShy. 

Have you always been this bad with your anxiety? I ask because you were at college before and then after everything seemed to stop in your life.

Maybe we should move this to another thread? if you want to discuss it.


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## UltraShy (Nov 8, 2003)

RockiNToM said:


> Wow that sucks UltraShy.
> 
> Have you always been this bad with your anxiety? I ask because you were at college before and then after everything seemed to stop in your life.
> 
> Maybe we should move this to another thread? if you want to discuss it.


Yeah, it's always been this bad.

I went to college because I didn't recognize other options like doing nothing. Clearly, I've become a true expert on that option since mid-1995. College was what was expected of me. I avoided classes that had presentations and such as much as possible and somehow I made it through. I guess I felt driven to finish because eventually you pass the point of no return -- after putting in 3+ years I wasn't going to stop without doing several more classes and getting a degree to show for it.


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## RockiNToM (Jun 15, 2009)

So after college I'm assuming it spiraled out of control and the anxiety ate you up? That realy sucks man, I hope you are doing ok.

In other news, my pain has been getting worse which really peeves me off, because I don't want to be taking anymore tramadol than 1 x a day. But at the moment I have no option to bump it up to 2 x day and hope the pain goes back down for me to take it 1 x a day. This really is getting out of hand. Why couldn't the docs just give me a clean med to take instead of a dirty one that works on so many receptors? :/

I couldn't see my doc this week as they were away, which totally sucks and I don't like explaining myself to another I doc I don't know.


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## jim_morrison (Aug 17, 2008)

Have you considered cymbalta or a TCA?


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## RockiNToM (Jun 15, 2009)

To switch to for the pain? Yeah, but I think I need to be off tramadol for a couple of days for it to get out of my system before switching, which quite frankly isn't really an option at the moment with the amount of pain.


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## jim_morrison (Aug 17, 2008)

Yeah for the pain/depression


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## UltraShy (Nov 8, 2003)

RockiNToM said:


> So after college I'm assuming it spiraled out of control and the anxiety ate you up? That really sucks man, I hope you are doing ok.


I've never applied for any job nor submitted even a single resume ever. I've never even created a resume.

College was much like a continuation of high school (minus the bullies who were too stupid to get in). The first 18 years of my life consisted largely of going to school and it was easy enough (in relative terms) to just keep going with that education thing that I was used to by then.

Then I graduated (with honors) with a BS in Business Administration (finance) and I was totally lost. Where do I do from there? How do I get a job? Eventually it just came to me that I'm not going to get one.

My psychiatrist deems me mentally disabled, unable to perform any job that exists in the entire economy. He hasn't yet been willing to say I'm a lost cause, probably because he fears that could create a self-fulfilling prophecy, but I'm sure he damn well knows I'm never going to be able to work.

I'm fortunate enough to have enough money that I don't have to work, though sitting around and doing nothing for decade after decade till death gets quite old & boring real fast. If not for my assets, I'd be on SSI as numerous other SAS members are.


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## meyaj (Sep 5, 2009)

Hey at least you've been able to graduate college! 

I tried twice and was never able to make it past the first year! Hell, not even past the first few months. I was doing finance as well, interestingly enough. I just can't keep up anything consistent. I can make a huge effort to remain functional on just a basic level for seemingly a few months, but eventually it all collapses. I stopped attending classes, or simply coming out of my room, or even showering and personal grooming. I can't even take care of MYSELF very long before I completely break down, for the latter part of those school years it was a chore just making sure I could go downstairs to the cafeteria and keep myself fed. If I hadn't lived in residence and had an apartment off-campus or something, and actually had to GO out to stores to keep myself supplied with food, and cook it, and everything else involved, I seriously may have rotted in that apartment.

A job is obviously out of the question for me right now too, I'd be fired as soon as I started, although I doubt I'd make it past an interview anyways.

I'm almost finished the process of applying for and being approved to collect disability. I'm financially eligible, my doctor's approved my "disability" and sent in the stuff today, and I've already received my drug card and a check in the mail. Sucks, but I need the drug coverage it provides. Picked up a prescription today and it was $0!!! Not even a co-pay. An enormous weight has been lifted off my shoulders.

The income support doesn't hurt either though, although it makes me feel guilty. Not as guilty as mooching off my parents though...


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## RockiNToM (Jun 15, 2009)

Guys and gals, I might be having surgery soon it all depends, no date has been given as of yet. However I'm wondering if taking something like diazepam on the day of surgery is wise? I'm gonna ask for some from my doc - hopefully in this type of situation I will get some!!

Also, my pain got quite bad recently, and I saw another doc (an out of hours one) and he recommended codeine with paracetamol. I took that for a few days and it did absolutely nothing. I was taking it around 4 times a day too.

Saw my proper doc recently and was told to come off the codeine and continue with tramadol, but take more of it.  So, I've now been given 5 boxes of 30 x 50mg capsules of tramadol. I was so shocked. I see an addiction definitely happening, if I'm not careful.

I'm on other medications too, like special types of laxatives, anti-spasmodics, anti-emetics, it's all crazy. I'm on all this just to get through each day until I have my cyst removed.

The anxiety is not helping either at the moment, because it makes me develop panic attacks over my symptoms when they get bad. Tramadol somewhat helps in keeping me cool but it's not made for that. I think I can get away with getting some diazepam for surgery but I doubt I will get anything leading up to it. I don't really like diazepam, but I don't have much choice if I want to remain calm. I remember when I was in hospital before for another op, I was given diazepam because they couldn't calm me down. I was given tons of the stuff and I was still suffering with panic attacks, it totally sucked. Maybe I will need a higher dose or something. I'd like to try Klonopin or xanax but in this country it aint gonna happen.


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## Vini Vidi Vici (Jul 4, 2009)

wow thats , not cool, but at least they didnt tell you to just stop and cut off your supply cold turkey! did you take the codeine with the tramadol? because they both use the same CYP enzymes. Tramadol is very weak before it is metabolized by CYP2D6. And codeine is inactive until it is metabolized into Morphine by CYP2D6. so taking both at the same time would result in a net decrease in metabolism of both...so u wouldnt get as much analgesic/antidepressant effects. maybe the Doc told you to keep taking tramadol because he doesnt believe it is addictive.... maybe you could talk to your docs and see if u could take the codeine instead. at least you have an alternative opiate!! many people just have 2 quit tramadol cold turkey....

when i had tramadol, it was always really cool knowing that i had a whole bunch. and the more i cut down, i just kept wanting to take more and more....just to get the pain and anxiety/depression to go away. who knows? maybe you won't even get any tramadol withdrawal..... another idea, is to take the tramadol until sometime after you have your surgery. save the codeine. then, as soon as possible, taper down slowly on the tramadol. then when you stop the tramadol, take the codeine to minimize the withdrawal symptoms as your body adjusts to the absence of tramadol


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## RockiNToM (Jun 15, 2009)

Well, the other doc told me to stop taking tramadol for a few days and take paracetamol and anti-spasmodics then introduce the codeine he prescribed. So I did that and used codeine with the paracetamol (no tramadol) for a few days and it really just totally sucked. It did absolutely nothing for my pain at all, I may as well have been taking just the paracetamol...

When I saw my own doc again and told them what had happened and that I was put on codeine and it wasn't working, he said to just take the tramadol and take even more if I needed to. He didn't seem to like the fact the other doctor gave me codeine, it was like he didn't agree and he much preferred tramadol. I find that odd as tramadol is the more addicting and acts on more chemicals, meaning harder to get off. However I only take one 50mg capsule a day if I can, maybe 2 but I don't take 2 very often - only when things get really bad.

What I think I will do is continue with the tramadol (I mean what choice do I have right?) until surgery and then after taper down off tramadol and switch to codeine. They may even give me something better than codeine anyway, like dihydrocodeine. Then, obviously come off everything completely.


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## jim_morrison (Aug 17, 2008)

Does the codiene formulation contain paracetamol? If it does then be careful not to exceed the paracetamol daily limit when you go back on it.


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## flaxepin (Nov 11, 2009)

I think the most addictive thing is the euphoria, altough for anxious ppl feeling normal could be even more addictive.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> Well, the other doc told me to stop taking tramadol for a few days and take paracetamol and anti-spasmodics then introduce the codeine he prescribed. So I did that and used codeine with the paracetamol (no tramadol) for a few days and it really just totally sucked. It did absolutely nothing for my pain at all, I may as well have been taking just the paracetamol...
> 
> When I saw my own doc again and told them what had happened and that I was put on codeine and it wasn't working, he said to just take the tramadol and take even more if I needed to. He didn't seem to like the fact the other doctor gave me codeine, it was like he didn't agree and he much preferred tramadol. I find that odd as tramadol is the more addicting and acts on more chemicals, meaning harder to get off. However I only take one 50mg capsule a day if I can, maybe 2 but I don't take 2 very often - only when things get really bad.
> 
> What I think I will do is continue with the tramadol (I mean what choice do I have right?) until surgery and then after taper down off tramadol and switch to codeine. They may even give me something better than codeine anyway, like dihydrocodeine. Then, obviously come off everything completely.


sounds cool man...tapering tramadol was actually pretty easy for me...i went really slow, just the last half a pill a day was the hard part. your probably right...i mean seriously, most people who get surgery, id think they get a stronger opiate anyway. i can't think of codeine/tramadol doing much for actual surgical pain really, except in ultra high doses.


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## RockiNToM (Jun 15, 2009)

Hmm, this isn't going to be easy. Been in a lot of pain recently, way more than I have been previously, so I'm taking more tramadol which is doing the job good. I always feel reluctant taking more, but what choice do I have?

Anyway, the real reason I'm here posting in this thread is because I've been reminiscing the last I felt really good about my life. Oddly, given everything that's happening to me health wise at the moment, as well as other bad news in my family health wise too, I'm feeling pretty good happiness wise - which obviously is because of the tramadol. So when I think about this, and the last time I felt happy (which was when I was on Paxil 3yrs ago), certain medications obviously really do help (which at one point I thought would never happen again).

I'll admit being on tramadol for pain and it working so great on my mood is not the ideal solution to my problems, but it has allowed me to put things into perspective, like my mood definitely being chemically related problem and not give up!

The trouble is of course, getting off the tramadol in the future when I obviously will have to. The problem is it works, so, so well. It's a real shame that because it's primary use is a pain killer, it's not allowed to be used as anything else - yet it's practically an anti-depressant anyway. So I want to keep happiness right? So what I'll probably do is (when the time comes) switch to codeine, and switch to Paxil, then finally come down and off the codeine. However I'm not sure how quickly I can switch to Paxil after coming off Tramdol with fear of serotonin syndrome. The best way to know would be to look at the half-life of the med, but I'm always a bit fuzzy on med half-lives because there's so much conflicting info on the net. The other problem is that I think SSRIs screw up opioid effects and (I think) rendering them useless (something to do with the way its metabolised) so it may not be as easy to do this as I think - I need to do some more research. Bah.

What do you guys think?


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## jim_morrison (Aug 17, 2008)

Paxil is a CY2D6 liver enzyme inhibitor, both codeine and tramadol rely on CY2D6 to be converted into the main metabolites which are responsible for their pain killing effect. So taking paxil with either of them may render them ineffective.


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## RockiNToM (Jun 15, 2009)

So I'm basically royally screwed. Looks like I'm gonna have to do it the hard way when the time comes. 

EDIT:

It seems that both Celexa and Lexapro are much weaker inhibitors of he CYP2D6 enzyme than Paxil, Zoloft and Prozac. I wonder if they will be ok?


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## Vini Vidi Vici (Jul 4, 2009)

you know, i have read a couple reports about people who have taken Tramadol for over a year, without significant tolerance to mood-lifting effects.....well any CYP2D6 inhibition will prevent Tramadol from being metabolized....and the active concentration of Tramadol will get larger. Tramadol is a weak SNRI.... So combined with any CYP2D6-inhibiting SSRI, it probably would work less, and cause more nausea.  

Im gonna check and see if i can find any information of what SSRIs and how strongly they inhibit Cyp2d6 .just gotta get some coffee first so i can concentrate.


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## RockiNToM (Jun 15, 2009)

Well I don't want to take tramadol and an SSRI. The idea is when I move to codeine to help with opiate withdrawal (when I want to come off) I can also move to an SSRI to deal with the withdrawal from tramadol's anti-depressant properties such as the inhibition of serotonin. So that's why I'm looking for an SSRI that will allow me to use codeine, so I can get off with minimal nasty withdrawal effects.


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## jim_morrison (Aug 17, 2008)

Vini Vidi Vici said:


> Im gonna check and see if i can find any information of what SSRIs and how strongly they inhibit Cyp2d6 .just gotta get some coffee first so i can concentrate.


Here you go;

http://www.psychotropical.com/2_cyp_review.shtml

Fluoxetine +++
Paroxetine +++
Phenelzine +++
Citalopram ++
Escitalopram ++
Bupropion ++
Moclobemide ++
Nortriptyline +
Clomipramine +
Sertraline +


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## RockiNToM (Jun 15, 2009)

jim_morrison said:


> Here you go;
> 
> http://www.psychotropical.com/2_cyp_review.shtml
> 
> ...


I need to recheck some of my sources. It's odd that from that source Sertraline/Zoloft is the better of SSRIs for CYP2D6, because everywhere else I was looking it was Lexapro and Celexa. Very interesting. I really don't wonna go back to Zoloft, apathy is so bad for me on that med. Plus I have tons of it kicking around at home, which ideally should be burnt.



rocknroll714 said:


> Note that in addition to its mu-Opioid receptor agonism and SNRI effects, tramadol is also a 5-HT2C and NMDA receptor antagonist. Very nice pharmacological combination both for pain and mood. Kinda makes me want some..


Interesting, I didn't know about it working on 5-HT2C as well. The closest med I've been told that is chemically similar to tramadol is venlafaxine/Effexor which is kinda like a kick in the teeth to me. I had a bad time with Effexor so it kinda is a big NO if I were to replace tramadol with something like that. However I only explored 75mg and never at the 150mg where norepinephrine kicks in. But the nasty withdrawal and other effects I'm not sure are worth it.

I keep saying this, but Tramadol is the BEST medication I have ever taken in terms of effectiveness on mood and few side-effects. The way it affects my mood makes me more social, happy, and generally positive and optimistic, which is not normally me. I hate the fact it's not licensed as an anti-depressant, that really ticks me off. From my experience it's so much better than any other anti-depressant I've tried. The closest med that made me feel good was Paxil (but I wasn't succesfully able to get it work again the second time).

If it was allowed and I wasn't so worried about tiring my brain out with Tramadol's opiate effects, I would probably just use it for as long as I can. But, because it's not an anti-depressant, I'm only allowed to use it for a short while and I am genuinly worried about ruining my brain with costant use I am going to have to call it quits as soon as my cyst is resolved.

Life sucks at times, doesn't it?


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## jim_morrison (Aug 17, 2008)

Rockintom; Does the buzz tramadol gives you remind you in any way of an alcohol buzz? I ask because alcohol increases endogenous opioids in the brain.


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## Vini Vidi Vici (Jul 4, 2009)

jim_morrison said:


> Rockintom; Does the buzz tramadol gives you remind you in any way of an alcohol buzz? I ask because alcohol increases endogenous opioids in the brain.


well for me at least, Tramadol buzz is only a little bit like alcohol. Tramadol, at first, is actually anxiogenic and nauseating, ...then i guess it has to be metabolized. when i take Tramadol, its like an hour before i get any good effects....but now that ive been offa it for a while, i can clearly see that it caused significant mood elevation. definetly quite potent.... but in addition to its NMDA antagonism, 5ht2c antagonism, and all the other obvious stuff......Tramadol might also be a GABA-A antagonist. this might be related to the high incidence of Seizures from people taking high doses of tramadol. A high dose can be anywhere from 150mg for an intolerant user, to like 800mg for a Tramadol junkie --people have gotten seizures in all of these dose ranges. so if u take Tramadol, maybe its would be a good idea to take it with a GABA agonist of some sorts?


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> I need to recheck some of my sources. It's odd that from that source Sertraline/Zoloft is the better of SSRIs for CYP2D6, because everywhere else I was looking it was Lexapro and Celexa. Very interesting. I really don't wonna go back to Zoloft, apathy is so bad for me on that med. Plus I have tons of it kicking around at home, which ideally should be burnt.
> 
> Interesting, I didn't know about it working on 5-HT2C as well. The closest med I've been told that is chemically similar to tramadol is venlafaxine/Effexor which is kinda like a kick in the teeth to me. I had a bad time with Effexor so it kinda is a big NO if I were to replace tramadol with something like that. However I only explored 75mg and never at the 150mg where norepinephrine kicks in. But the nasty withdrawal and other effects I'm not sure are worth it.
> 
> ...


it does suck...thats exactly what i was thinking when i had to stop tramadol. i wanted to go back on it sooo bad....but my Mom threw out the rest of my pills, down the garbage disposal. so i had no choice. but Tramadol is definetly not the most expensive drug ive ever seen....on the internet, it can be very cheap..its not a matter of affordabilty, i think its an issue with the Risk/Benefit/Addiction ratio thingy.


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## jim_morrison (Aug 17, 2008)

Vini Vidi Vici said:


> well for me at least, Tramadol buzz is only a little bit like alcohol. Tramadol, at first, is actually anxiogenic and nauseating, ...then i guess it has to be metabolized. when i take Tramadol, its like an hour before i get any good effects....but now that ive been offa it for a while, i can clearly see that it caused significant mood elevation. definetly quite potent.... but in addition to its NMDA antagonism, 5ht2c antagonism, and all the other obvious stuff......Tramadol might also be a GABA-A antagonist. this might be related to the high incidence of Seizures from people taking high doses of tramadol. A high dose can be anywhere from 150mg for an intolerant user, to like 800mg for a Tramadol junkie --people have gotten seizures in all of these dose ranges. so if u take Tramadol, maybe its would be a good idea to take it with a GABA agonist of some sorts?


Well alot of people (myself included) seem to say that klonopin is like alcohol without the euphoria or buzz. I attributed this to the fact that both benzos and booz are GABA A agonists, but alcohol additionally seems to increase enodegnous opioids which apprently owes to it's buzz, albiet alcohol also hits alot of other receptors so who knows.

See here; http://ezinearticles.com/?id=1319880

"Alcohol raises endorphin levels 
This kills pain and leads to an endorphin "high"


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## Vini Vidi Vici (Jul 4, 2009)

So here are all the possible mechanisms of Tramadol-- i just feel like making a list, i like lists, i dunno why. if i make any mistakes please correct me--

Tramadol-- Mu-opioid agonism (weak) , SNRI (weak), GABA-A antagonist, Muscarinic Acetylcholine Antagonist (possibly), NMDA antagonist.

O-DesmethylTramadol -- Mu-opioid agonism (strong) , 5ht2c antagonist, Norepinephrine Reutake Inhibitor (maybe)


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## crayzyMed (Nov 2, 2006)

I cant wait to try O-DesmethylTramadol .


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## RockiNToM (Jun 15, 2009)

jim_morrison said:


> Rockintom; Does the buzz tramadol gives you remind you in any way of an alcohol buzz? I ask because alcohol increases endogenous opioids in the brain.


Yes it gives you a very, very minor buzz similar to alcohol. The trouble is it doesn't last very long, as the body quickly gets used to it. The first hour or so after taking the pill always give the best buzz. But the problem is the buzz dips, further and further throughout the day, and you kinda crash and become tired. Taking a second one doesn't really help keep the buzz either other than stop the continuous pain. Even after the buzz, it does keep me fairly balanced mood wise, which is the main bit I like.

I'd also like the add, while the buzz may be similar to alcohol (if only small) the numbing of pain and generally caring less about things (disinhibition) is somewhat similar too. So you can understand why some people can become impaired in decision making with pain killers.

The problem with Tramadol is that is works great for lots of things but it's very hard to abuse. You can't take for example 4 tables at once to try and get a buzz because there's such a high risk of a seizure - it's very hard to abuse it. I would imagine people that have taken upto 700mg a day must have it spread out because I can't imagine how anyone would not get a seizure with that much all at once. I suppose you could with a benzo to counteract the seizures but I really don't think it's recommended. I've been told to take one every four hours if I need to, to remain safe from seizures. Any less than that between doses and I think I would be heading down a slippery slope.


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## RockiNToM (Jun 15, 2009)

Update:

Guys and gals, today I had to take 3 tramadol (150mg) because pain was extremely bad. For some reason though, I've been getting what I can only describe (or that seems makes sense) which is auditory hallucinations. 

It seems every now and then, I keep hearing things like the telephone ringing or the door bell when neither them are actually making any sound. I kept going over to both and checking them and the sound would always stop whenever I went to investigate. On top of that, I heard some cats fighting really loud that sounded just outside my window and so I went to have a look. As soon as I moved to look the sound disappeared and there weren't even any cats outside. But they sounded very close, like only a few feet away from my window.

I'm not sure if this is normal or not, I'm not even on that high of a dose. The max dose is 400mg a day and I've been spacing each 50mg dose 4 hours apart. But whatever it is that's going on it really is strange.


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## Vini Vidi Vici (Jul 4, 2009)

crayzyMed said:


> I cant wait to try O-DesmethylTramadol .


if only i knew a little bit of chemistry,....it couldn't be too hard to "desmethylize" Tramadol. especially since Tramadol is so readily available. somebody should just get a patent on O-desmethylTramadol, and market it as a "non-addictive" antidepressant. because as everyone knows, Tramadol is not addictive! so neither are its metabolites-- it could be called a "endorphinic antidepressant" with additional 5ht2c antagonist properties.


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> if only i knew a little bit of chemistry,....it couldn't be too hard to "desmethylize" Tramadol. especially since Tramadol is so readily available. somebody should just get a patent on O-desmethylTramadol, and market it as a "non-addictive" antidepressant. because as everyone knows, Tramadol is not addictive! so neither are its metabolites-- it could be called a "endorphinic antidepressant" with additional 5ht2c antagonist properties.


Tramadol is addictive man


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## Vini Vidi Vici (Jul 4, 2009)

crayzyMed said:


> Tramadol is addictive man


haha lol..but the doctors don't think so...maybe we could make this into a loophole.... i feel myself getting eviler by the minute.. i think its this N acetyl Cystiene stuff, making my OCD go away so now im not scared to think of devious plans...or maybe im just insane. last night...i started hallucinating, i think it was cuz i stayed up too long after taking 5 mg of zopiclone...i started thinking there were demons in my house, and i started seeing stuff, shapes,...and my cat was acting all weird, twitching and jumping around..gosh it was freaky


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> haha lol..but the doctors don't think so...maybe we could make this into a loophole.... i feel myself getting eviler by the minute.. i think its this N acetyl Cystiene stuff, making my OCD go away so now im not scared to think of devious plans


LOL.

Are you in fact on NAC now? Working great?


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## Vini Vidi Vici (Jul 4, 2009)

crayzyMed said:


> LOL.
> 
> Are you in fact on NAC now? Working great?


ya man...just bought it today, and only took one 600mg capsule. either i have a placebo effect, or its doing something....but i think its doing something to stop the OCD, because im not as Obsessive about what i write anymore. i have a bit of a headache... but i kinda feel somewhat better i think. ill keep taking 2 or 3 capsules a day and see if it works better and stuff


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> ya man...just bought it today, and only took one 600mg capsule. either i have a placebo effect, or its doing something....but i think its doing something to stop the OCD, because im not as Obsessive about what i write anymore. i have a bit of a headache... but i kinda feel somewhat better i think. ill keep taking 2 or 3 capsules a day and see if it works better and stuff


You definatly allways seem to respond to nmda antagonists no doubt about that. Good luck with it.


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## Vini Vidi Vici (Jul 4, 2009)

yeah i actually feel even better now. So what exactly is NAC? does it lower glutamate, or do something else unrelated .....i really wanna know..


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## RockiNToM (Jun 15, 2009)

Damn junkies.


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## crayzyMed (Nov 2, 2006)

Vini Vidi Vici said:


> yeah i actually feel even better now. So what exactly is NAC? does it lower glutamate, or do something else unrelated .....i really wanna know..


I dunno, it works on glutamate, didnt fulle research it.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> Damn junkies.


In regards to your hallucinations:....you mentioned you were taking other meds to help get through till your Surgery. Ive seen plenty of reports on Tramadol causing hallucinations...dunno why, but might be an effect of its complex NMDA and GABA-A activity. I wonder if any of your other meds could be contributing to hallucinations....it seems like everywhere i go, like all these random meds for anything have a possible side effect of hallucinations.


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## RockiNToM (Jun 15, 2009)

Well, I'm taking an anti-spasmodic and a anti-nausea med, nothing particularly special like tramadol.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> Well, I'm taking an anti-spasmodic and a anti-nausea med, nothing particularly special like tramadol.


well some anti-nausea meds could cause hallucinations...i dunno if these specific meds are widely used for nausea, but any anticholinergic/antihistamine or cannabinoid could cause hallucinations. if u don't mind me asking, what anti-nausea med r u taking?


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## RockiNToM (Jun 15, 2009)

For the record the day I had the tramadol I wasn't taking the anti-nausea med (in fact haven't used it all week) and that med is called Compazine or something.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> For the record the day I had the tramadol I wasn't taking the anti-nausea med (in fact haven't used it all week) and that med is called Compazine or something.


hmm...im merely speculating...but Compazine is actually an Anti-Psychotic. It is not an anti-nausea medicine... its only used for nausea because it has anti-nausea properties. Seriously, its one of the WORST things you could possibly take for nausea. Why not just take a 5ht3 antagonist, or an Anti-histaminergic or Anti-cholinergic med? Mirtazapine would be a better choice, even with its sedating properties!

Antipsychotics have a STRONG potential to cause/worsen depression and anxiety, due to their potent blockage of Dopaminergic activity.

i don't think this is the cause, but possibly, if one had been taking an antipsychotic for an extended period of time, sudden cessation of use could result in psychosis. But i strongly doubt this applies to your case....but anyway...i doubt the compazine is making anything better. its probably making you worse.


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## RockiNToM (Jun 15, 2009)

Actually, you needn't worry. I have already checked about the Compazine. Yes it is an anti-psychotic but only at high doses, compared to what it's used for as an anti-emetic. The dose I take is 3mg which way below the dose use for as an anti-psychotic, and only then it's taken when things get really rough, which is like once a week, if that. It's had no impact on me mentally at all. 

Plus mirtazapine is not recommended to me at all at the moment due to my stomach issues, with me having to be careful what I eat etc. When I was on mirtazapine before it kinda numbed my stomach, meaning I wouldn't know when I was full or what was going etc - and since I have to be tune with what is going on in my stomach I don't think it's a good idea.

On another note, I've found that because I've been taking more tramadol per day (due to more pain) I am not experiencing any more of it's mood boosting effects anymore. The more I take, the more it acts as a pain killer and less as an anti-depressant. If I take 1-2 a day however, it works far better on my mood. So I find it strange that people claim they are getting a high from high doses like 700mg - perhaps they are taking the doses closer together? I have been taking them spread out, every 4 hours as recommended to lessen the likelyhood of a seizure.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> Actually, you needn't worry. I have already checked about the Compazine. Yes it is an anti-psychotic but only at high doses, compared to what it's used for as an anti-emetic. The dose I take is 3mg which way below the dose use for as an anti-psychotic, and only then it's taken when things get really rough, which is like once a week, if that. It's had no impact on me mentally at all.
> 
> Plus mirtazapine is not recommended to me at all at the moment due to my stomach issues, with me having to be careful what I eat etc. When I was on mirtazapine before it kinda numbed my stomach, meaning I wouldn't know when I was full or what was going etc - and since I have to be tune with what is going on in my stomach I don't think it's a good idea.
> 
> On another note, I've found that because I've been taking more tramadol per day (due to more pain) I am not experiencing any more of it's mood boosting effects anymore. The more I take, the more it acts as a pain killer and less as an anti-depressant. If I take 1-2 a day however, it works far better on my mood. So I find it strange that people claim they are getting a high from high doses like 700mg - perhaps they are taking the doses closer together? I have been taking them spread out, every 4 hours as recommended to lessen the likelyhood of a seizure.


awesome dude. i was just worried that u didnt know of the possible side effects, u know, like someone getting injected with Haldol without their consent...lol. but yer on top of it ...word man.

Ya i noticed the same thing on tramadol! ok so i would take 1-2 (50mg) tablets a day when i first started. and it made me feel less depressed and anxious, i would assume that would make a normal person "high". so then the more i escalated my dose, the less mood-lifting effects it had. then when i was taking 6 tablets a day, i was getting nothing....... fast forward about 3 months, to when i was tapering...so im on 3 tablets a day, and im depressed, suicidal, and terribbly anxious. then i taper to 2 tablets. i feel better. then i taper to 1 tablet, split up in 2 halves which i take one in the morning, one at night. I feel BETTER than i ever did taking more tramadol. i was much less despressed and anxious...i was motivated, and it was awesome. ...


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## TheLonelyStoner (Nov 19, 2009)

ive had tramadol before and it makes you so happy. i took them with weed, and it makes you so happy and helps take away my sa


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## Vini Vidi Vici (Jul 4, 2009)

right on, man.


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## RockiNToM (Jun 15, 2009)

Vini Vidi Vici said:


> awesome dude. i was just worried that u didnt know of the possible side effects, u know, like someone getting injected with Haldol without their consent...lol. but yer on top of it ...word man.
> 
> Ya i noticed the same thing on tramadol! ok so i would take 1-2 (50mg) tablets a day when i first started. and it made me feel less depressed and anxious, i would assume that would make a normal person "high". so then the more i escalated my dose, the less mood-lifting effects it had. then when i was taking 6 tablets a day, i was getting nothing....... fast forward about 3 months, to when i was tapering...so im on 3 tablets a day, and im depressed, suicidal, and terribbly anxious. then i taper to 2 tablets. i feel better. then i taper to 1 tablet, split up in 2 halves which i take one in the morning, one at night. I feel BETTER than i ever did taking more tramadol. i was much less despressed and anxious...i was motivated, and it was awesome. ...


It's weird isn't it? I can only thing that the more tramadol you take the more it kinda gives the brain a burn out effect. The effect to me was similar to the burn out, apathy induced effect on Zoloft after first 2 weeks of mood boosting euphoria had worn off. Very bizarre.



rocknroll714 said:


> I'm getting some of this soon to try out.
> 
> Update on tramadol's pharmacology:


That's really interesting rocknroll. No wonder it gives such good effects, if it works on so many areas.

If you are going to be taking it as anti-depressant for the feel good effects, I'd recommend you start off taking 1 a day. Then 2 a day if you want maximum effect. Anymore and you risk feeling nothing or too much at once and risk getting a seizure.


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## UltraShy (Nov 8, 2003)

RockiNToM said:


> But can I just ask, you don't have any problems with your mood no? If your problems don't stem from your mood (I mean from what I've read you only take benzos for anxiety) then of course you're not going to feel a great deal of difference - there is nothing to fix.
> 
> For me it fixed my mood; made me happier, brighter, less negative, more optimistic, which then impacted my anxiety too, for me.


My mood sucks. When I see my psychiatrist on December 2 I damn well better get a prescription for an amphetamine as I'm sick & tired of being sick & tired.

I'm sure there have been people in worse moods than me. Note I used the past tense as it's unlikely they chose to remain in the present tense.

The fact that I don't use antidepressants is not an indication that I'm not depressed, but rather an indication that they don't work for me. (No, I haven't used any MAOI, so I can't comment on them and I'd very much prefer not to take MAOIs.)


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## RockiNToM (Jun 15, 2009)

That sucks dude. I hope you get the amphetamine you need when you see your doc.


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## Vini Vidi Vici (Jul 4, 2009)

rocknroll714 said:


> I'm getting some of this soon to try out.
> 
> Update on tramadol's pharmacology:


Trippy man.....this stuff is sweet. but some advice, that you already know...after taking the first dose (50mg) i experienced nausea and moderate symptoms of a panic attack, which could be expected due to Tramadol's mechanism. However, this feeling goes away, of course, i guess cuz it gets metabolized to O-desmethyl. Like id just be careful when starting it, cuz take too much at first, and youll feel bad.... the first dose i took, i had to take Mirtazapine to counteract the nausea/anxiety. which subsequently decreased the positive opiate dopaminergic effects...lol.... and i read somewhere, that to obtain the highest amounts of the O-desmethyl metabolite, one could dose multiple times with very small doses (10-25mg) of tramadol...and the O-desmethyl would accumulate after multiple doses, since it has a longer half life. there u go....lol i know u already knew all this stuff but anyways.

YES! u edited the wikipedia Tramadol page! (it was you, right?) now Tramadol has the Wiki page it deserves.


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## RockiNToM (Jun 15, 2009)

Yeah my very first dose of tramadol was weird. I felt like I was buzzed up on way too much caffeine, I felt very nauseated and hyper. After that though it gets much better.


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## RockiNToM (Jun 15, 2009)

Guys this stuff aint working anymore. Even at one pill a day it isn't doing much for my mood. I think I've worn my brain out with it all now. What a damn shame!!!


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> Guys this stuff aint working anymore. Even at one pill a day it isn't doing much for my mood. I think I've worn my brain out with it all now. What a damn shame!!!


thats definetly not cool....but when i was up to 6 pills a day, i was getting nothing, i was tolerant. so i stopped (involuntarily, but i still stopped) taking it for 5 days. then i started again, and it worked!! it helped my mood agian, and decreased the pain. the hard part was just those 5 days.


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## meyaj (Sep 5, 2009)

crayzyMed said:


> LOL.
> 
> Are you in fact on NAC now? Working great?


I take 1000mg NAC for my liver and chronic chest congestion. Doesn't do anything for what has been described by my psychiatrist as my OCD symptoms.


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## RockiNToM (Jun 15, 2009)

Vini Vidi Vici said:


> thats definetly not cool....but when i was up to 6 pills a day, i was getting nothing, i was tolerant. so i stopped (involuntarily, but i still stopped) taking it for 5 days. then i started again, and it worked!! it helped my mood agian, and decreased the pain. the hard part was just those 5 days.


I tried what you said. For the last few days I went back down to taking 1 or 2 but at different times from before. I had got to the point of taking 5 a day for pain which was quite ridiculous. But my pain has settled down for the moment now so it's ok for me to drop the doses for a while.

Anyway in doing so, I initially said I wasn't getting any mood improvements anymore, well since leaving (the 1 or 2 pills) till much later in the day (almost like skipping a dose), I had a very strange incredible experience.

I can't really explain what this was other than it definitely felt like I had a major surge in dopamine of some kind - a bit like when you're coming off anti-depressants where for a while at first you feel great coming off them, then the longer you're off them you feel like crap. Well, granted all I was doing was delaying my dose, I can only speculate a miniture withdrawal was going on, but a very pleasant one. I just had this urge to do things, it was very bizarre. I wanted to READ, work, do stuff I hadn't had the motivation to do in a long time. What was even more weird was that I was reading stuff I normally wouldn't understand and it was making perfect sense to me. I was totally zoned into what I was doing - it was fantastic!

So me being sensible, I killed it - I took my dose later on that day. Which you know, was ok, but nothing compared to how I was feeling. Today I feel much better on Tramadol, it almost feels like my brain has had the chance to restock on dopamine. It's now doing the mood altering effect it did in the beginning which is good.

So when I think about all this, could this be a dopamine related incident? It certainly felt so. Which makes me think I definitely do need some improvements in that area, if I want to take the step with my treatment in my SA and depression. Problem is, as you all probably know by now, is I haven't had much luck with a Pdoc or GP who will be willing to put me on a amphetamine of some kind.


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## Vini Vidi Vici (Jul 4, 2009)

RockiNToM said:


> I tried what you said. For the last few days I went back down to taking 1 or 2 but at different times from before. I had got to the point of taking 5 a day for pain which was quite ridiculous. But my pain has settled down for the moment now so it's ok for me to drop the doses for a while.
> 
> Anyway in doing so, I initially said I wasn't getting any mood improvements anymore, well since leaving (the 1 or 2 pills) till much later in the day (almost like skipping a dose), I had a very strange incredible experience.
> 
> ...


dude i think i totally know what you mean. i get those all the time, even when im not on tramadol. like ill always feel depressed, then for no reasons, ill just get this random, sruge of energy, as if im bipolar...it lasts for a while, then ill do something that triggers my OCD, and the surge of energy goes away. but this hasn't happened in a while though.

but like u said with tramadol, i always noticed it was really un-predictable in its effects. depending on when/if i took it, and even sometimes for no reasons that i know of, it would work great, but other times id be just as depressed suicidal as i was when i withdrew from Tramadol.... one thing, is i was taking other meds. maybe, depending on what time i took the other meds, those would have inhibited CYP2D6, so i woudlnt get any beneficial effects from tramadol.... i guess, even if a medication doesnt state it inhibits cyp2d6, it still could. but thats super sweet its working for you again man. Tramadol is awesome *when it works.


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## RockiNToM (Jun 15, 2009)

Vini Vidi Vici said:


> dude i think i totally know what you mean. i get those all the time, even when im not on tramadol. like ill always feel depressed, then for no reasons, ill just get this random, sruge of energy, as if im bipolar...it lasts for a while, then ill do something that triggers my OCD, and the surge of energy goes away. but this hasn't happened in a while though.
> 
> but like u said with tramadol, i always noticed it was really un-predictable in its effects. depending on when/if i took it, and even sometimes for no reasons that i know of, it would work great, but other times id be just as depressed suicidal as i was when i withdrew from Tramadol.... one thing, is i was taking other meds. maybe, depending on what time i took the other meds, those would have inhibited CYP2D6, so i woudlnt get any beneficial effects from tramadol.... i guess, even if a medication doesnt state it inhibits cyp2d6, it still could. but thats super sweet its working for you again man. Tramadol is awesome *when it works.


It's interesting you have also had a similar experience. What boggles the mind is why does it happen?

I want to put the record straight about this as I think I may be giving people the wrong impression. When I am feeling like this, with this dopamine type of high whatever, I do still have social anxiety. I can't emphasize that more, it very much still exists. But what's different is my overall mood, my approach to things, the way I now see things - which as a whole is much more enthusiastic and confident. The problem is, it's not perfect and I don't know how or why it happens. It's happening to me right now again as I type this. I haven't taken any tramadol yet today and already I feel a surge in dopamine going on.

The feeling that I experience, is very reminiscent of a childhood type of feeling and experience of happiness. I always had Social Anxiety, even way back as a child, but I was so much happier and my anxiety never really bothered me, even though it was an every day problem. I believe the problems with my mood (my depression) came later in my teens and threw everything out of balance, like motivation, learning, interests - lots of things. This lasted for quite a few years untreated until one day I said to myself this is not normal and went to a doctor about it. Inevitably the first line of treatment they gave me was CBT, then medications like Propranalol and then finally SSRIs.

I feel that ever since I was put on SSRIs that something changed in my brain. I had a few rough starts with them, Prozac and then Celexa both not working. Later came the Paxil which was the first to lift me out of the big deep whole of my depression and anxiety but it was far from perfect. Sexual dysfunction issues, weight gain - the normal crap that comes with using SSRIs. Then it stopped working and I was put on Zoloft, and then various others. But, when I decided to come off (after being on SSRIs for maybe 3yrs) I never felt quite the same. It felt like I couldn't get happy again and that my brain just fogged over without the aid of serotonin and left me with a depression that was much worse than when I started. This is because I firmly believe, all that serotonin has put my dopamine out of balance - as well as my brain not being used to the shortage of serotonin stimulation since coming off. Therefore, my brain is dealing with 2 problems at once and it's struggling to cope.

I don't know if I ever mentioned this. But for quite a few number of years while feeling 'numb' I would in the evenings drink a couple of beers to try and escape that feeling. It definitely worked, and I felt my creativity, motivation, and general interest in things come back - again being reminiscent of what I had felt before in my childhood. I would never drink to be drunk, only to just feel that stimulation of dopamine again. In the end, I decided it wasn't a very reliable thing to do (relying on alcohol) and stopped doing it. But this is proof that something is not right, and that the lack of dopamine is a definite culprit to a lot of my problems and probably a lot of other people's problems too.

Laters, gonna watch Back To The Future trilogy now.


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