Should I tell my PM doctor to take me off Tramadol?

[Kurt Codean]

Hello, I currently see a Pain Management doctor once a month and he gives me scrips for Tylenol 4s, Tramadol, Lexapro and Clonazepam. I've been doing a lot of research on Tramadol over the past few weeks and learned that Tramadol interacts negatively with SSRIs because the SSRI inhibits the CYP2D6 enzyme which metabolizes tramadol into 0-Desmethyltramadol (0-DSMT). O-DSMT retains activity as a Norepinephrine reuptake inhibitor (NRI). The  combination of the NRI and SSRI increases the risk of  Serotonin Syndrome, which can potentially be  fatal. I've been seeing this doctor since July and he wrote me scripts for Tramadol and an SSRI (Originally I was given Celexa but switched to Lexapro two months ago) along with the other medications I mentioned. I've been filling these scripts and taking bot the Tramadol and the SSRI for the past 4 months. I haven't noticed any symptoms of Serotonin Syndrome, and the tramadol has been effective for managing my back pain. In any case I was wondering if I should bring up the risk of Serotonin Syndrome during my next visit and ask him to discontinue my tramadol prescriptions. I want to continue taking the Lexapro and was also thinking about asking him if he can raise the dose from 10mgs to 20 mgs a day. The 10mgs of Lexapro that I've been taking for the past couple of months seem to be working in my opinion. I've been feeling much less depressed during this time period, but I would like to try 20mgs of it per day to see if i can get any greater benefits from the drug. The only thing is if I ask him to stop prescribing me tramadol, i would like to ask him for a different pain reliever, but I am not sure which pain medicine I should ask him for. I was considering asking him for Darvocet. I would like to continue taking the Tylenol 4s but I am not sure if that alone would be enough to manage my pain. Does anyone have any suggestions as to what pain medicine I should ask him for to replace the tramadol? I would be willing to give up the Tylenol 4s if he is willing to write me a script for a medication which is about the same strength as the tramadol and tylenol 4 combination that I've been taking. Any ideas would be highly appreciated. Thank you so much in advance!

CD212

 

[aintnouse]

I would not ask him for Darvocet. There is an interesting article on Webmd regarding the drug and 

its effect on people.  It is no longer used in the Uk and Europe because of  propoxyphene. 

I am not sure what to suggest. I would think there is something out there comparable, but since I am not a Dr. I 

would be hesitant to suggest.

 

[Kurt Codean]

I would not ask him for Darvocet. There is an interesting article on Webmd regarding the drug and 

its effect on people.  It is no longer used in the Uk and Europe because of  propoxyphene. 

I am not sure what to suggest. I would think there is something out there comparable, but since I am not a Dr. I 

would be hesitant to suggest.

Hi thanks for the response. I'm not sure what is wrong with propoxyphene but I think I won't try to ask him for Darvocet, or anything stronger than what he currently gives me. I'm afraid he might get frustrated with me and drop me as a patient if I push him to much. I was already kind of pushing it with him the first time I went there. He asked me what medication I wanted then I said Tylenol w/codeine, Tramadol, celexa and clonazepam. He agreed to give me all that but he stopped when I also asked for Adderral. Also on my second visit I got him to give me t4s instead of t3s, and on my third visit I asked him to up my quantity of t4 from 90 to 120 and he agreed. I wanted him to do the same with the tramadol but he said he didn't want to because it interacts with the Celexa. I was thinking maybe I should just ask him to quit giving me tramadol and instead try to get a script for adderall. I probably won't ask for any changes for a while though because I kind of sense he is annoyed when I ask him to alter my scripts. Take care,

CD212

 

[aintnouse]

I am not sure what is wrong with it either....if you read the article on Webmd regarding 

Darvocet , it said it causes heart problems.   It sounds as if you have a good relationship

with your Doc...so maybe do a little bit of research, find something  comparable, and request it.

I agree with your deciding to wait a bit.....sometimes Docs can have a long memory and a short fuse.  

Best of luck and I enjoy reading your  many posts.

 

[sunset15]

I was under the impression Darvocet was taken off the market, at least here in the US. It causes irregular rhythms in the heart.

I believe taking Tramadol with Lexapro can cause serotonin syndrome and can cause the seizure threshold to be higher.  My spouse is currently on Wellbutrin and was prescribed tramadol and I was pretty upset and would not let them take it. Fortunately, the pharmacist caught it and said not to take it as well.

I quit taking Tramadol in the last couple of weeks. It just made me feel numb, killed my appetite (I know that can be a good thing) but it also made other meds not work for me, so to speak. I had a headache for a week and just feel out of it. Hoping the brain will "reset" shortly.

 

[Kurt Codean]

yeah you are correct sunset15, I just read an article on Webmd that says Darvocet, Darvon was banned in 2010 because of those side effects on the heart you described.  There is a drug though on Starlite called Analvon that contains 32.5mgs of dextropropoxyphene and 325 mgs of paracetamol. So it seems sort of like Darvocet. I'm not sure if propoxyphene and dextropropoxyphene are the same but I think the effective dose of Darvocet had like 100mgs of propoxyphene. 

My doctor prescribed me celexa and tramadol and when I went to the pharmacy they wouldn't fill them because they said there was an interaction and they had to call my doctor and talk to him before they could fill them. They tried to call that day but couldn't get a hold of him so they told me to come back in a couple of days, which I did and at that time they filled the scripts. So I guess they must of spoke to the Doctor and he okayed it or something.  I was going to try talking to my doctor about taking the tramadol away and getting something else but he was pretty busy and when he called me he asked if I just needed refills so I said yeah because I wanted to get out of there. 

I am not sure what is wrong with it either....if you read the article on Webmd regarding 

Darvocet , it said it causes heart problems.   It sounds as if you have a good relationship

with your Doc...so maybe do a little bit of research, find something  comparable, and request it.

I agree with your deciding to wait a bit.....sometimes Docs can have a long memory and a short fuse.  

Best of luck and I enjoy reading your  many posts.

Yeah I just read that article. Thanks for pointing that out. Also the drug was banned in 2010 so it's not even an option anymore lol. but like I was saying in the post above I saw something on Starlite called Analvon that seems to contain similar ingredients to what was in Darvocet, but I think at a much lower dosage. 

Thanks for the compliment on my posts /default_smile.png , I'm glad someone likes what I write here. I didn't think anyone really payed much attention to them though. 

 

[Guest]

@Kurt Codean

Hello Kurt,

How many MGs of Tramadol are you on daily? I would not go up on your SSRI without your doctor's approval.

I want to continue taking the Lexapro and was also thinking about asking him if he can raise the dose from 10mgs to 20 mgs a day. The 10mgs of Lexapro that I've been taking for the past couple of months seem to be working in my opinion. I've been feeling much less depressed during this time period,

@Kurt Codean
 

To be quite frank with you, I think you're experiencing something called "tram boost" among Tramadol users/abusers (I'm not saying you're the latter!!!), I would just taper off Tramadol, very-very slowly (Tramadol WDs are a bitch...  ) And with your own words, Tramadol interferes SSRIs (and mostly SSNRS), especially if the anti-depressants are high dosage (SSNI=20-40g+) (SNRI=225-300mg, like Effexor). It's either/or. If you leave Tramadol behind and let your Celexa work on 20mgs for a month or two, I think that's a good way to find out if it really works. Unfortunately Tramadol has very significant antidepressant properties, very similar to SNRIs. Well good luck, and keep us updated!

 

[US Army Veteran]

Tramadol can give you seizures alone. Take it with an SSRI you're at a greater risk for seizure. I've been on it before and have had seizures w that combo you are and even had  seizures when I was only taking tramadol.