Talk:Tramadol

Better withdrawal info?

I'm not a doctor so don't know what may be available in the medical literature, and wish someone with the resources would look at this. I do not believe the statement that dependence only occurs at high doses and/or after extended periods of time is at all accurate. I took codeine at high doses every day for over a year for severe dental pain (actually, dihydrocodeine DF-118, c. 150-240 mg. per day), withdrew cold turkey, and had no withdrawal symptoms other than cold feet (literally) for a week or so. Fast forward another year and I start getting joint pain in my fingers (and I'm a musician). Can't take NSAIDs b/c I'm on blood thinners and paracetamol is worthless. Take tramadol instead. Take it LESS THAN TWO WEEKS at c. 200 mg a day (100 mg. bid) then stop b/c the pain is better. In 24 hours, I have severe chills and feel like I've come down with a bad flu (not fun in COVID time). Decide to take tramadol to see if it stops the chills ... it does. So a man who had no problems withdrawing from long-term, high dose codeine use becomes dependent on tramadol after two weeks. There are thousands of similar anecdotal reports. Anyone on the medical side who can validate this, please update the section on addiction/dependence. ___HB — Preceding unsigned comment added by 61.15.225.100 (talk) 03:46, 1 November 2020 (UTC)

It's probably dependent on the person. Codeine is incredibly weak for one but I doubt that's the issue. I had no problems with cold turkey withdrawal from O-DSMT (the active, stronger metabolite) after taking around 1g of it in a month. In comparison 15mg of it was as much as I could handle without "nodding" and I always stuck to the same dose. It's roughly 6x stronger supposedly (felt more like 15mg = 4mg hydromorphone to me, whereas tramadol does almost nothing to me, so I may be a poor metabolizer) so it should have been equivalent to about the same dose per day you were on, just lower doses by weight. I had no problems stopping it immediately. Tramadol is much dirtier than its main active metabolite on its own though, hitting GABA receptors, SERT, NET, DAT, and a mess of other crap. I'd expect it to be a sort of mild opioid withdrawl combined with a antidepressant withdrawal (especially if you weren't on them) combined with a mild benzo withdrawal combined with... you get the point. You don't see a receptor activity profile that random / scattershot outside of antipsychotic pages, normally. It usually indicates a really poorly designed dirty drug that just happened to work and managed to get approved.

The antipsychotics tend to be antagonists almost everywhere because a) the doctors have no clue whatsoever what will actually work because of lack of understanding of mental disorders involving hallucination and b) slowing down that much of the brain shuts the crazies up so everybody can just ignore them and pretend like they're ok. Ironically I was given anti-psychotics for sleep once, which is a fairly new and incredibly stupid practice, and found out that they cause me to hallucinate horribly, often for weeks after I stop taking them. Apparently doctors are just now figuring this out. It happens when they give them to people without psychotic disorders, and they usually try to treat the hallucinations with higher doses of stronger anti-psychotics. They also give you parkinsons symptoms that can last forever but that's just part of the magic of mental health care.

OTOH I seem to be immune to addiction from any normal pain relieving doses of opioids too. I think it's probably fairly common, if you don't get obsessed with the drug and it's only acting fairly weakly on MOR and KOR rebound is quick (it's just that people only post their life-wrecking horror story of hitting the needle and blowing businessmen in alleys for $5 to get their next hit). I'm fairly sure people who get addicted to something like vicodin TRY to get addicted to it. Stronger stuff like hydromorphone and fentanyl are a different story obviously. I've only had withdrawal from 8mg daily of buprenorphine for over a month and it was relatively short. — Preceding unsigned comment added by A Shortfall Of Gravitas (talk • contribs) 15:34, 22 May 2023 (UTC)

Mix with Benzos

Why is there no warning about mixing a narcotic with Benzodiazepines?? Or did I miss it?? Lady Meg (talk) 05:26, 27 July 2023 (UTC)

WADA ban

Tramadol will be banned for all international sport by WADA effective January 1, 2024. I don't have time to find the citation for this but should be easy to verify. 207.180.169.36 (talk) 14:25, 16 October 2023 (UTC)

Mechanism of action

Tramadol is a SYNTHETIC opioid analgesic Kenntex (talk) 02:04, 9 November 2023 (UTC)

"Dependence liability": moderate or low?

There have been some edits changing the classification of the "dependence liability" in the drug infobox. I reverted the first, unexplained, edit after cursorily checking the quoted literature, Dunn et al. 2019, and not directly seeing something to back up the change. Now the classification has been changed again. Can someone please point me to the proper section and quote in this paper that the classification should be based on? What I found was: "This review summarized 13 human laboratory studies that empirically examined the abuse potential of tramadol. [...] Overall, the reviewed data provide evidence that tramadol has a risk for abuse, but that its risk is generally lower than most of the opioids to which it was compared." https://pmc.ncbi.nlm.nih.gov/articles/PMC6775208/ Lower is not necessarily low. I suggest that the classification should not be based on this reference at all. Biologos (talk) 14:09, 12 November 2024 (UTC)