It all depends on why you are in pain. In my experience narcotics work on mechanical pain and the anti depressants work on nerve pain.

That sounds like a lot of tramadol and if it isn't working its time to talk to your doc. Only the two of you can decide what is best for you.

Hope you can find some relief. You might also want to go back to some of the basics like heat and cold. The oldies are goodies.

I take tramadol two 50mg pills when I need them every four hours but usually just two and never more in that 24hr period....I was given vicodin when I fell and hurt my knee more at the ER and when I was last at the MD othorpedic I asked for more which he gave me 30...I take just one of those and usually only once in great while when knee is bad...I do not usually mix tramadol and vicodin but I will mix both together with either alieve of PM Advil....

I would allow the doctor to decide the meds...I never ask for anything because I am an addict in recovery and tell the doctors that....at the orthopedist once when I told him that he asked me so you want me to give you oxycotin?

I said I am not the doctor and you are the guy who makes decisions like that I do not....and I got the med renewed that I was already on at that point....I was angry but thought my response was totally 200% right on the money when he went that way on me....

I do not know if this was helpful or not....reading some things here or should I say scanning some things given to me here about Tramadol I got a little scared about it too....maybe someone can explain more about the bad side of tramadol to you that I am just remembering parts of and could not explain well enough to you to give good information but people told me some pretty wild side stuff to Tramadol

hugs bill

15 months ago I was taking 4mg hydromorpone every four hrs, then every 6 hrs. Then I took hydromorphone 2mg every 6 hrs for about three months. Then I stepped down to Percocet 10mg every 6 hrs where I remain. About 8 mos. ago I tried to step down to Vicodin but they did absolutely nothing to stop the pain. Most days the Percocet works. I try to work with my Dr. to find the lowest level pain medication that works.

Hi Ian,
You're taking a lot of tramadol! You are prime for side effects like seizures. It may well be the time for you to ask for something else.

If you go on Cymbalta, you'll have to stop the tramadol, because of a high chance of serotonin syndrome. Most docs won't write for Cymbalta if you're on tramadol.

I was on Cymbalta for a long while and it really helped my depression and also helped with the pain. It can be very effective.

I think you might benefit from a long-acting narcotic, like OxyContin or Opana. This way you won't have the ups and downs of short acting drugs.

And if you stop the tramadol, be sure to wean it off slowly. I went through 3 days of hell when I stopped it cold-turkey. It's ugly. Especially if you've been on it for a while and at a higher dose.

I hope this helps!
Sandy

hey i take it be careful drugs like Zoloft cancel Tramadol . its really good i take three hundred mg a day i think Tramadol each day . they added gabapintin and flexrail three times a day .
searguil for sleep minnie

One of the strongest is Fentanyl, but it is narcotic like most of the strong ones. It comes in a 3 day patch.

Clancy

I took Tramadol for 11 years for my fibromyalgia pain and it helped a great deal. Originally I'd take 3-4 50mg pills per day, but slowly dropped down to 2 per day because it kept me awake if I took it later in the day. I stopped it cold turkey earlier this year to switch to Cymbalta which has worked even better than the Tramadol. On either one though, you have to be careful for any meds that have SSRI or SNRI qualities (typical anti-deppresants, Savella, Zomig, etc.) due to Serotonin Syndrome.

Currently your at the max daily amount of one of the most dangerous and addicting pain meds there is. Ultram (Tramadol) is also one of the most difficult drugs to detox off of. Also Tramadol has an anti-depressant quality built in so you can't take Cymbalta with it without risking Serotonin Syndrome which can be deadly. Also Tramadol is not a long acting pain med so you don't get constant full coverage pain coverage with it.

The type of pain you mention in your profile seems to be all nerve and arthritic pain. There are many "strong" pain meds as you put it but trying to plan your next one while still getting relief from one is a little, well, off-putting...most Dr.'s won't think to well of it.

For nerve pain Cymbalta, Lyrica, Neurontin, Neuroveen are all in the top lines of defense currently. But as mentioned before they are technically psych meds so they cannot be taken in conjunction with Tramadol. Good pain meds for Arthritis are strong dose NSAID's and depending how far advanced the arthritis is they can be paired with a low dose long acting narcotic.

Dr.'s over there in Australia tends to do things a bit different than Dr.'s here in the States do, so things that we suggest might not do you any good.

Just please be very careful mixing any off-label psych meds used to treat nerve pain with Tramadol...Serotonin Syndrome is no joke, I've almost died from it, and know if 1 other person on this board who also almost died from it, and 2 others on this board who've suffered from it. If your not seeing a Board Certified Pain Specialist, most family Dr.'s don't know that Tramadol has an anti-depressant property which adds to and effects Serotonin use.

Take care and good luck.

Kat

Hi aussie

I don't blame you for thinking ahead... your doc may even think that you are being proactive with your own care. You said you are looking for something possibly less addictive AND are willing to try a antidepressant? That just shows how open you are to different treatments...docs like that in a patient. lol...

I would say almost every time I took something new - whatever it was- I would wonder IF ...it was going to work, how well and what was going to be my next step- I had to be prepared and ( in a way) think two steps ahead -- when a person is in PAIN -- serious pain-- OF course they are concerned about "whats next" even when things were going well - you want it to stay that way...

I think the Cymbalta idea is a good one. IF... that one isn't right for you ( sometimes the first one or two you try aren't compatible) maybe ask your doc to try some others -- if you hit on the right one- it can do wonders!

Good luck!

Hi Aussie,
I've never taken Tramadol (Ultram), but I know people who do. Everyone is different as far as when the effectiveness will wear off. As you probably know, it is a natural physiological process when our bodies become dependent....NOT addicted. It just normally occurs...so I don't think it is a bad idea to be already thinking of the next step.

That said, I'm not so sure you should bring up a specific med to your doctor...especially if you are still getting relief from Tramadol. Doctors tend to see that as a "red flag" for addiction or diversion. I am not saying that's what your intentions are at all....just saying that's how the medical profession looks at it. But you do say you want something "less addictive". Personally, I think Tramadol is one of the least addictive painkillers. But of course, everyone is different.

I have been taking Cymbalta for a year now and I think it is very helpful. It has helped with depression and my mental outlook of the pain. But I don't think you can take it along with Tramadol.

I hope you continue to get along well with whatever you take.

Take care,
Lori

you are taking the time released Tramadol. you need to get the other tramadol . I take 100 mg 4 times aday and it pretty well keeps me pain free all day....

Whenever I hear the word Cymbalta, I get a little panicky. I've heard a lot of bad things about it, but that is only what I have heard. My friend was on it and was going to just stop taking it and the doctor nearly screamed at her and said no, it must be done very slowly. So that is what I know about Cymbalta. I don't know about Tramadol. I hope you find something that works. The best thing to do is talk with your doctor about how bad your pain is. All pain medications are hard to come off of because they are narcotics. That's the bad news. Sorry....Hugs..

I wouldn't listen to everyone else's advice about 200 mg being too much. In the UK, you can take up to 400 mg a day. I used to take Tramadol at 400 mg a day with no problems at all. The next notch up from Tramadol is probably Morphine. I hope this helps.

Actually Morphine would be a really big notch up from Tramadol...usually after one stops using Tramadol then the Hydrocodones and Oxycodones in Short Acting forms are tried, going through all of the various tiers in each pharmaceutical category, i.e. Lortab, Norco, Vicoden, then Percocet.... or so is how it's normally done here in the states.

Ultram time release you can only have 200 mg a day . the reg tramadol you can only take total of 400 mg in a 24hr period. 2 different pain medications..