When the cure is worse....
February 27, 2008 6:31 AM   Subscribe

How to wean off of tramadol?

I have been taking 400mg/day for 3 months for serious neck/ spine problems and I think I've developed a tolerance and I think it's messing with my health in other ways. I can tell that abruptly stopping is going to be hideous and possibly dangerous b/c even when I step down 50mg I feel as though my BP is through the roof.

I am definitely go to see a doctor about this- but I would be grateful if anyone could share what worked/ didn't work for them...

This really really sucks.
posted by ohdeanna to Health & Fitness (7 answers total)
Nasty, I have occasional low doses for back pain, the first time off them I had problems sleeping, quite frequent pooing and was pretty irritable with people for no good reason. You could try being away from people if you're going to be the same. NB: I was on some other stuff at the same time so some of this might be down to that.
posted by biffa at 6:38 AM on February 27, 2008

The best advice I've always gotten about weaning off drugs came from the pharmacist, not the doctor, if you have a good pharmacist. Not to say don't ask the doctor, certainly you should, but I'd ask the pharmacist for a second opinion as well.
I've also had the best luck by weaning off until the symptoms get unlivable, then taking one extra pill in there someplace to knock the edge off, and going back to the schedule.
posted by unrepentanthippie at 7:05 AM on February 27, 2008

Tramadol is a nightmare to come off of in my experience- just to warn you. They gave it to me a few years ago for a broken rib and I just abruptly stopped after a month and it was...not pretty. Your doctor will certainly tell you this but make sure you drop down as gradually as you can. One weird thing I discovered- take Immodium. I have no idea why this helps with withdrawal, but it does, a bit.
When you're talking to your doctor, you might want to ask if he/she would give you a couple of Ativan or something similar to take for a couple of days once you're completely off the tramadol- that might help you get through some of the nastier physical symptoms. Good luck.
posted by Dormant Gorilla at 7:18 AM on February 27, 2008

I came off a 320mg/day oxycodone habit over four days in a detox unit with Buprenorphine (aka, Subutex, Suboxone). It sucked pretty horribly (there's really no way it won't) but was no where near what cold turkey would have been like. There are doctors that will privately prescribe it and spare you the detox trip if you don't feel you need it, but it will be pricey. Maybe your doctor could refer you somewhere if he or she feels it's an appropriate medication considering your other health concerns.
posted by The Straightener at 8:35 AM on February 27, 2008

Immodium helps because it's an opiate, although not one that crosses the blood-brain barrier. I didn't think tramadol would be as similar as opiates, but sounds like it is.

For blood pressure, get the Clonidine patch. When my boyfriend was getting off Fentanyl the doc gave him that.
posted by herbaliser at 11:19 AM on February 27, 2008

heyho gives excellent advice. And I'd talk to a pain specialist. They ought to know exactly what's going on chemically and should be best qualified to help.

But yeah, it won't be fun. You know how when you wake up in the middle of the night and have to go to the bathroom, and you go in there and turn the light on, and it hurts like hell? That's what's going to go on with your pain/numb system. Normal will hurt for a while, but it will go away pretty quickly.
posted by gjc at 11:28 PM on February 27, 2008

Response by poster: I'd like to mark all of you as best answer. Thank you.

heyho: extra thanks for your thoughtful response.

gjc: your pain specialist idea is a very good one.

I am pretty freaked out- not so much about the discomfort I know I'm facing, but about whether or not I am at risk for any real complications. I normally have lowish- to average healthy BP- I'm so afraid of having a stroke or something when I come off of this!!

Someone mentioned clonidine/ catapres... I'll look into that as well...
posted by ohdeanna at 5:35 AM on February 28, 2008

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