Health Organization for Pudendal Education

calluna wrote: He tells me that I am 'seriously addicted to tramadol', as I've been taking it now for 16 months. He said that at some point I'm going to have to wean myself off it, and that that will be very difficult because I will very likely get pain as part of the withdrawal symptoms, so it will be very difficult for me

That is nonsense. I took Tramadol for years and it helped me tremendously. I kept my job thanks to Tramadol. It then stopped working after 2+ years so I had to stop. I did encounter withdrawal symptoms so I went back on it and slowly cut back 1/4 tablet every 3 or 4 days. When I was down to 1/4 (12.5mg) a tablet per day, I just stopped and took for 3 days valium and I was completely fine.

I understand that there are Tramadol addicts that take 20-30 tablets per day. That may be a different story.

I also would like to say that I did not benefit from the tramadol extended release. My pain was manageable in the morning and unbearable starting around noon. So by taking the regular strength tramadol around 11 AM I could prevent my afternoon flare.
With the extended release tramadol, the delivery around the clock was just too small to have any effect.
Everybody is different but don't discard using just plain tramadol. It works better in some situations than the extended release.

Totally agree, we are all different and what helps one may not help another. For me, tramadol SR takes the edge off, for me that is a valuable help. I am now moving to stop taking it though, at the end of this year I will have been taking it for 18 months, time for a change I think.

The pain clinic are helping me - taking the nortriptyline dosage up first, and will be restarting gabapentin, then taking the tramadol down slowly. I still hope that the nerve is going to heal and that this pain will just go away. They say 1 - 2 yrs for nerves to heal, don't they.

I got a clue that when I get off the stuff I will have to wean; I had a sinus infection this last week and was taking so much stuff I just quit taking the tramadol for a day or two because I was like, "I'm not even sure this is helping me, why take one more thing?" Well it was hard to tell if I had withdrawl as i was also sick, but I woke up the next morning feeling so low-energy I felt like I would never get well; I also had chills although no fever and just generally felt like crap - no specific symptoms but just felt much sicker than I should have from a sinus cold without a fever. I started wondering if any of it was related to my stopping the tramadol, so I started taking it again and lo and behold, I felt way better by the middle of the day. So in December when I try to get off the stuff for good, I am definitely going to WEAN off. I'll get back on if my PN symptoms increase, but I have a pretty strong suspicion that it is no longer helping me and I am just taking it to avoid withdrawl.

When I stopped suddenly, I did experience withdrawal symptoms such as itchy back skin, headaches, and flu like feeling. I then went back on it and by gradually decreasing my dosage, in 2 weeks I was done with it without any adverse effect.
I heard that if you are an ex-substance abuser, it is tough. It is not my case.

I've heard that it is unpredictable. And no, I'm not an ex substance abuser either.

When I sort of stopped it earlier in this thread - I only stopped it for a day or so - I didn't notice any strange effects, but of course the pain was back full blast. This time I am going to try an increased dose of nortriptyline and also restarting gabapentin. Last time I was taking the dosage up slowly as my GP had said, the consultant said stop messing around and took the dose right up over a week, I could not cope with the side effects. This time round we are sticking with the slow increases and hopefully the side effects will settle.

I thought I would just add to this thread - I have now stopped tramadol completely. I took the dose down gradually, it has taken me 14 days to go from 300mg of tramadol SR down to zero. I've had no problems at all.

The pain is up, of course, but I am managing, and I hope that the gabapentin will deal with it when I get it up to an effective dose.

I am glad that you now know that you were never seriously addicted to tramadol, silly GP. As if you didn't have enough to cope with before this daft remark.
I would love something to replace my Tramadol, I get SO constipated with it so have a love hate relationship with the stuff. I have also stopped it and suffered no repercussions other than paying with more pain. I do LOVE my gabapentin tho' I hope that you learn to cope with it and it helps you too. The 'gross stupidity' and 'zombie' effects do dissapate after a while, just 'stupid' now . I have heard that cymbalta is also effective for nerve pain and as an anti depressant can be taken along side some other medication.
I did stop taking Gabapentin after my recent piriformis injection as I wanted to be able to tell just how well it had worked, but did suffer side effects, flu like symptoms and massive sweats. Just though I had the flu but had no temperature, anyway back on them again and all is well. Now I wonder am I still menopausal or is it just a late gabapentin tablet ? ? I will, as I am sure everyone else will echo, be glad to be rid of all medication eventually but I am so glad to have them now.
Take care,
Helen

I will have great satisfaction in saying that I am completely off the tramadol when I next go in to see the GP. I am going to keep it in the sidelines, as it were - I do tolerate it very well and have no side effects, not even constipation. In the meantime I am going to take none at all, for a couple of weeks. The pain is right up, I am managing but it is hard work.

The gabapentin - I am only up to 900mg a day, taking it up by 300mg a week. After I increase the dose I am knocked out for three days, very sleepy and can't find the right words to say what I want, and trouble spelling, and keep waking up and not knowing where I am. Also I keep feeling ill - looking in the leaflet it says more than 10% - dizziness, drowsiness, fever, tiredness, viral infections, difficulty thinking..... yes to all those. It does ease off as the days go past, I had intended to hold at this dose for a couple of weeks to see if it all subsided completely, but the pain is making me reconsider. (Menopause is all over and done with here! )

The nortriptyline is helping a bit, I know, but if I take it any higher then I get the palpitations and rapid heart rate again. Most annoying. So am holding at 25mg daily.

Cymbalta - that's duloxetine, yes? I see it is still black triangle rated. Its been quite a while now, I wonder why they haven't taken it off the list yet.

The piriformis injection was with Dr Greenslade, wasn't it? How did it go, and are you feeling any improvement?

Calluna,

How did you do getting off tramadol? I am doing it right now: I gave myself 3 weeks to wean and it will take the entire 3 weeks. I am down to two half pills (half in a.m., half in p.m) daily from 4 whole pills per day, but when I got a little over enthusiastic and cut out my night dose entirely before going from 1 to 1/2, I woke up after 21 hours of no tramadol with chills and puking.

Did you decide to quit the tramadol because you think what you are experiencing is "rebound pain" that will settle over time once you are off it awhile? I am having trouble understanding why you decided to get off something that seems to have been helping you to be pain free. I am confirming for myself in coming off the tramadol that it never really did much for me at all; I feel almost the same. My goal is to actually add another med once I have subtracted this one (I have never found an antidepressant I did not have to give up due to side effects and want to try nortriptyline), with the ultimate goal of finding a med that is a good enough substitute for neurontin, that I can ditch the neurontin and get my mental capacity back. But to get off a med that was working for you and then just live with more pain indefinitely I believe is not a good idea as pain self-perpetuates (puts you into a "pain cycle").