I've Been Weaning Down My Tramadol (ultram), Perhaps This Is Contributing To All Of The Anxiety / Panic ???

[Guest GaryRN]

I have been on just 50mg twice/day for about a year now. It was prescribed for body aches related to the Lyme. I no longer have these aches, so I decided to come down off of this drug and eliminate a drug from the regimen.

I dropped it to just 50mg/day and perhaps that is what is causing all of this additional anxiety and panic.

Ultram is not a narcotic and it does bind to the mu opioid receptors in the brain, so perhaps this is some kind of withdrawal. My resting HR has been way up lately at around 100-110 and 150 while standing. Amazingly, my BP is 110/70 sitting and goes way up to 140's/90's while standing. What is up with that ?

Ultram also has a low affinity for Serotonin and Norepinephrine uptake, so perhaps there is some cause / effect there as well. Any thoughts ?

Gary

[janiedelite]

I pulled some info about ultram withdrawal off the first site that came up:

Withdrawal

Withdrawal symptoms may occur if ULTRAM? is discontinued abruptly. (See Drug Abuse And Dependence.) These symptoms may include: anxiety, sweating, insomnia, rigors, pain,nausea, tremors, diarrhea, upper respiratory symptoms, piloerection,and rarely hallucinations.Other symptoms that have been seen less frequently with ULTRAM discontinuation include: panic attacks, severe anxiety, and paresthesias. Clinical experience suggests that withdrawal symptoms may be avoided by tapering ULTRAM at the time of discontinuation.

Physical Dependence and Abuse

ULTRAM? may induce psychic and physical dependence of the morphine-type (u-opioid) (see Drug Abuse And Dependence).

When my hubby's doc prescribed Ultram after his car accident, the doc said he wouldn't experience narcotic dependence because even though part of the drug does act like an opioid, part of the drug is also an opioid antagonist (like nubain). That was all fine until he had to wean off his 50mg twice a day. Then he had terrible withdrawal.

Due to the accident, I severely injured my hip and had a couple surgeries. I took quite a bit of oxycodone after the first surgery and went through withdrawal... nausea, cramps, diarrhea, panic/surges of anxiety, pain all over, cold sweats... Just like what my hubby experienced. It took over 2 weeks for the worst of the withdrawal to be over and I only took oxy for a couple weeks (but I'd taken 1-2 vicodin a day for several months prior to the surgery). It was really horrible. As I mentioned before, nortriptyline helped my hubby out of the worst of his withdrawal symptoms. I've needed narcotics off and on for my neuropathy/POTS pain and during some flares I've had to take them pretty regularly. Lately though, when I stop taking the meds I don't really notice withdrawal much, partly because I really try to not take it regularly but also because when my POTS is flared I feel quite similarly to going thru withdrawal.

I'm sorry you have to go through all this, and I hope I didn't overstep my bounds...

[janiedelite]

I just thought of something I should have thought of earlier... could you go back on your original ultram dose for a few days? If your symptoms lessen, then you'll know...

[Guest GaryRN]

I just thought of something I should have thought of earlier... could you go back on your original ultram dose for a few days? If your symptoms lessen, then you'll know...

Funny you mention that as I took 50mg this morning, which is 25mg more than I have been taking and will take 25mg before bed, which is closer to what I was taking total for the day less 25mg, i.e I was taking 50mg 2x/day, now 50 in the morning and 25 at night, which will be 50mg higher but 25mg less than what I was originally taking.

With that said, I will know if that is the culprit I would guess by sometime tomorrow or by the latest monday. It takes 2-3 days to reach peak plasma concentrations with this drug.

So, if that works, than I will knock off 12.5 from the morning dose for a week or so and go down gradually instead of how quickly I did.

Thanks for you second thought though. My anxiety is nowhere near as bad today as it was yesterday, so I'm now thinking this was the cause. Can't believe some of this stuff.... I wish I never had to take another pill in my life.

Gary

[firewatcher]

Gary, I know it is not the same drug, but when I weaned off Klonopin for my ANS testing, I did it super slow. I still had withdrawal symptoms. I think with our hyper-responsive nervous systems we are far more sensitive to meds that effect it than most. Once the chemical is removed, we overcompensate and worsen. I took six weeks to come off .5mg a day (which truly is a tiny dose!) Good luck!

[Guest GaryRN]

Gary, I know it is not the same drug, but when I weaned off Klonopin for my ANS testing, I did it super slow. I still had withdrawal symptoms. I think with our hyper-responsive nervous systems we are far more sensitive to meds that effect it than most. Once the chemical is removed, we overcompensate and worsen. I took six weeks to come off .5mg a day (which truly is a tiny dose!) Good luck!

Yes, I agree. Since all this began with me which has been 2 years now, I have been hypersensitive to meds both going on and coming off.

I can't tolerate SSRI's at all period... I tried every one on the market, and that goes for Tricyclics too.

Coming off meds has always been difficult for me and landed me in ER's. I had this condition I would get called Akathisia. Google it, as it is absolutely terrible and I would get it even with slow tapers that a normal person could handle.

Very interesting that POTS screws with these neurotransmitters.

Gary

[mjan]

See? I thought it was some kind of withdrawal.. ALL meds have the potential even if not physically addicting.. its called DISCONTINUATION SYNDROME.. and its REAL. I have seen this with people who stop their SSRIs even and get so depressed they feel suicidal!!! Ultram and Tramadol CAN have serious effects when trying to quit.

So SLOWLY very very..S L O W L Y...my dear RN. Or like I said an addictionologist is an expert at this stuff.

Glad its improving at least and now you know

Jan

[ramakentesh]

LOL. yeah we saw a guy who stopped his ssri abruptly in emergency and it was not a pretty site - he had neurological symptoms so bad that they thought he had had a stroke.

[morgan617]

I think it's very common for us to have problems titrating up or down on most drugs. My doctor gets this fully, but many don't. And I don't require nearly as much as normal people. I absolutely despise going to an ER because they will typically make me worse by not listening to me about this, and then when I react to the meds, they say I'm "anxious."

If it says cut it by half, I cut it by a tenth or the same with going up. it's not like I'm in some big hurry anyway. My son had absolutely the worst time getting off effexor and he has never had trouble stopping meds before. it broke my heart to watch it and he had only been on it a month. So, I just do everything ten times slower than I'm told to.

I hope you are feeling better gary, nothing like constant adrenaline rushes to push you over the edge...morgan

[ramakentesh]

http://journal.shouxi.net/html/qikan/jcyxy...816_350768.html

[Guest GaryRN]

Well, it does appear the Tramadol is the culprit. I increased my dose yesterday in the morning and added back in the pm dose, just lower than I had been taking. I woke up somewhat shaky, but not as bad as I had been. I took 50mg and with about an hour, the shakiness began to resolve. Thank God is all I can say........ I didn't know how much more I could take of that torture. I've been reading and some of the reading suggests that coming off this particular drug is worse than coming off Oxycontin or Percocet. I don't understand how this could be, but it is in many articles I have found. I guess having POTS makes it even more difficult, so I will get myself back to a dose that doesn't cause symptoms and wean over the next few months or longer. I'm in no rush as the POTS keeps me on disability.

I know one thing, and this I don't need any more stress in my life than this illness has caused. I guess it's pace not race !

Thanks to everyone for your input and support. It's tough to go through any of this alone. It's ironic because I have a good grip on the neuro Lyme and I don't post much on Lymenet these days and find myself posting here now. This tells me the POTS is affecting my life more than the neuro Lyme.

On top of that, my wife is the most UNSUPPORTIVE person I have ever met and as a result, I will part from her once my house is sold. It's very sad as my kids suffer in the end, but I can't live with someone who vowed to stick it out with me for better or for worse.

I usually have my father take me to my MD appts. as I have seen my wifes attitude in all of this. Well, the one time he was out of town, I asked her to take me down to Hopkins for one of my appointments. I was very weak in my legs at the time and told her I would need a wheelchair to get from the parking garage to the outpatient center. I got in the wheelchair and she walked 30 paces in front of me as if she didn't know me. I was able to wheel myself into the building and I just didn't talk to her during the appointment, but when we got back in the car to leave, I asked her why she acted as she did. She told me she was embarrassed and that I wasn't a quadraplegic, therefor I should have been able to wheel myself. I told her we were at a freaking hospital where many were in wheelchairs and just didn't understand how she could have this attitude towards my illness. This is what I've been living with, and she sleeps on the couch every night and won't talk to me unless she needs something.

I will be much better even if I need to hire a Nannny to help with my kids once I get out of this living situation. For those of you that have spousal support, be glad and know that your spouse really loves you.

Gary

[Rene S.]

Well, it does appear the Tramadol is the culprit. I increased my dose yesterday in the morning and added back in the pm dose, just lower than I had been taking. I woke up somewhat shaky, but not as bad as I had been. I took 50mg and with about an hour, the shakiness began to resolve. Thank God is all I can say........ I didn't know how much more I could take of that torture. I've been reading and some of the reading suggests that coming off this particular drug is worse than coming off Oxycontin or Percocet. I don't understand how this could be, but it is in many articles I have found. I guess having POTS makes it even more difficult, so I will get myself back to a dose that doesn't cause symptoms and wean over the next few months or longer. I'm in no rush as the POTS keeps me on disability.

I know one thing, and this I don't need any more stress in my life than this illness has caused. I guess it's pace not race !

Thanks to everyone for your input and support. It's tough to go through any of this alone. It's ironic because I have a good grip on the neuro Lyme and I don't post much on Lymenet these days and find myself posting here now. This tells me the POTS is affecting my life more than the neuro Lyme.

On top of that, my wife is the most UNSUPPORTIVE person I have ever met and as a result, I will part from her once my house is sold. It's very sad as my kids suffer in the end, but I can't live with someone who vowed to stick it out with me for better or for worse.

I usually have my father take me to my MD appts. as I have seen my wifes attitude in all of this. Well, the one time he was out of town, I asked her to take me down to Hopkins for one of my appointments. I was very weak in my legs at the time and told her I would need a wheelchair to get from the parking garage to the outpatient center. I got in the wheelchair and she walked 30 paces in front of me as if she didn't know me. I was able to wheel myself into the building and I just didn't talk to her during the appointment, but when we got back in the car to leave, I asked her why she acted as she did. She told me she was embarrassed and that I wasn't a quadraplegic, therefor I should have been able to wheel myself. I told her we were at a freaking hospital where many were in wheelchairs and just didn't understand how she could have this attitude towards my illness. This is what I've been living with, and she sleeps on the couch every night and won't talk to me unless she needs something.

I will be much better even if I need to hire a Nannny to help with my kids once I get out of this living situation. For those of you that have spousal support, be glad and know that your spouse really loves you.

Gary

Gary, my heart aches for you. I know all too well the lack of spousal support. I was diagnosed 9 years ago with fibro/cfs (now this lovely dsyautonomia). I was happily married (although I thought!) and once I was diagnosed with the fibro, everything seemed to change. My husband (now ex) became less and less involved with me. Never believed that I was "ill". Resented me and the way my life so drastically changed. 3 year ago, on our 22nd wedding anniversary, he announced he wanted a divorce! broke my heart. We were together since the age of 15. Whatever did happen to better or worse?

My kids are grown but I have no support from anyone. My ex (as of last year) is now remarrying someone he worked with and she's younger. Still you would think he would call once in awhile email, etc to find out how I'm doing? There are days now that are so bad that I don't leave the house. I barely drive anymore and have lost so much weight that I can barely function. Glad my ex can't see me now. he would bolt for the door! Yet if the shoe were on the other foot, I would have stuck by him through thick or thin.

I'm sorry that your wife is treating you so poorly. Those on the board are indeed lucky to have supportive spouses. It's awful doing this alone.

I wish you the best and glad your anxiety is better today. If only I could get mine under control. After 1 week on the Zoloft I just couldn't deal with it anymore. And in the past I was always fine with it. Go figure.

Take care

Rene

[janiedelite]

Hi Gary,

I'm glad you figured out the culprit. It really stinks that you have to go through all the physical trauma of Lyme and POTS while having so little support. I hope you can get off the Ultram safely, and I'm glad you don't need it anymore for the pains you were having last year. Janie

[morgan617]

Glad you figured out the culprit. I have thought at times maybe I should wean off stuff, then wondered, why? If it helps, it's pretty much the least of my problems. Is there a particular reason you want to wean off, do you feel you don't need it, or are you worried about dependence? I think many of us struggle with the stigma of certain drugs, but man, I say if it helps, why stop it, there are so few things that do!

As far as your wife, I am really sorry. I am one of the lucky ones and I thank God every day. My hubby has stuck by me and I have a very supportive son. I think people who have maintained really good health all their lives may have a harder time with this than people who have had a lingering illness, or anxiety or whatever. My son actually understands more about my illness and I think it's because he's been sick almost his whole life. So, although my husband is very supportive ( he bought me a chair and made me use it, I was the resistant one, till I realized it was hurting him too) I'm not sure he gets it, he just gets that I'm really sick.

Many people on this forum have been in your position and it breaks my heart. And as a nurse, I'm sure you it saw it in your jobs. I'm not sure what kind of nursing you did, but I saw non supportive families all the time in hospital patients and in clinics. It is very sad. And in the long run, I believe many people regret the way they have acted.

I took a joke to my doctor a couple weeks ago. It was a guy on cloud in heaven, on the phone. The caption was, "hey doc, remember me, the hypochondriac? Guess where I am?" It made him laugh, but he said unfotunately it's not all that funny. Nope, it's not. morgan

[nantynannie]

Hi Gary,

Not sure if this helps at this point, but cutting down on Tramadol (even slowly) definately causes withdrawal symptoms, anxiety being one of them. It can also cause shaking and sweating as well as nausea and trapdoor. Even after I stopped all together after slowly taking the dose down, I had anxiety for a few weeks as my body got used to not having the drug. Good luck.

Ann