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TRAMADOL FOR CHRONIC PAIN AND WITHDRAWAL EFFECTS WHEN COMING OFF IT…

Tramadol, sold under the brand name Ultram among others, is an opioid pain medication used to treat moderate to moderately severe pain. When taken by mouth in an immediate-release formulation, the onset of pain relief usually begins within an hour. It is also available by injection. Wikipedia

Side effects include constipation, itchiness, dizziness and nausea to name a few. It was patented in 1963 and launched under the name “Tramal” in 1977 by the West German pharmaceutical company Grünenthal GmbH. In the mid-1990s, it was approved in the United Kingdom and the United States.

On the NHS website they say that it works by blocking pain signals from travelling along the nerves to the brain. It’s possible to become addicted to tramadol, but this is rare if you’re taking it to relieve pain and your doctor is reviewing your treatment regularly. It’s best not to drink alcohol with Tramadol as you’re more likely to get side effects like feeling sleepy.

Tramadol comes as:

  • fast-acting tablets – these contain 50mg of tramadol
  • slow-acting tablets – these contain 50mg, 75mg, 100mg, 150mg, 200mg, 300mg or 400mg of tramadol
  • fast-acting capsules – these contain 50mg of tramadol
  • slow-acting capsules – these contain 50mg, 100mg, 150mg or 200mg of tramadol
  • drops that you swallow – these contain 100mg of tramadol in 1ml of liquid
  • an injection (usually given in hospital)
  • soluble tablets – these contain 50mg of tramadol
  • tablets that dissolve in the mouth – these contain 50mg of tramadol
  • an injection (usually given in hospital)

There is also a new type now called Tramadol hydrochloride/Paracetamol 37.5 mg/325 mg film-coated tablets.

Medicines explains Tramadol hydrochloride/Paracetamol Tramadol/Paracetamol is a combination of two analgesics (pain killers) tramadol and paracetamol that act together to relieve your pain. Tramadol/Paracetamol is intended for use in the treatment of moderate to severe pain when your doctor recommends that a combination of tramadol and paracetamol is needed.

I have been on Tramadol for around 19 years. I started on a small dose then increased it but then my pain consultant changed me to the slow release dose which I took for many years. My pain was starting to increase and so it was decided that maybe I should go back to a normal dosage which meant on bad days I could take extra.

As you know the pain team here wanted me off the Tramadol completely but my GP decided the best way to do it was to take the one thar has paracetamol in it and wean myself off it that way. When I read up on withdrawal from Tramadol on the Very Well Mind website, it said you can expect to feel “flu-ish and sick to your stomach. You may sweat and have the chills. You might have trouble sleeping and feel much more irritated and aggravated than usual. You might also experience varying degrees of anxiety and depression.” Reading those symptoms filled me with dread.

Although the sweating and shaking were the biggest withdrawal symptom to me I think overall it was a lot easier than I thought it would be. My sleep was no worse as it’s problematic anyway but I think if you are in the right mindset to come off a drug then that’s half the battle.

I have now managed to get right down to just 50mg once a day of the Tramadol/ Paracetamol mix and for the time being I’m happy to be taking so much less. It’s a fine line to be able to control chronic pain but the biggest difference to me has been my clear head. It feels so different, less fuzzy and fresh. My left had still shakes but I know part of that is due to my cervical disc problems.

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OVER THE COUNTER MEDICATION FOR BACK PAIN AND FIBROMYALGIA…

This is a question that millions of back pain sufferers ask all the time. Is there any medication that works? The truth of the matter is that it all depends on the type of back pain that an individual has.

If the back pain is acute due to some injury, over-the-counter medication may be enough to relieve the symptoms while the body heals naturally. However, if you suffer from chronic back pain due to more serious issues such as degenerative disc disease or osteoporosis, the medication will only help to a minimal extent.

Medication is not the be-all and end-all of back pain treatment. You’d do well to lose excess weight, maintain a good posture, avoid sitting for long periods and even try out acupuncture or acupressure to help aid in the healing process.

The medication that you take will help to relieve the pain and discomfort so that you can exercise and improve your condition. Most over-the-counter medication will not only provide temporary pain relief, but will also relax your muscles and reduce swelling and inflammation while altering your perception of pain.

Holistic remedies are great, but when the pain is bad, there’s nothing like painkillers or non-steroidal anti-inflammatory drugs (NSAIDs) to bring fast relief. There’s nothing wrong with using these medications.

You’ll need to see what side effects you experience. They can vary from person to person. You may not even have any. You’ll only know when you try.

 

• Acetaminophen

Most over-the-counter types of medication contain paracetamol, also known as acetaminophen. These can be used to treat anything from headaches to fevers to back pain. It works by preventing the body from releasing pain chemicals. In this way the pain signals going to the brain are altered and you feel less pain.

While generally harmless, consuming these in the long run can lead to a toxic buildup within the body, and the liver may be affected.

 

• Opioids

Another type of medication that is used to treat back pain is opioids. Only a doctor can prescribe opioids because they’re much stronger drugs and usually used to treat chronic back pain.

The drugs work by increasing your tolerance to pain and reducing the body’s perception of pain. They’re similar to the acetaminophen, but on a much higher degree.

While opioids are powerful, in some cases, the back pain may be so bad that even though it’s mitigated, you can’t eradicate it. To make matters worse, the body develops a tolerance to opioids over time and they lose their effectiveness.

Therefore, it’s imperative that you use these painkillers as a temporary measure while you go about changing other aspects of your life to make the back pain more manageable. Maintaining a good posture and an ideal weight is far more beneficial to your back in the long run than any opioid or medication could be.

 

• NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs_ are extremely effective for pain treatment. In most cases of back pain, there will be accompanying inflammation of the soft tissues around the area. NSAIDs will reduce the inflammation and bring about much relief.

They’re more powerful than both acetaminophen and opioids. However, they do have side effects like nausea, indigestion, fatigue, etc.

At the end of the day, when it comes to medication for your back pain, it’s best to speak to a qualified doctor, and if possible, get a second opinion too. Use medication as one of several tools to treat your back pain. Don’t rely on it completely. As long as you adopt a multi-pronged approach to treating your back pain, you’ll find relief sooner and may even get rid of the pain totally.

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ANTIDEPRESSANTS AS A TREATMENT FOR FIBROMYALGIA…

If, like me you have had Fibromyalgia for some time now you will probably have been given an antidepressant to try for the pain, or maybe even tried a mixture of these type of medications.

If you read all the information on the drug it could immediately put you off trying one but I’ve always felt you should always try before you decide if you want to stay on this type of meditation long term.

I will use my own personal usage of these as an example. Back in 2002 when I was first diagnosed with Fibromyalgia I was put onto ‘Fluexetine (Prozac)’ of 20 mg once a day. I seemed to get along well with this during the early years but it wasn’t long before they also offered me Amitryptyline (Elavil) of 10mg x 3 going up to 50mg, which I took alongside my Fluexetine.

I stayed on both these for a number of years but as I increased the Amitryptyline, it left me with one particular side effect of a very dry mouth. I mean really dry whereby I would sometimes struggle to get my words out and I also started having problems with my gums. My dentist suggested eating sugar free gum but to be honest with you I’m just not a lover of gum.

The pain team decided to then change me from Amitryptyline to Nortryptyline (Pamelor) as it was known to not cause as many side effects and could help me sleep better at night which was another symptom of Fibromyalgia that I was suffering from. The dosage was the same dosage as the Amitryptyline.

Fast forward 16 years and this year I was also advised to come off the Fluexetine as I had been on it for so long. They told me to come off it gradually and to see how I felt. I did exactly as they said and even though I was only taking 20mg I struggled so hard not just because I’m in more pain but from feeling extremely low and tearful, which isn’t me.

So, I decided I would go back onto Fluexetine (it’s still on my repeat) but it made me realise how you really can get addicted to these types of medications and that maybe someone should have suggested I tried to come off it a long time ago. I’ve never shied away from taking any medications they have offered me for pain relief and believe you really do have to take them for a few months to see any difference but it is also important that long term use should be taken into consideration.

On the website My Fibro Team they have a page on all the medications offered for Fibromyalgia and its overview of the three I have mentioned are – ‘Nortryptyline Pamelor is a prescription medication originally approved by the Food and Drug Administration (FDA) in 1964 for the treatment of depression. In cases of fibromyalgia, Pamelor can help reduce pain. The drug name of Pamelor is Nortriptyline.

Pamelor should be used with caution in people with a history of depression, bipolar disorder, or glaucoma. People who are recovering from a recent myocardial infarction (heart attack) should not take Pamelor.

Pamelor is a tricyclic antidepressant. It is believed that Pamelor works in cases of fibromyalgia by changing the balance of neurotransmitters in the brain.’

And ‘Amitryptyline Elavil is a prescription medication originally approved by the Food and Drug Administration (FDA) in 1961 for the treatment of depression. The drug name of Elavil is Amitriptyline. In cases of fibromyalgia, Elavil can reduce pain and improve sleep problems and fatigue.

Elavil should be used with caution in people with a history of depression, bipolar disorder, glaucoma, liver or kidney problems, high or low blood pressure, diabetes, seizures, trouble urinating, or alcohol dependence. Elavil is not suitable for use by women who are pregnant or breastfeeding. 

Elavil is a tricyclic antidepressant. It is believed that Elavil works in cases of fibromyalgia by interfering with nerve signals that communicate pain.

And as for Fluexetine- Prozac is a prescription drug approved by the Food and Drug Administration (FDA) in 1987 to treat depression. In people with fibromyalgia, Prozac can help improve mood and reduce fatigue. Prozac may also help reduce pain, sleep problems, and fatigue. Prozac is also known by its drug name, Fluoxetine hydrochloride.

Prozac should be used with caution in people who have a history of depression, seizures, anorexia, glaucoma, and heart problems, as well as those who are taking diuretics.

Prozac is an antidepressant of the selective serotonin reuptake inhibitors (SSRI) class. Prozac is believed to work by changing the balance of neurotransmitters in the brain. 

The My Fibro Team website has lots more information on medications taken for Fibromyalgia and is well worth reading if you are trying something new. Do you take any of these medications and if you have did they help with your pain?