Tramadol and ssnri antidepressants

[Float]

HI there.
Recently for pain I took Tramadol.
Bizarrely it helped orthostatic hypotension and stopped standing tachycardia. Assume due to action on norepinephrine.
After researching I found its a ssnri like cymbalta and efexor.
I can't carry on taking Tramadol for OH and mood lift (I'll ask my doc but assuming a no) so wondering other people's experience with ssnris ...in general and have they helped raise your blood pressure?
Thank you.

 

[jesse's mom]

bump

 

[andyguitar]

Tramadol also has an effect on Serotonin. Looks like it raises it by inhibiting the enzyme Mono-Amine-Oxydase. The exact way these types of drug work is not as defined as the Pharma industry would like everyone to think so be careful of it.

 

[hmnr asg]

hi there,
I am taking cymbalta for pain and it has been very effective. Unfortunately it has made me sleep way more than normal and as someone who is still trying to hold on to their job, it was impossible to keep taking it. So now im trying to wean myself off and the withdrawal is terrible.

But if i didnt have a job and didnt mind sleeping even more i would definitely stay on it.
I dont have POTS and so i dont know how it has effected blood pressure etc.
I was taking 40mg for 4 months. It was given to me for my trigeminal neuralgia (it really helped!).

 

[Pyrrhus]

Recently for pain I took Tramadol.
Bizarrely it helped orthostatic hypotension and stopped standing tachycardia. Assume due to action on norepinephrine.

At low doses (50-150mg) Tramadol acts as a pain reliever through a combination of serotonin and opioid effects.

At higher doses (300mg) Tramadol is a norepinephrine booster that can alleviate orthostatic intolerance and ‘fatigue’. This is because, at high doses, tramadol is a norepinephrine reuptake inhibitor, whereas at low doses it is not.

I took high-dose tramadol for fatigue for many years.
Although it worked, it made me able to overexert myself and I got progressively worse.

If you want a pure norepinephrine reuptake inhibitor, without any opioid or serotonin effects, you would have to try Strattera/atomoxetine, which is the only pure norepinephrine reuptake inhibitor. For more information, see:

Strattera (atomoxetine)
https://forums.phoenixrising.me/threads/strattera-atomoxetine.19755/

It has many of the same effects as high-dose tramadol, but you only need a very small dose. Note that some people have a genetic mutation which extends the atomoxetine half-life from ~5 hours to ~22 hours.

The last time I tried 10mg of Strattera/atomoxetine I felt cured for about 8 hours, and then crashed for a month.

Hope this helps.

 

[Float]

Thanks @Pyrrhus
Did you carry on taking the med beyond that first day and into.the crash?
Not a great result short term . 😕

 

[Float]

@Pyrrhus thats interesting about different dose effects of tramadol.
It's hard to know what helped me as a single dose didn't bit cumulatively it did.
I wonder what is happening in the 150 to 300mg dose .

Venlafaxine is the same according to wiki, needing higher doses to exert norepinephrine reuptake inhibition.

 

[Float]

Thank you @hmnr asg hmn
I'm sorry you had to give up something helpful.
And I'm sorry you have to go through withdrawal. I know that's terrible.
Maybe tramadol is an option for you?
Though I'm sure it has its own withdrawal.
Good luck.

 

[kelle]

Hi @Float, I've recently been taking Tramadol and have found the same effects on my OI and tachycardia. I don't know anything about SNRIs because I have previously had bad reactions to them, so I was surprised that the Tramadol didn't produce a bad reaction.

I will say that I personally seem to be able to get a decent, albeit short-lived, effect from taking 50mg of Tramadol, or a longer positive effect from taking 100mg slow release. I'm not sure if that's because I'm more sensitive to drugs in general since developing ME/CFS.

I did slide into dependency easily after taking it nearly daily for only a month (I think because of the SSRI and SNRI component more than the opioid), but I tapered off and now take it only for 'special occasions' where I might want to say, leave the house.

However as @Pyrrhus mentioned, I find it easy to overexert myself when on Tramadol and have crashed hard because of this before, so am now super careful with pacing.

 

[Pyrrhus]

Did you carry on taking the med beyond that first day and into.the crash?
Not a great result short term . 😕

I just took a single 10mg dose on an empty stomach, which made me feel completely like normal for 8 hours. And then I crashed for a full month. Never took a second dose.

Yes, not a great result.

NB: Some people have a genetic mutation which extends the atomoxetine half-life from ~5 hours to ~22 hours. I can’t imagine what these people experience.

 

[Float]

Thanks for all your responses.
The nearest thing I could get is efexor do I will try it with interest to see if it has any effects on blood pressure and heart rate.

 

[Float]

Update I tried an efexor and felt so disgustingly yuk nauseous and an odd feeling that I cannot face taking anymore.
Experiment over.
Next stop midodrine.

 

[kelle]

Sorry to hear about your negative efexor experience @Float.

Have you considered the thing that helps with standing and tachycardia is actually the opioid? I can't find it now, but there is a thread on this forum somewhere discussing how opioids seem to induce a mini-remission of sorts that extends beyond the numb/euphoric feeling one would expect. It's worth a read if you can find it.

The concept intrigues me because I am also having success with LDN, so it would seem there's something going on with our opiate receptors.

Also, thanks for doing these experiments and reporting back – I would be very happy if a snri produced the same results.

 

[Float]

@kelle thank you for the information ☺
Ldn and opiates I will have to do some research.
I'd love to find something to reverse this frustrating state of physical capacity.
I really hope you get absolute success with LDN. good luck x

 

[ebethc]

At low doses (50-150mg) Tramadol acts as a pain reliever through a combination of serotonin and opioid effects.

At higher doses (300mg) Tramadol is a norepinephrine booster that can alleviate orthostatic hypotension and ‘fatigue’.

I took high-dose tramadol for fatigue for many years.
Although it worked, it made me able to overexert myself and I got progressively worse.

Hope this helps.

Tramadol REALLY screwed up my stomach.... I took it every day for a month (100mg total per day) felt less pain (btw - serotonin drugs had no effect on me , so it was the opioid-like attributes of tramadol that helped me feel better, more energetic).... I didn't like taking it everyday, since it seems like it was just masking problems and not solving them, but I had to do something so that I could work... Well, it boomeranged right back at me and I got the worst stomach infection of my life... I was really out of commission for 2-3 months.. Nothing to do but rest and mild diet and water... New food intolerances since then (eggs) One of my worst experiences w an Rx... Be careful.

 

[jesse's mom]

@ebethic, you think that tramadol gave you a stomach infection? That sounds horrible!
Do you think it wore the lining of your stomach like Advil can then a bacteria was able to take hold? That is bizarre.

 

[ebethc]

@ebethic, you think that tramadol gave you a stomach infection? That sounds horrible!
Do you think it wore the lining of your stomach like Advil can then a bacteria was able to take hold? That is bizarre.

No, I don't think tramadol gave me the infection, I think it irritated my digestive tract to the point where my gut was way more hospitable to infection.... It took months to clear the infection and for my body to calm down... then I noticed that eggs made me nauseated

there are a lot of opioid receptors in the gut, so I'm guessing that something about tramadol's opioid qualities interacted w the receptors in a way that made something flare up

 

[jesse's mom]

It always strikes me how different we are!

 

[ebethc]

It always strikes me how different we are!

BTW - a couple of the proteins in milk (casein) and wheat (gluten) break down to peptides (casomorphin and gliadorphin) that are morphine like substances.... any morphine like substance modulates the immune system... e.g., exogenous, rx opioids can suppress the immune system (see pubmed for studies), whereas endogenous opioids (eg endorphins) can help the immune system (ditto).... I think that's why removing gluten and dairy from your diet may help your immune system, even if you don't have celiac, lactose, etc. ( the problems that ppl are more familiar with...) More info below...


https://www.forbes.com/sites/michaelpellmanrowland/2017/06/26/cheese-addiction/#24f2bd973583
https://en.wikipedia.org/wiki/Gliadorphin
https://en.wikipedia.org/wiki/Casomorphin

 

[pattismith]

At low doses (50-150mg) Tramadol acts as a pain reliever through a combination of serotonin and opioid effects.

At higher doses (300mg) Tramadol is a norepinephrine booster that can alleviate orthostatic hypotension and ‘fatigue’.

I took high-dose tramadol for fatigue for many years.
Although it worked, it made me able to overexert myself and I got progressively worse.

Atomoxetine is a SNRI that only acts on norepinephrine.
It has many of the same effects as high-dose tramadol, but you only need a very small dose.
The last time I tried Atomoxetine I felt cured for a day, and then crashed for 1-2 months.

Hope this helps.

Thank you for your feedback,

I took Tramadol during two years, but could only tolerate low doses and felt very bad on it even though it was efficient on my pain.

I also tried Duloxetine at low doses and had some good results (but very bad side effects that forced me to stop).

It was efficient on my burning pains, and also my HR improved going from 75 to 60 at rest.

My head pain worsen at first and then improved.

I wonder if I should try Atomoxetine, what dose did you try?