Tramadol and ssnri antidepressants

[DrUniverse]

Tramadol.

https://pubmed.ncbi.nlm.nih.gov/31368376/

It fucks up the brain mitochondria. I had really bad crash from it.

 

[Pyrrhus]

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

I just took a single 10mg dose on an empty stomach, which made me feel completely like normal for 8 hours, so I took advantage of my newfound physical abilities and cleaned my apartment thoroughly. And then I crashed. Never took a second dose.

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.

 

[TinaYesen]

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 experienced the same effect at just 25mg of tramadol. It drastically improves my ability to stand and be upright, I basically feel normal. I have POTS and don't feel it at all. Now I will test my pulse to see if this is why.

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.

Interesting that I get the improvement from POTS (alleviates my orthostatic hypotension and ‘fatigue’) at just 25mg. Any idea why this would be? Maybe low doses are also still boosting norepinephrine?

That said, when I take it a couple days per week to spend time with friends, I know not to overdo it. I still pace myself and lay down every couple hours. I only get mini-crashes one-day-long afterwards, so I know I'm not pushing myself too far.

It works very well for me in this way to have some quality of life in the social arena. 😌

 

[helen1]

@TinaYesen
I have the same experience with the opioid buprenorphine which is that a tiny dose (unbelievably tiny) allows me to function well for 8-10 hrs. I don’t have PEM from doing more than usual though.

I’m quite sure it’s due to the super fast variant of the liver enzyme that metabolizes this opioid, which I have. My guess is that you have the super fast variant of CYP 2D6, which metabolizes tramadol.

It puts me at very high risk of opioid overdose, and likely you too, so be careful about that.

There appears to be a huge variation in response to opioids due to these genetic variations. That’s certainly been my experience.

“In a 2007 study, the area-under-the-curve (AUC) diagram of morphine concentration over time varied at least 30-fold between PM and UM patients taking codeine [18].”
PM=poor metabolizers
UM=ultra rapid metabolizers

You may also be increasing your enzyme speed & thus opioid levels with enzyme inhibitors, the best known of which is grapefruit juice, but there are many others.

 

[TinaYesen]

I’m quite sure it’s due to the super fast variant of the liver enzyme that metabolizes this opioid, which I have. My guess is that you have the super fast variant of CYP 2D6, which metabolizes tramadol.

Wow, so interesting, thank you. How did you find out you had the CYP 2D6 variant? How could I find out?

With getting ME last year I developed sudden sensitivities to chemicals and medications I didn't have before, mostly because I get bad side effects. I'm not sure if this is related.

Is it possible that the CYP 2D6 variant happened only after ME, or would this be something I've had my whole life? Thank you so much for the insight.

 

[helen1]

@TinaYesen
Actually my variant of concern is CYP 3A4 but the CYP 2D6 is the one that processes tramadol. You can find out about them by getting your genes analysed by one of the commercial companies like 23and me or ancestry.com & then downloading your raw data elsewhere.
You’d have the same variants all your life, yes.

 

[DrUniverse]

I experienced the same effect at just 25mg of tramadol. It drastically improves my ability to stand and be upright, I basically feel normal. I have POTS and don't feel it at all. Now I will test my pulse to see if this is why.




Interesting that I get the improvement from POTS (alleviates my orthostatic hypotension and ‘fatigue’) at just 25mg. Any idea why this would be? Maybe low doses are also still boosting norepinephrine?

That said, when I take it a couple days per week to spend time with friends, I know not to overdo it. I still pace myself and lay down every couple hours. I only get mini-crashes one-day-long afterwards, so I know I'm not pushing myself too far.

It works very well for me in this way to have some quality of life in the social arena. 😌

The magic of Adrenalin and Noradrenalin.
Be careful it can make you easily overextend. Also have in mind its not good for the mitochondria.