Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Can Discontinuing Tramadol Lead To Withdrawal Symptoms?
Question: Dear Doctor,
I have written lots of information about myself below. At present, I am weaning off Tramadol as I was getting a tolerance to it. However... due to the Fibromyalgia, coming off it is flaring up IBS, interstitial cystitis, tinnitus and the usual aches and pains. I'm wondering whether I could use a Norspan patch 5 (I've never used one before) to help with these symptoms or whether that would mean I would have to go through another withdrawal off that two weeks later (assuming I used them for two weeks while I come off the Tramadol). Do they both target the same receptors? How can you see me coming off Tramadol without flaring up these other things?
Many thanks
Weight 92 kg Height 175 cm Age: 54
Diagnosed conditions: Fibromyalgia, C2/3 facet joint damage (MVA), C6/7 nerve root impingement (MVA), RSI right wrist (35 years), plantar fasciitis (comes and goes), sacro-iliac pain (comes and goes).
Recent blood test: bit low in Vitamin D. Mobitz type I arrhythmia brought on by using certain medications.
Medications: Tramadol 100 mg/day, Codeine 30 mg day PRN, Citalopram 10 mg, Oxazepam 7.5 mg Piroxicam 100 mg PRN
Hi – I feel very breathless on little exertion and my heart rate increases a lot – for example just bending down to do up shoelaces. However, I can go for a 50 minute walk and not get too out of breath (except on hills). Having trouble sleeping for last two months as came off Stillnox after eight years on it. Sometimes used codeine, Temazepam and periactin to sleep. But last night took none of these and still feel very short of breath. Doctor has listened to chest – all ok. Might have a bit of reflux at night – not sure – but I think morning coughing could be due to that. Put on 10 kg in a six month period recently – it’s plateaued at 92 kg for about three months. Also feel pretty exhausted and tired and lacking motivation quite a bit of the time. Thanks
I have written lots of information about myself below. At present, I am weaning off Tramadol as I was getting a tolerance to it. However... due to the Fibromyalgia, coming off it is flaring up IBS, interstitial cystitis, tinnitus and the usual aches and pains. I'm wondering whether I could use a Norspan patch 5 (I've never used one before) to help with these symptoms or whether that would mean I would have to go through another withdrawal off that two weeks later (assuming I used them for two weeks while I come off the Tramadol). Do they both target the same receptors? How can you see me coming off Tramadol without flaring up these other things?
Many thanks
Weight 92 kg Height 175 cm Age: 54
Diagnosed conditions: Fibromyalgia, C2/3 facet joint damage (MVA), C6/7 nerve root impingement (MVA), RSI right wrist (35 years), plantar fasciitis (comes and goes), sacro-iliac pain (comes and goes).
Recent blood test: bit low in Vitamin D. Mobitz type I arrhythmia brought on by using certain medications.
Medications: Tramadol 100 mg/day, Codeine 30 mg day PRN, Citalopram 10 mg, Oxazepam 7.5 mg Piroxicam 100 mg PRN
Hi – I feel very breathless on little exertion and my heart rate increases a lot – for example just bending down to do up shoelaces. However, I can go for a 50 minute walk and not get too out of breath (except on hills). Having trouble sleeping for last two months as came off Stillnox after eight years on it. Sometimes used codeine, Temazepam and periactin to sleep. But last night took none of these and still feel very short of breath. Doctor has listened to chest – all ok. Might have a bit of reflux at night – not sure – but I think morning coughing could be due to that. Put on 10 kg in a six month period recently – it’s plateaued at 92 kg for about three months. Also feel pretty exhausted and tired and lacking motivation quite a bit of the time. Thanks
Brief Answer:
My suggestion
Detailed Answer:
Hi,
I understand you want to wean off from Tramadol.
It is clearly evident that you are facing withdrawal symptoms and due to fibromyalgia, you are not able to tolerate it.
It is anyway advisable to take Norspan patch, as it is Buprenorphine helps in wean off from Tramadol, as both of them target the same receptors.
You need to taper one forth of dose in 1week and can be stopped completely.
I would like to advise you to take SSRIs like ESCITALOPRAM along with the above medication, to deal with fibromyalgia.
I feel very sorry for the health problems you are facing.
I can find that there is recent weight gain, it is better to rule out thyroid function tests.
I would advise you to consult your physician regarding the breathlessness problem.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Soujanya, Psychiatrist
My suggestion
Detailed Answer:
Hi,
I understand you want to wean off from Tramadol.
It is clearly evident that you are facing withdrawal symptoms and due to fibromyalgia, you are not able to tolerate it.
It is anyway advisable to take Norspan patch, as it is Buprenorphine helps in wean off from Tramadol, as both of them target the same receptors.
You need to taper one forth of dose in 1week and can be stopped completely.
I would like to advise you to take SSRIs like ESCITALOPRAM along with the above medication, to deal with fibromyalgia.
I feel very sorry for the health problems you are facing.
I can find that there is recent weight gain, it is better to rule out thyroid function tests.
I would advise you to consult your physician regarding the breathlessness problem.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Soujanya, Psychiatrist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr XXXXXXX
Thank you for your help. Could you please explain the Tramadol taper again?
If they both target the same receptors, wouldn't I then have to go through withdrawal off the buprenorphine after coming off the Tramadol, just delaying the withdrawal symptoms ie I would just be delaying the withdrawal, not helping it?
I am already on 10 mg Citalopram, and yes, it does help with pain but apparently it's not very suitable for my Mobitz type I arrhythmia.
Thanks, Lxxxxxx
Thank you for your help. Could you please explain the Tramadol taper again?
If they both target the same receptors, wouldn't I then have to go through withdrawal off the buprenorphine after coming off the Tramadol, just delaying the withdrawal symptoms ie I would just be delaying the withdrawal, not helping it?
I am already on 10 mg Citalopram, and yes, it does help with pain but apparently it's not very suitable for my Mobitz type I arrhythmia.
Thanks, Lxxxxxx
Brief Answer:
My suggestion.
Detailed Answer:
Hello,
Both these drugs act on the same receptors but there is a difference in the mechanism of action in both of them.
As, Tramadol is an opioid agonist which acts on the mu receptors and provide analgesic, euphoric and an addictive effect.
But, Buprenorphine is a partial agonist.
Even then it produces euphoric and analgesic effect but with less intensity and it does not have an additive effect due to its ceiling property.
It means, it reaches a threshold level, so even if the dose is increased, cannot have addictive potential.
Anyway, I would like to advise you to take Suboxone, which is a wonder drug and is a combination of Buprenorphine and Naloxone
So, discuss this combination with your treating doctor.
Coming to Citalopram, it is better to start Sertraline with cardiac problems.
So, discuss all these issues and follow accordingly.
Hope I have answered your query.
Take care
Regards,
Dr Soujanya, Psychiatrist
My suggestion.
Detailed Answer:
Hello,
Both these drugs act on the same receptors but there is a difference in the mechanism of action in both of them.
As, Tramadol is an opioid agonist which acts on the mu receptors and provide analgesic, euphoric and an addictive effect.
But, Buprenorphine is a partial agonist.
Even then it produces euphoric and analgesic effect but with less intensity and it does not have an additive effect due to its ceiling property.
It means, it reaches a threshold level, so even if the dose is increased, cannot have addictive potential.
Anyway, I would like to advise you to take Suboxone, which is a wonder drug and is a combination of Buprenorphine and Naloxone
So, discuss this combination with your treating doctor.
Coming to Citalopram, it is better to start Sertraline with cardiac problems.
So, discuss all these issues and follow accordingly.
Hope I have answered your query.
Take care
Regards,
Dr Soujanya, Psychiatrist
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
