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Suggest Ways To Wean Off Tramadol
Question: I recently went to the ER for seizures, which I now find were as a result of an overdose of TRAMADOL (Was assured I was taking 10mg codeine tablets). Docs put me on keppra, 1000mgs; can't get off of it til I see my primary neurologist. How long does it take to wean, and what side effects can I expect while getting off of it - have anxiety on it so bad that I am forced to take Ativan 3 times a day as prescribed. I am a veteran; would the va medical center consider admitting me for observation?
Brief Answer:
Stopping the drugs would be doctor's decision
Detailed Answer:
Hi, thanks for writing through HCM.
I have read your query and understood that you were taking high dose of tramadol [but you didn't mention the dose] that resulted in a seizure and you went ER for treatment and they gave you keppra 1000 mg which is causing anxiety and agitation. [correct me if I am wrong]
Anxiety and agitation are common side effects of keppra. There is no XXXXXXX in it.
If you were having seizures just because of the high dose of tramadol then there is no need to take antiepileptic drugs for long duration. I feel that this must have been explained by your doctor upon prescribing. Were your doctor aware of your tramadol overdose? They must have gone for urine screen for drugs.
Weaning off keppra is simple. Gradually decreasing 250 mg every week would suffice. By doing this you shall be off the drug within 1 month. But you need to consult a doctor for observation upon discontinuing it.
Regarding veteran medical center, I feel that if you are registered under the veteran health benefits then they will entertain your problems effectively. You just have to give details of your problems, drugs and how the seizure developed. There is a veteran affairs toll free line on the website of veteran health administration: VA toll-free 1-877-222-VETS (8387) between 8:00 AM and 8:00 PM ET, Monday-Friday. You can call on this and ask your query and get updates.
Don't discontinue keppra on your own without guidance of a doctor.
Hope I have answered your query. If you have further query then I shall be happy to help. Wish you good health.
Stopping the drugs would be doctor's decision
Detailed Answer:
Hi, thanks for writing through HCM.
I have read your query and understood that you were taking high dose of tramadol [but you didn't mention the dose] that resulted in a seizure and you went ER for treatment and they gave you keppra 1000 mg which is causing anxiety and agitation. [correct me if I am wrong]
Anxiety and agitation are common side effects of keppra. There is no XXXXXXX in it.
If you were having seizures just because of the high dose of tramadol then there is no need to take antiepileptic drugs for long duration. I feel that this must have been explained by your doctor upon prescribing. Were your doctor aware of your tramadol overdose? They must have gone for urine screen for drugs.
Weaning off keppra is simple. Gradually decreasing 250 mg every week would suffice. By doing this you shall be off the drug within 1 month. But you need to consult a doctor for observation upon discontinuing it.
Regarding veteran medical center, I feel that if you are registered under the veteran health benefits then they will entertain your problems effectively. You just have to give details of your problems, drugs and how the seizure developed. There is a veteran affairs toll free line on the website of veteran health administration: VA toll-free 1-877-222-VETS (8387) between 8:00 AM and 8:00 PM ET, Monday-Friday. You can call on this and ask your query and get updates.
Don't discontinue keppra on your own without guidance of a doctor.
Hope I have answered your query. If you have further query then I shall be happy to help. Wish you good health.
Above answer was peer-reviewed by :
Dr. Shanthi.E
In regards to the high dose tramadol - at the time I went into the ER, we were under the impression that what I had taken was 120mgs of codeine. My labs (blood and urine) were run in the ER. While they showed elevated sugars (likely a result of the medication injected to stop the 2nd seizure), they showed no drugs of any kind - certainly no opiates which I thought I had taken.
As a result, they treated my case as a "new onset seizure." The tests all came back normal, so I was given a prescription for KEPPRA, and told to take it twice a day for 30 days; nothing was ever mentioned about getting off of it...
Since the keppra is causing me horrible anxiety, and the VA has a facility to monitor me, would it be safe enough to take me off it quickly - so long as I was being monitored? Would be nice to be off it all together in a week rather than a moth...
As a result, they treated my case as a "new onset seizure." The tests all came back normal, so I was given a prescription for KEPPRA, and told to take it twice a day for 30 days; nothing was ever mentioned about getting off of it...
Since the keppra is causing me horrible anxiety, and the VA has a facility to monitor me, would it be safe enough to take me off it quickly - so long as I was being monitored? Would be nice to be off it all together in a week rather than a moth...
Brief Answer:
Urine screen should have shown opiates
Detailed Answer:
Hi, thanks for writing again.
If you had taken codeine then it should have shown in urine screening. There is no possibility that it can be missed by urine drug screen. That is why they have considered you as a case of 'new onset seizure'.
What was about high level of sugar? Did you go for blood sugar level again?
Were you on any narcotic analgesics? Did you actually take codeine or tramadol or it was just misinterpretation? Why you had impression that you had taken codeine? I can not get this.
If you are a true case of 'new onset seizure' then I would suggest you not to make any changes in keppra dose and visit your veteran medical center. They will evaluate your case and adjust the dose accordingly. You may ask them to change the antiepileptic because keppra is causing you much trouble. There are other safe antiepileptics available. It is not safe for you to wean off keppra without confirmation that 'you are not a case of new onset seizure'. Be patient and visit veteran medical center.
Hope I have answered your query. If you do not have further query then close the discussion and rate the answer.
Wish you good health.
Urine screen should have shown opiates
Detailed Answer:
Hi, thanks for writing again.
If you had taken codeine then it should have shown in urine screening. There is no possibility that it can be missed by urine drug screen. That is why they have considered you as a case of 'new onset seizure'.
What was about high level of sugar? Did you go for blood sugar level again?
Were you on any narcotic analgesics? Did you actually take codeine or tramadol or it was just misinterpretation? Why you had impression that you had taken codeine? I can not get this.
If you are a true case of 'new onset seizure' then I would suggest you not to make any changes in keppra dose and visit your veteran medical center. They will evaluate your case and adjust the dose accordingly. You may ask them to change the antiepileptic because keppra is causing you much trouble. There are other safe antiepileptics available. It is not safe for you to wean off keppra without confirmation that 'you are not a case of new onset seizure'. Be patient and visit veteran medical center.
Hope I have answered your query. If you do not have further query then close the discussion and rate the answer.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thanks for your message.
In regards to the codeine - NORMALLY I get it from a very reliable online sourse. Have taken it for years to releive menstrual cramps. No harm has ever come to me.
Due to severe storms my mot recent shipment was delayed indefinitely, so I ordered 30mg tylenol codeine tablets from a difft source.
What I received were small unmarked round white pills. I were told these were each 10mgs of codeine w some acetomeniphen. Idoing the math calculations I took 12 - 1st the equivelant of what I thought to be 60mgs, then a 2nd '60mgs' a short time later.
In the er we explained the pill situation and thy said they were unable to analyse them, yet my blood and urine came out clean of any drgs.
Yesterday I found an exact image of the pills I took - via an fda warning about fake aderall. Rather than having any amphetamines, it has instead acetomeniphen and TRAMADOL. Best info I could get, each pill contained 50mgs of tramadol. Since I didnt know tramadol was what had sent me to the hospital, the mds did not test specifically for it, and gave me a diagnosis of new onset seizure.
In regards to the codeine - NORMALLY I get it from a very reliable online sourse. Have taken it for years to releive menstrual cramps. No harm has ever come to me.
Due to severe storms my mot recent shipment was delayed indefinitely, so I ordered 30mg tylenol codeine tablets from a difft source.
What I received were small unmarked round white pills. I were told these were each 10mgs of codeine w some acetomeniphen. Idoing the math calculations I took 12 - 1st the equivelant of what I thought to be 60mgs, then a 2nd '60mgs' a short time later.
In the er we explained the pill situation and thy said they were unable to analyse them, yet my blood and urine came out clean of any drgs.
Yesterday I found an exact image of the pills I took - via an fda warning about fake aderall. Rather than having any amphetamines, it has instead acetomeniphen and TRAMADOL. Best info I could get, each pill contained 50mgs of tramadol. Since I didnt know tramadol was what had sent me to the hospital, the mds did not test specifically for it, and gave me a diagnosis of new onset seizure.
Brief Answer:
I am still with urine screen results
Detailed Answer:
Hi, thanks for writing again.
It is very confusing for me but I feel that even you had tramadol and acetaminophen combination, it should have shown with drug screen. If you were taking codeine on regular basis then you must have became dependent on it. When you have taken the drugs that are not actually codeine [considering the tablets you had taken were multivitamins, fake ones], you were in withdrawal and it had caused seizures.
If they were tramadol then 12 tablets of it can calculate to be dose of maximum 300 mg in a day, so that can cause seizure on sudden high dose for the first time. Since you were clean on drug screen, it seems unlikely to me.
I feel that all you have to do is to trust on your new doctors and give them each and every detail about the pills and seizures. You can also take the pills with you and ask them to run test on pills so that they can know which drug does it contain.
I feel that I have tried my best to clarify the situation but I can not help you further. You have to rely on your doctors now.
Hope you shall be satisfied with this. If you do not have further query then close the discussion and rate the answer. Wish you good health.
I am still with urine screen results
Detailed Answer:
Hi, thanks for writing again.
It is very confusing for me but I feel that even you had tramadol and acetaminophen combination, it should have shown with drug screen. If you were taking codeine on regular basis then you must have became dependent on it. When you have taken the drugs that are not actually codeine [considering the tablets you had taken were multivitamins, fake ones], you were in withdrawal and it had caused seizures.
If they were tramadol then 12 tablets of it can calculate to be dose of maximum 300 mg in a day, so that can cause seizure on sudden high dose for the first time. Since you were clean on drug screen, it seems unlikely to me.
I feel that all you have to do is to trust on your new doctors and give them each and every detail about the pills and seizures. You can also take the pills with you and ask them to run test on pills so that they can know which drug does it contain.
I feel that I have tried my best to clarify the situation but I can not help you further. You have to rely on your doctors now.
Hope you shall be satisfied with this. If you do not have further query then close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by :
Dr. Raju A.T
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