My girlfriend experiences twitches, mainly during sleep and just before she falls asleep.
When she is sleeping, her toes and fingers can be moving almost constantly at times.

I've read something about Serotonin Overload in people taking Tramadol Hydrochloride. She takes Tramadol for chronic arthritis pain. I'm unsure of the dosage but I think she may be on between 100-200mg daily.

In addition, she is also on Gabopentin for her neuralgia and she also uses Cannabis daily.

Could one or a combination of these be responsible?

I have been prescribed Tramadol for back pain, and I have caught my hands moving on numerous times just before I would fall asleep, so I think that Tramodol has something to do with it.

I took tramadol and it actually made my legs twitch...they jerked all the time. I think that tramadol is a narcotic that should be taken seriously. I didn't like the way it made me feel and it gave me these awful thoughts....I'd talk to your friend about her taking it. Maybe she can find an alternative medicine for her arthritis. She smokes cannibas? Well i think that if that is taken w/ tramadol it can cause the twitches even more. Talk to her about this if you can.... i hope she gets better =]

--shefalls

Hi.....I have osteoarthritis throughout my body and have for many years
possibly due to heredity along with being a dancer all of my life. I have
taken prescription motrin for years with no side effects. Recently I have
discovered that I have bone on bone in my right hip and am looking at a
total hip replacement in the near future. I limp from pain and can now
only walk short distances. I was given tramadol hcl to take with the motrin
when the pain is unberable, but I only take 50 miligrams. I also go the an
acupuncturist once a week. The combination of the motrin and a little
tramadol has been very affective in alleviating pain when it is intolerable.
I have had no side effects from this but I will keep the dosage down. Karen

This condition is actually similar to Restless Leg Syndrome. I have it myself and it started when I switched to Methadone for Chronic Pain. I have heard others that have various drugs (Opiate pain meds) that affect them in this way. I believe it is probably (I'm almost positive) that it's the Ultram (Tramadol HCL) and if she switches to something else, it will go away.

One other thing and I feel this is very important. You said she is also on Gabopentin. This is also called Gabitril Filmtabs and it is a medication used for seizures or epilepsy. I was on this at 24 mg a day (taken at bedtime) to help the twitching I have all night. When I refilled it about a month ago, it came with a notice that the FDA has issued a warning that patients taking this medications who DO NOT normally have seizures or epilepsy can in fact begin to have seizures from taking this med. I took it to my doctor and he checked with the head pharmacist at the hospital and then took me off it immediately. Actually, he had me titrate down and then off to avoid having a seizure. I think she needs to talk to her doctor or better yet her pharmacist about taking Gabitril (Gabopentin).

I'm sorry, this was my mistake. I thought it was the generic for Gabitril when it's actually Neurontin. Gabitril is the medication that can cause seizures in people who do not have that condition prior to taking Gabitril. So, if you don't have a condition that causes seizures, do not take Gabitril.

Try the 50Mg dose that may improve things i was on 100mg Tramadol SR which made me drowsy has anything

But i found the 50mg dose is as effiective maybe she could give that a try?

I was presribed Tramadol last week for what felt like a very painful kidney stone. 50mg 4 times a day. It dulled the pain but did not take it away completely .. like it was not strong enough .. but it got me through. I have also been told I can use it for Migraines .. there again .. 50mg is not quite strong enough .. but I cannot take codeine as it's affecting my kidney .. so if this is all I can take .. I'll have to be happy with that. I have however found it is causing quite bad diarrea which I'm not so happy about as I used to get that from IBS and don't need it starting up again ... I have not noticed any other side effects ... I'm also on an anti depressant called Cipralex :)