Shoreline

Hi BH, Unfortunately, This isn't new information and I certainly hope the symptoms pass. It's a reminder to investigate the med you have been prescribed before taking it. I don't mean to tell people to read all the possible side effects and catastophize every possible problem that may occur, But there are some very basic problems with Ultram that are well known by patients, some docs and even the DEA wanted to reclassify Ultram as a scheduled drug. As it stands, it can be purchased over the internet withut a prescription and is perfectly legal.

Ultram has both opiate properties and SSRI properties, neither of which can be stopped abruptly. Honestly discontinuing a SSRI can be much more serious than discontinuing opiates. Although not a true opiate, It binds to he MU opiate receptor and when discontinued abruptly you experience opiate like withdrawal, through in withdrawal similar to paxil and you have weeks of fun ahead.

Your right, It was marketed by ortho Mcneil, claimed to be as potent as 60 mgs of codeine and a useful pain med withotut the risk of abuse and diversion. However It has a max dose which can cause seizures when you exceeed it and stopping abruptly will cause abstinence or withdrawal syndrome. You would probbaly be better served by a Psychiatrist that practices addictionology. They will be informed about the risks involved with using Ultram as prescribed.

If you do neeed a cardio consult the Psychiatrist can arange that, but likely it's just a matter of getting through the withdrawal symptoms without losing it. A short course of benzo usually rsolves the restless leg syndrme and anxiety your experiencing. I couldn't find anything abou casing heart problems which would lead me to think it's severe anxiety. People are eager to talk about how bad the physical part of withdrawal is, but the pshycological part, onset of srapid sever depression and anxiety can be worse than physical symptoms like nause and shaking.

After my second surgery I came home with Percocet every 4 hours, that wasn't quite cutting it so they added Ultram to the mix, 2 tabs evry 6 hours, The max dose.

After 3-4 weeks post op on the max daily dose, the doc discntinued the Ultram and left the percocet thinking there wouldn't be a problem. The withdrawal from ultram was terribale and not quite like opiate withdrawal. It screws with your brain chemistry more than opiates because of it's SSRI properties. It throws serritonin out of whack which will likely take several weeks to return to normal.
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Ultram Withdrawal

Ultram is the brand name of the generic drug Tramadol (TRA-ma-doll). Ultram is an analgesic used to treat or prevent pain. Ultram is not a non steroidal anti inflammatory drug, nor is it a narcotic. Ultram binds to certain opiod pain receptors in the body. By blocking the reuptake of the neuro chemicals norepinephrine and serotonin, it modifies the pain message resulting in pain relief.

Ultram was introduced in 1995, no control was recommended based on review of its uncontrolled use in 40 other countries. However, once Ultram was released in the U.S., Ultram addiction became readily apparent. Large doses of Ultram can interfere with the ability to breathe, especially if Ultram is taken with alcohol. Individuals dependent on Ultram may experience Ultram Withdrawal symptoms.

Ultram Withdrawal symptoms include but are not limited to:

difficulty sleeping
agitated
hallucinating
dizziness
depression
diarrhea
lethargy
sweats
body aches body much worse than before taking the drug
irritability
increase in tremor

This is from Oertho Mcneils full prescribing info on Ultram
DRUG ABUSE AND DEPENDENCE
ULTRAM may induce psychic and physical dependence of the morphine-type (µ-opioid). (See WARNINGS.) Dependence and abuse,
including drug-seeking behavior and taking illicit actions to obtain the drug are not limited to those patients with prior history of
opioid dependence. The risk in patients with substance abuse has been observed to be higher. ULTRAM is associated with
craving and tolerance development. Withdrawal symptoms may occur if ULTRAM is discontinued abruptly. These symptoms may
include: anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, piloerection, and rarely
hallucinations. Clinical experience suggests that withdrawal symptoms may be relieved by reinstitution of opioid therapy followed
by a gradual, tapered dose reduction of the medication combined with symptomatic support.
Clinical Pharmacology
Pharmacodynamics
ULTRAM is a centrally acting synthetic opioid analgesic. Although its mode of action is not completely understood, from animal tests,
at least two complementary mechanisms appear applicable: binding of parent and M1 metabolite to µ-opioid receptors and weak
inhibition of reuptake of norepinephrine and serotonin.
Opioid activity is due to both low affinity binding of the parent compound and higher affinity binding of the O-demethylated metabo-lite
M1 to µ-opioid receptors. In animal models, M1 is up to 6 times more potent than tramadol in producing analgesia and 200 times
more potent in µ-opioid binding. Tramadol-induced analgesia is only partially antagonized by the opiate antagonist naloxone in
several animal tests. The relative contribution of both tramadol and M1 to human analgesia is dependent upon the plasma concen-trations
of each compound (see CLINICAL PHARMACOLOGY, Pharmacokinetics).
Tramadol has been shown to inhibit reuptake of norepinephrine and serotonin in vitro, as have some other opioid analgesics. These
mechanisms may contribute independently to the overall analgesic profile of ULTRAM. Analgesia in humans begins approximately
within one hour after administration and reaches a peak in approximately two to three hours.
Apart from analgesia, ULTRAM administration may produce a constellation of symptoms (including dizziness, somnolence, nausea,
constipation, sweating and pruritus) similar to that of other opioids. In contrast to morphine, tramadol has not been shown to cause
histamine release. At therapeutic doses, ULTRAM has no effect on heart rate, left-ventricular function or cardiac index. Orthostatic
hypotension has been observed.

Good luck and I hope your feeling better soon.
Dave