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    Old 02-07-2004, 08:28 PM   #1
    Cloie
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    Overmedicated/Ultram

    Hi all,

    I take about six different medications for a myriad of things. Docs and pharmacists tell me they are fine to take together and there are no contraindications, only slight additive effects causing drowsiness, but should be okay. However, many times, I feel over medicated, almost toxified or poisoned by too much medicine...tired, but wired. Not sure what the solution is. Anyone else feel overmedicated?
    Anyone out there on Ultram? Any info/experiences good or bad appreciated. I just started on it yesterday. Cloie

     
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    Old 02-08-2004, 07:00 PM   #2
    REC73
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    Re: Overmedicated/Ultram

    Hi Cloie, nice to hear from you again

    What are the other meds that you are taking? I'm sure your doc nor your phamacist would prescribe or give to you any meds that would in some way harm you when taken at the same time. I currently am on oxycontin and endocet for pain and flexeril and every now and then ambien when i'm down and out and i can't sleep because of the pain from my fibromyalgia. Before my surgery to decompress a ruptured disc i was on neurontin for the sciatic nerve pain but i no longer need to take it and the elavil just didn't seem to work for me.

    As far as the ultram goes.......i was put on it when it first came out and my GP told me it was going to be this great med for people with chronic back pain because it was a non-narcotic and people didn't need to worry about physical dependence. WRONG! I can attest as i'm sure many other people can that it works on the same receptors as narcotics do therefore it mimics one very well and can cause dependence if taken for a length of time. I took it for about 6 mo. and it worked well for my pain in the beginning. I went through a period of time where my back wasn't hurting like it does now so i quit taking them because i felt like IB 800mg. was able to make the pain tolerable and i didn't want to take anything prescription if i didn't have to. I soon learned quickly that i was going to withdraw from it in a terrible way. It not only has analgesia properties but anti depressant ones too.

    If it works well for your pain then AMEN i believe in pain management. I just wanted you to know if you already didn't that it behaves like a narcotic even though it's synthetic.

    Hope you are feeling well and take care

     
    Old 02-09-2004, 07:17 AM   #3
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    Re: Overmedicated/Ultram

    Hey Cloie, I wanted to add to what REC said. Ultram can cause physical dependence just like any opiate medication, I've done the Ultram withdrawal too, It's particularly bad because Ultram also acts like an antidepressant or has antideprerssant qualities. It should be slowly titrated onto a theraputic dose and needs to be slowly tapered off of.

    Like 1 tablet twice a day week one, 1 tablet 3 times a day week 2, 1 tablet 4 times a day week 3.

    Because it not only has opiate properties and antideprtessant properties it greatly effects serritonin reuptake and discontinuing Ultram can be as bad as stopping Paxil abuptly. The physical part of withdrawal syndrome is something most folks can deal with and know what to expect, But withdrawal from drugs that effect serritonin reuptake can really make you feel like your brain is fried and misfireing. It's not the amazing wonder drug, that's abuse proof and non addicting that Mcneil originally claimed.

    It can cause seizures when you exceed the max daily dose of 400mgs, The difference between a safe dose and a dangerous dose is merely one pill. It's not like opiates that you become acustomed too and have virtually no ceiling. If you are accomadated to opiates there really is no ceiling if you are titrated slowly and safely. You can go from 100mgs of morphine to 1000mgs of morphine in less than a year, "just an example" but with Ultram their is definitely a ceiling and many docs will take you right to the edge at 400 mgs. IMO There is just something wrong with a med when the theraputic dose and a dangerous dose is only seperated by one pill.

    On the other hand there are folks that Ultram does relieve their pain and make normal functioning much easier. As long as you know the potential hazzards you can avoid them and be aware, and report any strange feelings that might be a sign that this med is not for you.

    It kind of sounds like your doc has the shotgun aproach to pain management. Blast you with as many non opiate drugs as they can and withold the true opiates that will actually give pain relief. Trying non opiate methods is part of Pain management and it wouldn't make sense to go from surgery to post op pain to pain management with OxyContin or LA morphine with nothing else tried in between.

    Educate yourself about the meds you take. Don't scare yourself with every possible negative side effect but be aware of how these meds effect you and what the potential for negative side effects are.

    If you don't mind, if you list your other meds I would bet it's a pretty common CP cocktail of anti depressants, Antiseizure meds, sleep meds, anti inflamatories and, muscle relaxers and pain meds. See, I just named 6 different classes of meds used to treat CP.

    So your meds may not be unusual, you just need to be aware of how they effect you and what our other options are. Almost every med I named has potential for physical dependence and you need to be aware of this so you don't discontinue a med without tapering and throw yourself into withdrawal which can be pretty nasty depending on the drug.

    Most folks are aware of opiate withdrawal, but these other classes of meds used for CP can cause just as severe withdrawal syndrome and the ones that effect brain chemistry can be particularly nasty since docs aren't familiar with how to deal with anti depressant withdrawal, or withdrawal from meds that are being used for off label purposes.

    IE many Family docs will prescribe Paxil or other antidepressants but have no idea how to deal with seritonin syndrome or the withdrawal syndrome caused by antidepressants. Most docs don't even recognize that Ultram can cause withdrawal. If they don't believe it they certainly can't treat or manage it.
    Take care, Shore

     
    Old 02-10-2004, 12:27 AM   #4
    Cloie
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    Re: Overmedicated/Ultram

    Hi Shoreline/Rec,

    Thanks for getting back to me. I also had my husband ask about Ultram in another forum (benzo withdrawal) and several people there had taken it and agreed with you that it is addictive. It just amazes me that a consensus of people who've taken Ultram know that it is addictive and causes withdrawal symptoms, and the doctors don't. Benzodiazepines are another wonder drug prescribed like candy with horrible withdrawal symptoms for many people. There is something seriously wrong with how medicine is practiced when the patients know more than the doctors. Seems the doctors (like our politicians) rely on faulty intelligence sources (pharmaceutical companies). How can they not know they're being snowed by this time?
    I also take Neurontin (was on 1800 mg. day reduced now down to 600 mg. day) for carpal tunnel pain, Aleve, Omeprazole (gastritis), Diovan (high blood pressure) and doxepin (tricyclic antidepressant). Since I have had carpal tunnel surgery on right hand, I was able to reduce the Neurontin. However, that is when enormous pain in elbows began. It is intolerable most of the time without some major pain med and fluctuates from mild to severe depending on a number of factors. Doc says its tendinitis.
    I'm wondering if I should ask doc to increase my Neurontin back up to see if that helps alleviate pain. Does Neurontin only work on certain types of pain? Nerve pain, but not muscle inflammation? Or does it work on any type of pain since all pain eventually is felt in the nerves? They don't usually prescribe Neurontin for tendinitis, but I think it got worse when I reduced dosage. Wonder if that was just coincidence. Think it may also have something to do with dislocation in neck. Also have mild to moderate neck pain all the time.
    I was taking Oxycodeine 5/325 (half to 3/4 tab bid). 3/4 of tab killed about 90% of pain, but made me drowsy and totally lacking in energy or motivation; and I was afraid of getting addicted or acclimated and it not working anymore. Ultram plus Aleve seems to kill only about 60 to 75% of the pain, but doesn't make me tired. However, Ultram makes me very dizzy and very nautious, which I'm told will wear off. Neither solution is ideal.
    I just don't know where to turn for med advice as I think most doctors don't know what the h*ll they are doing and are playing guinea pig with us. Hard to trust any of them.
    I think there are synergistic effects that docs just don't know about. I know doxepin and Ultram don't mix well...had to cut out doxepin to tolerate Ultram. Psychiatrist that prescribes doxepin insisted there wasn't any interaction, but web info says otherwise. Both raise serotonin levels. When I mixed doxepin and Ultram, felt weird vibrations in my head, nose and tongue, so I cut out the doxepin to try Ultram. However, I never felt good on Paxil or Prozac either. All of those SSRI's made me feel spaced out like Ultram does. For some reason, doxepin doesn't affect me like that, because it's a tricyclic not an SSRI. So if Ultram is just as addictive, then why am I going through all this, when I felt better on Oxycodeine and doxepin? I think I may just go back to square one when I felt better, on 1800 mg. of neurontin, oxycodeine and doxepin and forget about the Ultram. I'm so exasperated with all of this.
    Any remedies for tendinitis greatly appreciated. I'm trying accupuncture which seems to help. Thanks for listening. That helps more than I can put into words. Hugs, Cloie

     
    Old 02-10-2004, 07:29 PM   #5
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    Re: Overmedicated/Ultram

    Please do take the seizure risk seriously. I know someone who recently started ultram and had a seizure from a rather low dose on the third day. It was very scary.

     
    Old 02-18-2004, 10:37 PM   #6
    Sandson
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    Re: Overmedicated/Ultram

    Quote:
    Originally Posted by wirry1422
    Please do take the seizure risk seriously. I know someone who recently started ultram and had a seizure from a rather low dose on the third day. It was very scary.

    Wirry:

    Whoa!

    I was sad to read about your friend. I am relieved about deciding not to take Ultram. My experience with taking that medicine wasn't too pleasant either because I delt with awful indigestion, dizzyness, and nausea (took medicine for 2 days). I am glad that I followed my mind and went back to my other medication.

    I definitely agree with your suggestion. Avoid ultram at all cost if you can.

     
    Old 02-19-2004, 06:53 AM   #7
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    Re: Overmedicated/Ultram

    I guess I'll be the dissenting voice here but I like Ultram, whereas my husband can't stand it. He has osteoarthritis in his knees, I have endo/benign ovarian cysts, and, while he did say it gave good pain relief, he couldn't stand the headaches and went back to OTC stuff after a couple of days. I had headaches too at first but they went away after several days of using the Ultram, I guess your body adjusts to it. I am not too happy about it being physically addictive but I'll take shoreline's tapering plan and use it (cut down by .25 every four days). .

     
    Old 02-19-2004, 09:01 AM   #8
    Cloie
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    Re: Overmedicated/Ultram

    Has anyone every experienced tingling/buzzing of their nose or tongue after taking a med? Is this a sign of mild seizure activity? Just curious. It's happened to me a few times on different combinations of meds. Thanks, Cloie

     
    Old 02-19-2004, 12:44 PM   #9
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    Re: Overmedicated/Ultram

    Hi Cloie, The reason why docs would prefer to prescribe Ultram is because of the DEA drug classification system. Percocet or oxycodone is a class 11 med and has the highest restrictions and enforcement of reguilations where ULtram I believe is a class IV with very minmal regulations to protect patients from abusing this med.

    It draws no attention to the docs prescribing practice because it's not considered a desirable drug for abuse by the DEA. People don't inject or party with it because it's not a true opiate where a buzz can be attained by missusing it. But the real reason is simply docs will never be questioned for prescribing Ultram for years where a doc that prescribes any class 11 med may eventually be questioned about his prescribing of potent opiate medications.

    It's safe for the docs to prescribe! But no safer for the patient than percocet.
    It's actually much riskier for patients to take than pure opiates. But docs like to think they are looking out for our own good by not prescribing those evil painkillers that people abuse.

    I don't mean to imply that nobody benefits from it, but as far as physical dependence, It's just as bad as an opiate or antidepressant as far as experiencing withdrawal syndrome if discontinued abruptly.
    Take care, Shore

     
    Old 02-19-2004, 03:11 PM   #10
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    Re: Overmedicated/Ultram

    Actually there is something very wrong with our doctors and medical system, but its not that patients know more than doctors. The real proble m is that doctors know that pure opiates are more effective and safer than benzos and synthetic narcotics, but they hope the patient doesn't know this, so they lie and say that ultram is safer than percodan, because they are afraid of the DEA, but they don't say that, they just say its safer, in the hopes that patients are ignorant and will take there word fot it, because they won't admit to the patient that the real reason is because of the DEA, otherwise patients would demand the safer drug regardless of the DEA, thus subjecting the doctor to more scrutiny by the government. I agree that many docs are playing with a very dangerous combination of drugs rather than prescribing the safer drugs. For example i left a pain doctor after being prescribed a stew of drugs. I was originally on zoloft 150 mg daily prescribed by my psychiatrist purely for depression. I was having severe pain however from nerve and spine problems, so i went to a pm doc 20 miles from my house. This quack kept me on the zoloft, and prescribed neurontin 2100 mg a day, elavil 50 mg daily, amantadine (used to treat the flu and parkinson's disease according to literature) 400 mg's a day, and darvocet 100/650 up to 8 per day. I kept up this regimen for 3 months even after having some pretty severe side effects, both neurological and gastrointestinel. In addition i was getting maybe a 10-15% reduction in pain at most, even with 6 darvocet a day (my pharmacist told me never to take 8 a day, which i already knew anyway, regardless of what the doc said because of apap toxicity). After the tree months, i left after he refused to do anything but raise the elavil. From what i read after leaving, the elavil-zoloft-amantadine-neurontin combo was rather dangerous, and indeed i was lucky not to have even more severe side effects. My new pm stopped everything but the zoloft (which i was previously on anyway) and prescribed oxycontin 10 mg's twice a day, and oxy ir up to 3 a day for bt. All of the severe side effects i had ceased immediatly, and my pain relief shot up to 80% most of the day. In other words, the oxy was 4 to 5 times more effective than the combo of 5 (some 22 pills per day) i was previously on, and with maybe 5% of the side effects (just some fatigue in the beginning and mild constipation) and no dangerous neurochemical interactions. And the first guy did all of that just to avoid prescribifng a safe and effective opiate because he was scared of the government. He was willing to risk my life, how crazy (even my new pm doc said he was playing with fire and had dangerous prescribing practices. Yet the DEA would investigate my new doc before it would ever look at the old pm doctor, how insane!) So it seems as though the government puts all the emphasis on these relatively safe and effective medications (oxycodone, morphine, hydromorphone, hydrocodone) and ignores the prescribing of more dangerous classes of drugs including anti-depressants, benzo's, synthetics like ultram, and stimulants like adderil and ritalin. This is totally backwards, but who ever said the government made sense?! The only thing we can do is just be informed patients and don't rely on your doc or the government to make the best decisions for you without being proactive and educated. Take care everyone.

     
    Old 02-20-2004, 10:38 AM   #11
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    Re: Overmedicated/Ultram

    Shoreline, I'm sure this will shock you, but Ultram/Tramadol & Ultracet are NOT scheduled drugs at ALL. It is easier for me to get Ultram than to get a cough syrup with codeine or a Lomotil!

     
    Old 02-20-2004, 11:55 AM   #12
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    Re: Overmedicated/Ultram

    I am shocked that it's not at least a schedule V that you have to sign for. If it's unscheduled you shouldn't even need a script. Yikes

     
    Old 02-20-2004, 03:52 PM   #13
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    Re: Overmedicated/Ultram

    Mouse, you are absolutly correct, Ultram and ultracet (compound known as tramadol) is not a scheduled drug on the DEA's list of schedules I-V. That may eventually change as the DEA gets wind of increased abuse and diversion of this drug, that will inevitably occur more often if hydrocodone is rescheduled to schedule II status, which is what the federal DEA and FDA are proposing. Shoreline, there are many drugs that are unscheduled prescription drugs. The FDA has the power and authority to declare drugs as OTC or prescription, depending on its danger, and need for doctor-patient interaction, advice, and regulation for safe and effective use. Whereas the DEA, a totally different agency that works with the FDA at times, has the authority to declare a medication a scheduled drug, based on its potential for abuse, dependence, additction, and diversion. A drug need not be a prescription medication for it to be scheduled by the DEA. For instance, many OTC caugh medications are actually Schedule V drugs according to the DEA. By the same token, prescription drugs definetly need not be scheduled by the DEA. For example many colesterol lowering medications, heart burn medications, and anti-biotics are classified by the FDA as drugs available only by prescription. The DEA would have no reason to place an anti-coagulant like warfarin into scheduled status because nobody will ever abuse or become dependent on warfarin. However it can be dangerous and should only be used under close doctor supervision, and that is why the FDA has declared it a prescription drug. Now DEA sheduled drugs II-IV are only given by prescription from doctor with a medical license and a DEA license. Schedule V meds (and in some states that have schedule VI) are in some cases available OTC, with a few minor regualtions which mostly apply to the vendor. Prescriptions are only available by prescription (obviously ) and can be prescribed by doctors who have a medical license, but no dea license is required, so medical and surgical residents, who are ineligible for a dea license, can prescribe cholestrtol lowering drugs, anti-biotics, etc. etc. Hope that clears some things up for you.

     
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