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FairyMagick 12-07-2005 11:19 PM

Enhancement Drug Question?
My doctor prescribed hydroxy pam and said it was an enhancement drug for utlram. I'm really confused by this. I looked this medicine up, and it is an antihistamine! Anyone have experience with hydroxy pam ? Why would it be an enhancement for pain meds?

Shoreline 12-08-2005 06:04 AM

Re: Enhancement Drug Question?
Hi Fairy M, You have the generic for visterill andit is commonly given with denerol shots to both control nausea and enhance the effects. Phenerganb is another anti nausea md that's also a antihystamine but as far as enhancing ultram, I kinda doubt you going to notice a hge difference unless Visterill on it's own causes aenough sedation to feel like it's enhanced the Ultram. Do be careful with the Ultram, It's not quite as benign as many docs lead us to believe, It does have opiate properties in that it binds to some of the MU opiate receptors and it also has SSRI properties and you need to watch for drug interactions if your taking other SSRI's.You can become dependent on Ultram and it does have a max dose of 400 mgs a day or you could be at risk for seizures if you exceed that dose or aproach it too quickly, Ultram should also be titrated "slowly increase the dose", start with 2 pills a day then 3 and so on untill your body gets used to it.

It is possible by virtue of Hydroxines' sedative properties and anti nausea properties that it will help with pain but it's really not a great potentiator other than with demerol. However any drug that calms and relaxes when you hurt so bad you can't catch your breath could be considered a potentiator, mainly through it's combined CNS depressant effects.
Good luck, Dave

FairyMagick 12-08-2005 09:16 PM

Re: Enhancement Drug Question?
Hi Dave,
Thank you for the helpful info! What are SSRI's? I have been worried about taking ultram, but I didn't want to complain to my doctors. Is the seizures side effect common? I have been on ultram for about 10 days. With no side effects except a little medicane head feeling. Do you think that means I wont be at risk for seizures? I get so scard taking new meds. Sorry for all the questions. Thanks again :)

Fabrashamx 12-09-2005 09:58 AM

Re: Enhancement Drug Question?
Hi Fairy, I have been taking Ultram (Tramadol) for about 10 years now, It works well as my base med for DDD. I have been on the highest dose, 100 mgs 4x per day for years, although most days I take less than that. You have to build your dose up slowly, and be even more careful bringing it down, I was once caught out of town not realizing I had no refills left and had to go 3 days without it. I never had a seizure, but it was a horrible experience, I felt these like electric shocks shooting through me and I had restless leg problems, was tired and miserable. I can see where someone could have a seizure. I know a lot of people don't care for this medication because for one thing it claims to be a non-opiate but it does have synthetic opiate properties, and the risk of seizure is always there, But my pain is greatly improved on it and my dose has not needed to go up in all these years. I also take an opiate medication daily and the two seem to work very well together. What works for one person won't always work for another, but I have been very happy with it. Good Luck and be kind to yourself~ Fabby :wave:

Shoreline 12-09-2005 12:46 PM

Re: Enhancement Drug Question?
Hey Guys, I used Ultram as an adjunct med while taking post op pain meds and it did make a big improvement. THis was in the 90's when less was known about the med. SSRI 's are a class of antidepressants that are "seletive serritonin reuptake inhibitors" It's what makes them work. Prozac, Zoft, Paxil, Effexor,I can't even name them all, but most of the the antidepressants used are SSRI's. A few like evelvil and some others are in a different class and some are unique. Ultram has SSRI properties too so you should be careful if your taking one of these antiD's and follow the same guidlines for discontinung Ultram.

Neither opiate nor SSRI should be stoped abruptly. Discontinuing antiD's can cause serritonin syndrom whih can be deady or cause other things like psychotic breaks. So stopping Ultram abruptlyi s like a taste of both kinds of withdrawl where you brain feels really fried and your whole body feels electrified like Fabby happened to mention. I wonder if that was the beginning of withdrawal if you were significanlty alterng daily doses. It should be titrated onto and titrated off. However some docs still don't know how nasty this stuff can be and how severe the withdrawal is. They did a great job of marketing it as the benign, non opiate pain med.
Take care, Dave

FairyMagick 12-09-2005 10:39 PM

Re: Enhancement Drug Question?
Hi Guys,
Thanks for replying to my post. I'm sorta scard of Ultram now. I'm wondering if my PM doctor would get bent out of shape if I mention my concerns. I wasn't aware of the SSRI properties. I don't take any of the meds you mentioned Dave. But I'm upset the doctors didn't bring up the whole SSRI and withdrawl issues. I guess there is always side affects with any pain med. Ultrams seems to work for me so far. I know I will be on pain meds long term. I just want something that had the least problems. I'm glad to learn about what can go wrong. Thanks so much again guys!

stacykgb20 12-10-2005 12:51 AM

Re: Enhancement Drug Question?
Please don't be scared of Ultram--each person's experience is unique and if you ask enough people, you'll hear horror stories about every medication. But if you're already on Ultram and not having bad side effects, I doubt you'll have trouble with it as long as you stay under the maximum daily dose. The main question is does it help with your pain, and if so, I'd suggest you keep taking it, but if not, there's no need to have it in your system. The stuff Dave was saying about SSRIs is true, but it's mainly an issue that you have to worry about during withdrawal--it's dangerous and just a really bad idea to abruptly stop Ultram cold turkey because of its SSRI properties, while stopping pure opiates cold turkey can be pretty miserable butt usually doesn't pose serious risks unless you're on a really high dose or have certain risk factors. But other than withdrawal issues, I don't think Ultram will cause you any serious problems like seizures; just take it as prescribed and realize that it can produce the same euphoric effects as opiates which means there is a potential for abuse and even addiction with it if you take more than you're allotted in order to get high. Dave sure is right that the Ultram manufacturers were sneaky geniuses in order to get Ultram classified as non-narcotic, when in fact it binds to opiate receptors and poses other potential problems relating to addiction and withdrawal because of its SSRI effects. And for me, Ultram was just as potent as an average opiate and gave me more of a buzz than Vicodin or Percocet. The nice thing for people on Ultram is that since it isn't technically classified as a narcotic, you don't have to deal with stupid state laws like not being able to get refills or have prescriptions called or faxed in. Again, I don't think you need to be worried about Ultram if you take it as prescribed and don't have many side effects, though you should NEVER hesitate or feel awkward about asking questions and expressing concerns to your doctor. If you don't feel comfortable talking openly with him, I'd get another doctor, because the more you communicate and the more upfront, honest, and assertive you are with your doctor, the better care you will receive. It's taken me several years of dealing with CP and doctors to realize that they will be pretty passive unless I take the lead in keeping them updated and letting them know what I need. The more firm and knowledgable you are about your condition and treatments, the more respect you'll get from your doctor and the better questions you'll ask, which means that you'll get more helpful and detailed information from your doctor. I would also strongly advise you to be aggressive about pursuing alternative therapies outside of your regular doctor's office--if your docs are like mine, they will tell you things like acupuncture, biofeedback, chiropracture, vitamin and herbal remedies, etc. might not help but won't hurt, which makes these treatment options become more and more appealing the more time you spend dealing with the side effects of traditional medication. It's also usually quite helpful to see a psychiatrist (a medical doctor is best) to discuss your concerns about relying on medication, your feelings about your pain and worries about the future, and just have a helpful professional who is well-trained in helping chronic pain patients cope with life as best they can. If you are stuck with a permanent condition and aren't happy taking medications, there are several good pain rehabilitation centers scattered across the country that can apparently work wonders in helping people learn to live normal lives again and gaining control over their pain even though they can't eliminate it. They know a lot about alternative therapies like eastern medicine--acupuncture in particular can be very helpful in alleviating pain and doesn't have any dangerous side effects, so please don't be discouraged, as there are a lot of potentially effective treatments out there that you can try, not just traditional western prescription medications, which are often a frustrating and insufficient, even ineffective, remedy for chronic pain. Good luck and take care! :wave:

FairyMagick 12-10-2005 10:55 PM

Re: Enhancement Drug Question?
Stacykgb20, wow I'm really touched and grateful for you informative post. I will take your advice and let my doctors know about my concerns my next visit. Getting all this info has been a good thing for me. I get so scared taking new meds, but now feel relieved that I have more knowledge. And I totally agree with you all meds have side effects. I was just telling my Mother the other day about my worries and she was saying even aspirin can cause serious side effects for some people. Thank you again for sharing your knowledge with me. Best of luck to you!

Fibbles 12-12-2005 04:11 AM

Re: Enhancement Drug Question?
I was given Ultracet (Tramadol and Tylenol) for BT a few years ago. I was afraid to take it and usually am when taking new meds, but I do remember it giving me a nasty feeling high and sort of sick feeling. I did not like it much, even on the lowest dose. I didn't have any other problems since I didn't take it often or in quantity.

Also, a few years back, I was also given an SSRI called Celexa to see if it would help my insomnia. One of my GP's (I have 3) wanted to see if it did anything with regards to my serotonin levels, so she prescribed half a tablet of I-don't-remember-how-many mg's every day. After 2 months, my insomnia was still present and the side effects were bothersome, so I decided to stop taking it. I quickly figured out that I needed to taper. Even then, I still had some nasty side effects like extreme sensitivity to light, this feeling my head was conducting electricity, and a feeling that people were sticking their fingers inside my brain - it felt like warm hands were on top of my head and hot fingers were electrically buzzing inside it.

When I mentioned the side effects of Ultracet to my PM doctor, she decided to give it a try for her upcomming bladderstones. I don't think she liked it cause she got rid of her samples :confused:

Shoreline 12-13-2005 12:17 PM

Re: Enhancement Drug Question?
Hey Fairy, Seizures raerly occur unless you exceed the 400 mg mark or or are predisposed t o seizures. So I'm sure you doc won'ty exceed the recmeded dsose, and took a history ot ensur you don't have a history fof seizure activity.

It can be an effective tool in pain management, just because there are potential risks if youexceed the recmeneded dose shouldn't mean it shuld be pulled from the market. My beef with Ultram is the way it was marketed as totally benign, no dependnece, no withdrawal and completely safe.Many docs still think the same that don't use it regualrly in PM and that's the scarry part because when it first came out Docs were entirely mislead by McNeil Pharma about his new non opiate pain med

The spacey feeling will likely deminish as you become used to the med just as it does with opiates. If it doesn't get better than I would bring it to your docs attn. Like many others my Uncle used it for years for knee pain and had no problem untill he tried to stop takking it, He did eventually taper off but he was in no way prepaired for the idea of becoming dependent. As long as you follow the instructions, taper on and off and don't exceed that limit you really should be fine.

I didn't mean to make you worry, just inform you if you had been mislead about Tramadol.

The interesting thing about when I used it in conjunction with percocet for post op pain is that I discontinued the ultram first and experienced withdrawal while still taking percocet. It's a unique med , so just be careful and be aware it has a max dose and not to stop taking it abruptly.
Take care, Dave

conductor 12-13-2005 05:37 PM

Re: Enhancement Drug Question?
Please see the next message.

conductor 12-13-2005 05:39 PM

Re: Enhancement Drug Question?

I do understand that this thread wasn't specifically meant to deal with Ultram experiences, but I have read through the responses and noticed the comments about the relationship between the ingestion and seizures.

When I was Rx'd Ultram (in approximately 1996), I had about 3 seizures within a month's time. Because seizures (and miniature strokes) are related to my Lupus Anticoagulant condition, my physician (the jury, naturally, is still out on whether or not he really has a valid medical degree--I had to go ahead and get the sarcasm out of the way) dismissed these episodes as "micro-miniature strokes" [his words].

Since Ultram provided absolutely no relief, I was moved to a vast array of different pain medications. [B]I never had another "episode"![/B] Although I certainly cannot place the blame of these grand mal seizures on the Ultram, it is certainly curious that they never occurred once I was removed from the medication.

I should add that I had several EEG's, one MRI, and one CT--all dealing with the seizures.

If I have left something out, please feel free to ask me. I will be glad to respond.


P.S. If I recall correctly, I took--at the most--200 mg per day.

FairyMagick 12-13-2005 10:05 PM

Re: Enhancement Drug Question?
Hi Guys,
Glad to hear more info about Ultram. Thanks so much. This board is so helpful!
Dave if you dont mind just wanted to ask you what you think of something. I started taking Ultram on November 29 along with Baclofen. Every sense last Friday I have had a brake to were I am in not so much pain! I take the Baclofen daily. Not sure if it is the reason for the change in my pain. I stopped taking the Ultram on Friday. Every so often I can get a brake for a few days were I'm in a tolerated pain cycle.
I guess my question is. Is that also a bad idea? Should I be taking Ultram even on the days I don't think I need them? I had asked my Pharmacist if I can just take my new meds when I need them. He said "yes". I trust your knowledge. I can see how doctors and pharmacist views are after learing about there views on Ultram. Today I feel slightly dizzy but that could be from my IBS meds.

Shoreline 12-13-2005 10:49 PM

Re: Enhancement Drug Question?
Hey Fairy, I saw another thread about baclofen I didn't get a chance to post about, It's an anti spasmodic but it also hasunique propertis that work on the nuerotranmitter level that disrupt chronic pain, It's often the mainstay drug in MS patients with intrathecal pumps, The severe ragidid and spacticity seems to respond to baclofen the best. I have a pump and have been tryng different adjunct drugs for their neuro chemical blockading charicteristics, I wasn't looking to treat spcaticity or spasms more agressively, but to change the way your brain chemistry works in CP patients. Unfortunately the anti spacticty effect is litmiting my ability to use it due to urinary retention from it's effect on the smooth muscle mainly the bladder.

Don't stress about this because pumps that deliver meds to the the spinal cord and reach the doesal horn of the brain are 100 times more effective when bacfloen is delivered via a pumps Vs oral meds.
As far as laying off the Ultram on good days, It would likely be OK to reduce your dose but stoppng it completely is probably a bad idea. Taking your morning dose to prevent pain is art of treating CP. Catch it before it gets out of hand because it's easier to control than to bring down.

Conductor obviously had major problems, He was also predisposed to have seizures but it can even if the dose isn't exceeded.. I think you would have probably had an experience by now if it was going to be a problem, But each increase or step in titrtion, does carry a little risk. I don't know your dose or schedule. If you're taking 100 mgs a day and nothing the next, It's not the same shock to your system as taking 400mgs and skipping a day or two.

You need to be careful with Baclofen too, it shouldn'ty be stopped abruptly, It' very dangerous when delivered by pump if you run out. The only thing to abort the withdrawal is to give more aclofen and remeber your trying to stay ahead of the game, perhaps the prior use is why your having good days. As long as you do get use the meds safely they can be taken for prolonged perods withut any il effect and can be discontinued should they cyre your problems, if dose corectly. So bth drugs have risks but are very sueful. You have to decide if you aid is worth the risk and price we pay fif a drug causes dependence.
Hang in there, I didn't mean for you to stop your meds. If you restarrt, follow the original titration schedule, don't just start where you left off.
Do you really want to know this much about the meds????
There really are risks with any drug. Always refer to your doc because there can always be exceptinos.

My daughter has had allergic reactions where he lips turned blue from IV steroids once and milder reactions to ear drops and nasal spray. None of the 8 docs seen think she can be allergic to steroids and it must be some common added ingredient. I understand you're body makes steroids and it's the natural response to inflamation etc. But some peope are allergic to water? SO anything is possible.

Sorry about the missed key strokes, I'm a terrible edditor and it's time to by another 10 dollar keyboard.Being dylexic doesn't help either.

As far as your qustions, Your doc is well read to coose Baclofen althoughg it's not a great drug for acute spasms. Spactitiy and spasm are a little different.
Take care, Dave

Fabrashamx 12-13-2005 11:37 PM

Re: Enhancement Drug Question?
Hi Fairy, as I have said before I have taken ultram for many years and while it works well for me, it certainly is not the medication for everyone, as I can see by Jons experience. I also take Baclofen, I have taken the two medications together (along with lexipro) everyday for about a year ( I have been on the ultram a lot longer, but didn't switch to the baclofen til then) and I can tell you the dizziness you experienced is something I notice if I miss a dose of the ultram. Like Dave said, it is very very important that you not start or stop either of these medications abruptly. My doctor gave me about 20 pages of reading material on ultram, It is a medication that can work very well as it does for me but it has to be closely monitored. My lexipro and the prosac I was on before are both counter-indicated for drug reactions with tramadol, because it is basically taking a double dose of the seritonin reuptake inhibitor. My lexipro dose is lower than it would be were I not on the ultram. I am aware of the risks, but I still choose to take it because it works very well for my pain. I also have not had a noticable tolerence develop, I am on the same dose I was on 9 years ago and am still getting good results. I think when you get to the levels of medications most of us here are, anything you take must be taken with extreme caution, such simple things as taking an herbal suppliment can have serious consequences. starting, stopping, or adding new medications must be done carefully and under the care of a doctor you trust. There was an allergy medicine a few years back, one of the first perscription 'non-drowsy' medications, I believe the brand name was Seldane. It worked great, except if you forgot to mention to a doctor you were taking it, and were given an antibiotic, it could be fatal. After several deaths in the US it was taken off the market, I think it is still avalible in Canada. With the new way the FDA is pushing through medications, I think you have to find out everyything you can about a medication, thats one reason these boards are such a God send, we can compare notes long before we have to read about another recall in the news. I think it was the AIDS crisis that started the FDA fast tracking medicines that used to take decades to be approved, I can see their point, if people are dying, why not take a bigger risk when the odds are many more lives can be saved, but the downside is we end up being guinea pigs. Sorry for the rambling post, Hope you all have a good night~Fabby :)

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