Posted by bleauberry on April 26, 2009, at 18:04:05
In reply to Tramadol Withdrawal Question...Anxiety is crazy, posted by ChuckChuckAlong on April 25, 2009, at 17:42:50
I've been through a bunch of psych drug withdrawals, but not tramadol or opiates. But the strategy remains the same. Which is, slow and in tiny steps.
Rather than setting a preconceived dose target, reduce your dose in a way that is tolerable. You'll know when you overdid it, as you are feeling right now, and you'll know when you are ready to take another step.
Tramadol pills can be customized by breaking them, pulverizing them into powder, or cutting them with a pill splitter, razor blade, or knife. Doses do not need to be exact. Close is close enough.
Keep doing the twice a day dosing. What you want is for the blood level to very gradually decline over time, without any huge ups and downs which you would get if you did once a day dosing.
Example: 3 days at 90mg twice a day; 3 days at 80mg twice a day; 3 days at 70mg twice a day; oops, overdid it, back up to 80mg for a couple days; 70mg for 3 days...and so on. Maybe it is 5 days at each step, maybe just 2, maybe 10. Maybe you drop dose by 5mg instead of 10mg. You don't know. You have to let your reaction be the steering wheel. You won't know what your next move is until after you see what happens from your last move.
Basically, drop the doses down in tiny little steps. My worst withdrawal was from Zyprexa 5mg. It took me 3 months, dropping the dosage by tiny little chunks off the pill, maybe .25mg at a time max.
Tramadol isn't a strong opioid, but it is an opioid. So that is hard enough. But, it is also an SNRI, similar to Effexor. Effexor has about the worst withdrawals of all the ADs. So you are withdrawing from serotonin reuptake inhibition, norepinephrine reuptake inhibition, opioid action, all at the same time.
Take it slow and easy and it will work out. If it takes 3 months to accomplish what you hoped would be 3 weeks, so be it. Be safe.
If you absolutely need a benzo for anti-anxiety during withdrawal, just realize that you will also have to withdraw from that at some point, which is not fun either. You might want to use longer acting ones such as Klonopin or Valium rather than Xanax, and take them only when you absolutely need them, not on a prearranged schedule. Xanax can actually set you up for even worse anxiety. As it wears off with its very quick halflife, anxiety is worse than before you took it, added on top of the tramadol withdrawal anxiety. Not pretty.
For Effexor or Paxil withdrawals, there is a strategy of taking small doses of Prozac every other day or so. It's long life and similar function makes it a bit easier to withdraw from short life similar meds such as Effexor.
poster:bleauberry
thread:892766
URL: http://www.dr-bob.org/babble/20090426/msgs/892922.html