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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by rogdog on May 12, 2001, at 13:33:13
I HAVE TRIED EVERY MED OUT THERE FOR OCD, TO HELP ELIMINATE THESE HORRIBLE THOUGHTS AND COMPULSIONS. AND ULTRAM HAS HELPED ALOT WITH THE OCD AND TOURETTES! ANY ONE ELSE HAVE SIMILAR RESULTS. ROGDOG
Posted by Michele on May 12, 2001, at 13:52:38
In reply to ULTRAM: EXCELLENT MED FOR OCD!!, posted by rogdog on May 12, 2001, at 13:33:13
I have been prescribed, and used ultram for about a year now for chronic pain. I have noticed that it also has an anti depressant effect for me.. so I'm not at all suprised that it's helped your ocd. Can I ask what dosage you are on?
Posted by cole on May 12, 2001, at 15:15:10
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!!, posted by Michele on May 12, 2001, at 13:52:38
Hey Rogdog,
If you don't mind my asking, what type of med is ultram exactly? My boyfriend that I was asking about months ago (he has OCD and Tourettes) is _finally_ going to a neurologist. He's felt his "anxiety" is out of control lately, my old serzone seemed to help, then he ran out. I'm wondering if the anxiety isn't really the OCD, but they tend to be very closely linked, so who knows. If you could give me a bit more information on this new med of yours, I'd appreciate it.
cole
Posted by Michele on May 12, 2001, at 15:49:30
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!!, posted by cole on May 12, 2001, at 15:15:10
Cole,
I know your post wasn't directed for me, but I thought I'd tell you what I know. I've been treated with this drug for a long time!
Ultram is generic for Tramadol...so using that for a search, I'm sure you can find a ton of info
It started out being prescribed for pain. That's what I took it for... now they are starting to find other things it is relieving as a nice little side effect. I've noticed my anxiety and depression has gotten better since taken it. What's even better.... is that since I thought it was strictly a pain med... I know the rest of what I am feeling is not placebo. It's really working for these other things!!
Posted by shelliR on May 12, 2001, at 18:04:15
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!! » cole, posted by Michele on May 12, 2001, at 15:49:30
> Cole,
>
> I know your post wasn't directed for me, but I thought I'd tell you what I know. I've been treated with this drug for a long time!
>
> Ultram is generic for Tramadol...so using that for a search, I'm sure you can find a ton of info
>
> It started out being prescribed for pain. That's what I took it for... now they are starting to find other things it is relieving as a nice little side effect. I've noticed my anxiety and depression has gotten better since taken it. What's even better.... is that since I thought it was strictly a pain med... I know the rest of what I am feeling is not placebo. It's really working for these other things!!
Michele, I thought you should have this information on ultram from Dr. Bob's tips before sharing its positive effects on depression and anxiety, without including a warning:
Date: Wed, 27 Mar 1996 12:29:30 -0800 (PST)
From: "H. Westley Clark" < carter@itsa.ucsf.EDU >
Subject: Potential of tramadol to cause addictionI just received in the mail the notice from Ortho-McNeil detailing the revised prescribing information
about tramadol.There have been 115 spontaneous domestic reports of drug abuse, dependence, withdrawal, or intentional
overdose. McNeil is making it clear that patients with histories of addiction or dependence on opiods
should not receive tramadol.From: ClarkCA@aol.com
Date: Thu, 13 Feb 1997 17:34:40 -0500 (EST)
Subject: Potential of tramadol to cause addictionEven though it is being touted as a non-addictive alternative to opiates for chronic pain, the PDR clearly
states that the drug has the potential to cause physiological addiction, craving, drug seeking, and
tolerance.I have seen two patients who came in addicted to Ultram (tramadol) with classic withdrawal symptoms
when they discontinued the drug. Both had a history of polysubstance dependence well known to their
primary care doctors -- who told them Ultram was safe for their chronic pain from orthopedic injuries.
They both had been clean and sober for years and now found themselves with addiction, craving, and
drug seeking behaviors again.I tried to refer one of them to an outpatient treatment program with a slow detox plan, but the insurance
company would not authorize it, saying that the patient could not possibly be addicted to Ultram! It was a
battle to get care for both of these patients. They feel duped by their doctors and the company who
manufactures and advertises Ultram as non-addictive!
Posted by Michele on May 12, 2001, at 20:10:56
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!! » Michele, posted by shelliR on May 12, 2001, at 18:04:15
Wow..... that is really interesting. I was prescribed this after telling my doctor that "I did not want something addictive... etc, etc"
I'm glad you posted that. I don't think it was necessary for you to post that I shouldn't give my opinion without a "warning"..... everyone on this board posts their experience.... and if you ever followed any of my posts... I almost always say" this is my opinion,.. I'm not a doctor, drugs work differently on different people, etc"
I'm not quite sure if your attacking me because I agreed with someone that this drug has worked on these issues.... but if you feel so strongly... you should check out some of the other posts above where people are actually saying to go out and get some methadone... or other opiates for that matter.... and I am always the one saying not to. I respond to this poster.... with MY experience.... not telling anyone to try it... just what had happened to me after taking it.
From my experience.... and in living with cancer, this is definately one of the more milder drugs the doctors have prescribed me for pain... not saying it's not addicting.... but there are definately worse,... just look at the above posts.. I'm not sure why you picked this one to react to.
As far as addiction.... I have no doubt there are addicting qualities..... but I'm not sure how extreme. In my case,.... I take them when needed.... in fact... basically just when I'm in so much pain I can't stand it... because I happen to be one of those people against drugs in general. I take one 50mg tablet... um, maybe 3-4 times a week. It's not a staple of my diet.
Again.... I was not recommending this drug to anyone.... someone asked questions... I responded to them, in how they react to me.
Posted by Michele on May 12, 2001, at 20:21:01
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!! » Michele, posted by shelliR on May 12, 2001, at 18:04:15
Sorry to post again...... but hey, what's up with this? I just read some of your above posts where you are defending opiates such as hydrocodone, methadone... etc. Huh? I'm really confused now. I don't notice that you put any warnings on your posts either... just seriously defending their use. I'm really confused.
Posted by Elizabeth on May 12, 2001, at 21:45:19
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!!, posted by cole on May 12, 2001, at 15:15:10
> If you don't mind my asking, what type of med is ultram exactly?
It's a mild opioid analgesic with very minor monoamine (serotonin and norepinephrine) reuptake effects. Because it isn't a controlled substance (*yet*), you might be more likely to get a prescription for it from a psychiatrist for depression or OCD than some other opioid such as morphine.
It has been known on occasion to cause severe interactions (central serotonin syndrome) with SSRIs, and it's absolutely contraindicated with MAOIs. It's also supposed to carry a risk of seizures at higher doses. So be careful, ok?
-elizabeth
Posted by Michele on May 12, 2001, at 22:07:48
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!!, posted by Elizabeth on May 12, 2001, at 21:45:19
I am really just curious. Has anyone but me noticed that the last 2 posts.... warning you about ultram because it is a minor(as one poster used) opiate..... but is above telling all the wonderful things about the heavy duty opiates? Hmmmmmmmm.... I just found that really interesting.
Posted by shelliR on May 12, 2001, at 22:09:27
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!! » shelliR, posted by Michele on May 12, 2001, at 20:21:01
> Sorry to post again...... but hey, what's up with this? I just read some of your above posts where you are defending opiates such as hydrocodone, methadone... etc. Huh? I'm really confused now. I don't notice that you put any warnings on your posts either... just seriously defending their use. I'm really confused.
Michele, I'm not attacking you. I just feel that if you tell someone how wonderful a medication is, it is good to include that it may be addictive. That doesn't mean that it shouldn't be taken, just that the person has a heads up about it. And obviously you didn't know, anyway, so that's why I gave you the information.
Things are not so black and white with my thoughts as you have expressed them. I think for some people for whom antidepressants have not worked, that opiates are a possiblity. And I believe that they are a last resort, to be used with one's eyes fully open to possible consequences. And yes, if a person comes to the board who hasn't tried opiates, I am very careful to advise them to try an MAOI first, and to hope they realize that they may have to increase their dose to get the same effects. It is never my recommendation as an antidepressant. Most of my posts concerning opiates are to others in my position, who have tried dozens and dozens of combinations of antidepressants and remain in a suicidal depression.
I used an anti-depressant for many years that worked for me. About two years ago it didn't work anymore and I have gone through so failed drug trials in those months that finally I felt it was enough, and for now hydrocodone will have to help get me through. I do not seem to have an addictive personality. I am also in therapy dealing with childhood physical and sexual abuse, so the medication is not a substitute for working out my problems (as in avoiding my problems).
As far as methodone, I have never tried it, don't plan to. But I can't discount some positive antidepressant effects for some people from it, and they deserve the right to share that on this board, without getting bombarded by people who have had or seen a different experience.
Shelli
Posted by Michele on May 13, 2001, at 14:08:55
In reply to Re: ULTRAM: EXCELLENT MED FOR OCD!! » Michele, posted by shelliR on May 12, 2001, at 22:09:27
Shelli,
Here is a copy of my post there you are having such a "difficult" time with.
It started out being prescribed for pain. That's what I took it for... now they are starting to find other things it is relieving as a nice little side effect. I've noticed my anxiety and depression has gotten better since taken it. What's even better.... is that since I thought it was strictly a pain med... I know the rest of what I am feeling is not placebo. It's really working for these other things!!
You give me this lecture on giving my experience without giving a warning.... yet you up above are suggesting hydrocodone, vicoden, and other opiates. Do I see warnings? Do you see anything wrong with this picture????? Does anybody else see anything wrong with my post to my experience with ultram? Isnt this was this whole board is about?????
Posted by Mitch on May 13, 2001, at 19:12:56
In reply to Re: ULTRAM: EXCELLENT MED. elizabethneedstogetshoc, posted by rogdog on May 13, 2001, at 17:12:45
Maybe Tramadol has another not so obvious mechanism that is unique (and incidental) that hasn't been discovered yet that could lead to a an even more effective drug being discovered? It is common knowledge that people with chronic pain are often prescribed antidepressants (mainly TCA's)and anticonvulsants. What about the guy in the news that bad Parkinson's disease that took Ecstasy (MDMA) and had a significant relief of his symptoms?? MDMA was evidently hitting some receptor or other that was creating the relief.
Posted by Elizabeth on May 15, 2001, at 9:38:54
In reply to Re: ULTRAM: check this out, posted by Michele on May 12, 2001, at 22:07:48
> I am really just curious. Has anyone but me noticed that the last 2 posts.... warning you about ultram because it is a minor(as one poster used) opiate..... but is above telling all the wonderful things about the heavy duty opiates? Hmmmmmmmm.... I just found that really interesting.
Actually if you'll read again you'll discover that I didn't "warn" anyone about Ultram's opioidergic properties. I warned about potential drug-drug interactions with monoaminergic ADs, and possible proconvulsant activity at higher doses.
Adults in the modern world should already know to be careful not to overuse opioids. If they don't, you can bet their doctors will make sure they do before prescribing anything of the sort.
-elizabeth
Posted by Elizabeth on May 15, 2001, at 10:38:38
In reply to Re: Ultram-perhaps a prototype drug for OCD?, posted by Mitch on May 13, 2001, at 19:12:56
> Maybe Tramadol has another not so obvious mechanism that is unique (and incidental) that hasn't been discovered yet that could lead to a an even more effective drug being discovered?
Yes, that's quite possible. Many drugs for which some mechanism has been found may have other (unknown) pharmacologic actions as well. It's a mistake to assume that once we've found out that a drug has a particular action, we can rest assured that any activity of that drug is due to that action.
-elizabeth
Posted by niss on May 18, 2001, at 22:13:40
In reply to known and unknown drug actions » Mitch, posted by Elizabeth on May 15, 2001, at 10:38:38
If you go to www.gnc.com, you will find an interactive drug database which shows what the effects are with various combinations.
> > Maybe Tramadol has another not so obvious mechanism that is unique (and incidental) that hasn't been discovered yet that could lead to a an even more effective drug being discovered?
>
> Yes, that's quite possible. Many drugs for which some mechanism has been found may have other (unknown) pharmacologic actions as well. It's a mistake to assume that once we've found out that a drug has a particular action, we can rest assured that any activity of that drug is due to that action.
>
> -elizabeth
Posted by Elizabeth on May 21, 2001, at 17:05:49
In reply to Re: known and unknown drug actions, posted by niss on May 18, 2001, at 22:13:40
> If you go to www.gnc.com, you will find an interactive drug database which shows what the effects are with various combinations.
I don't understand how that relates to the post you're responding to. Could you clarify it for me? Thanks.
-e
> > > Maybe Tramadol has another not so obvious mechanism that is unique (and incidental) that hasn't been discovered yet that could lead to a an even more effective drug being discovered?
> >
> > Yes, that's quite possible. Many drugs for which some mechanism has been found may have other (unknown) pharmacologic actions as well. It's a mistake to assume that once we've found out that a drug has a particular action, we can rest assured that any activity of that drug is due to that action.
Posted by Chrissie on June 27, 2001, at 15:04:11
In reply to Re: known and unknown drug actions » niss, posted by Elizabeth on May 21, 2001, at 17:05:49
I find myself in a very awkward position while reading the above. I kind of fit into all categories... and in ways agree with all of you. I initially started taking Ultram for pain, got addicted to it, the pain subsided, however I noticed it was changing my life in ways in regards to depression/having energy to do things such as clean and stay focused etc. and especially paranoia. So I continued to complain of the pain, because I didn't know that the reaction I was feeling from the Ultram was normal and that it had helped others with depression problems nor how to explain it to my Dr. I thought it was just me. I didn't take it to get "high", I took it to feel normal. There is a big difference there and I think alot of people are dubbed "addicts" when really they are self medicating with other substances (just my opinion) to feel the norm. Many Doctors do not recognize this, nor do they seem to care. Its all black or white/one way or the other.
So, now I can no longer take it.... but not by my own free will (yes I did overdue it after awhile)
I'm doing ok, haven't used any Ultram since Aug 2000 & am taking St. Johns Wort, but I still feel that need/urge for my previous.
Is there any drug comparable for the depression/parania aspects?
Please comment on any of the above! Thank you!
Posted by JD_online on June 27, 2001, at 16:21:33
In reply to Re: Ultram and all of the above, posted by Chrissie on June 27, 2001, at 15:04:11
I've never posted before, but according to an abstract I found on Medline, Effexor and Ultram share important similarities:
http://www.medscape.com/server-java/MedLineApp?/member-search/getdoc.cgi?ord=1&searchid=1&have_local_holdings_file=0&local_journals_only=0
Venlafaxine-tramadol similarities.Med Hypotheses 1998 Aug;51(2):167-8 (ISSN: 0306-9877)
Markowitz JS; Patrick KS [Find other articles with these Authors]
Department of Pharmacy Practice, Institute of Psychiatry, Medical University of South Carolina, Charleston 29425-0810, USA.
"Venlafaxine and tramadol are relatively new compounds indicated for the treatment of depression and pain, respectively. These agents share a number of molecular and pharmacological features that may allow for broader and overlapping therapeutic indications for both drugs. Additionally, certain patient populations with coexisting depression and pain syndromes could potentially be treated with a single agent."Since I have a chronic pain condition and treatment resistant depression, I attempted to go on Effexor, but just could not tolerate the nausea, vomitting, and sleepiness--even at minute doses (tapered down to half of a 37.5 mg capsule and stayed there for 3 weeks!). I don't know if it would have worked, but it sure was an interesting/ hopeful concept.
JD_online
Posted by shelliR on June 27, 2001, at 18:03:54
In reply to Re: Ultram and all of the above, posted by JD_online on June 27, 2001, at 16:21:33
> "Venlafaxine and tramadol are relatively new compounds indicated for the treatment of depression and pain, respectively. These agents share a number of molecular and pharmacological features that may allow for broader and overlapping therapeutic indications for both drugs. Additionally, certain patient populations with coexisting depression and pain syndromes could potentially be treated with a single agent."
>
> Since I have a chronic pain condition and treatment resistant depression, I attempted to go on Effexor, but just could not tolerate the nausea, vomitting, and sleepiness--even at minute doses (tapered down to half of a 37.5 mg capsule and stayed there for 3 weeks!). I don't know if it would have worked, but it sure was an interesting/ hopeful concept.
>
> JD_onlineHi JD
Thanks for that information. Did you ever try ultram for your pain, and if so, did it affect your depression? BTW, I could not even keep the tiniest bit of effexor down; my body outright rejected it.Shelli
Posted by Elizabeth on June 27, 2001, at 23:32:38
In reply to Re: Ultram and all of the above, posted by Chrissie on June 27, 2001, at 15:04:11
> I didn't take it to get "high", I took it to feel normal. There is a big difference there and I think alot of people are dubbed "addicts" when really they are self medicating with other substances (just my opinion) to feel the norm.
Well, a lot of people start out self-medicating and then *become* addicted because they don't have a doctor to monitor their use. Unfortunately, most doctors won't prescribe Ultram for depression, OCD, etc., so people who need it have no choice but to self-medicate (either by getting "grey market" Ultram, or by getting much harder drugs on the black market).
-elizabeth
Posted by Elizabeth on June 27, 2001, at 23:37:31
In reply to Re: Ultram and all of the above » JD_online, posted by shelliR on June 27, 2001, at 18:03:54
> Thanks for that information. Did you ever try ultram for your pain, and if so, did it affect your depression?
I wanted to mention this, thanks for reminding me. Ultram does *not* work for my depression although buprenorphine, morphine, etc. do, which is unfortunate because Ultram isn't a controlled substance, comes in a pill, and seems to lack the annoying side effects of the stronger opioids. (It's *very* weak.)
> BTW, I could not even keep the tiniest bit of effexor down; my body outright rejected it.
I had the same problem with immediate-release Effexor (but not XR): every time I took it, I got sick to my stomach.
Effexor isn't a very good pain medicine, although these days it's trendy to try to throw ADs at people for chronic pain. Ultram seems like it would be especially well suited for use in chronic pain because of its long-acting primary metabolite (O-desmethyltramadol). It's a pretty poor choice for acute pain because it takes like three hours to work!
-elizabeth
Posted by Chrissie on June 28, 2001, at 19:09:10
In reply to Re: Ultram and all of the above » shelliR, posted by Elizabeth on June 27, 2001, at 23:37:31
> I wanted to mention this, thanks for reminding me. Ultram does *not* work for my depression although buprenorphine, morphine, etc. do, which is unfortunate because Ultram isn't a controlled substance, comes in a pill, and seems to lack the annoying side effects of the stronger opioids. (It's *very* weak.)
Ultram in VA is considered a class 6 controlled substance.
Posted by Elizabeth on June 28, 2001, at 21:27:48
In reply to Re: Ultram and all of the above, posted by Chrissie on June 28, 2001, at 19:09:10
> Ultram in VA is considered a class 6 controlled substance.
Sorry: I should have said it's not *federally* controlled. States can have additional drug laws on top of the federal ones. In New York, they've put all sorts of outrageous restrictions on benzos (triplicate prescriptions, etc.). The result: doctors have started prescribing older, more dangerous (and more addicting) drugs, such as meprobamate (Miltown).
-elizabeth
This is the end of the thread.
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