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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by sam K on September 8, 2009, at 23:31:02
man o man.... Im doing great, a remission you could say. But tramadol is really bringing out the smoker in me. I cant help it at all. I orderd nicotine gum (is that stuff mild?)and hopefully it takes this problem away.
Tramadol also makes me so irritable. But once i smoke a lil then it goes away. (I have to test this more, but Im pretty sure)
I hate the taste of smoke and I am disgusted that I am actually smoking. I dont inhale because I love my lungs and respect them. I like to run and all that good stuff without weezing and potentially developing cancer.
Damn.. I'm in a sticky situation. The benefits of the tramadol is great. NO TOLERANCE OR ADDICTION. It takes away my depression and doesnt cause too much mania.
So ill try nicotine gum and see if that works.
BUT PLEASE? Do you think there are any other synthetic opioids that have this same thing, no tolerance and addiction. Because if there is I might want to try it.I just smoked two cigarellos and they are gross. They make me feel cool, calm and all that but I want to get rid of the smoke. IM A HEALTH FREAK and here I am smoking. AHHHHH.
Posted by bleauberry on September 9, 2009, at 10:02:43
In reply to tramadol and increased desire to smoke PLEASE, posted by sam K on September 8, 2009, at 23:31:02
Your experience thus far is fairly inline with what others have said at med-rating forums. Some people do horrible on Tramadol, but it seems that in the depression category of people it has marked potential. Oddly, most people who did well with it were started on it for post-op pain or something like that, and were taken by surprise to see their longstanding depression vanish.
The addiction and tolerance thing however is real. It is early in the game for you. People suffer horrible withdrawals even after just a couple weeks on Tramadol. Tolerance for most people does happen. For some, they let it get out of control and they keep ramping it up to absurd levels. Others find a pateau and stay there and do well. Others take weekend holidays from the drug.
Self discipline and management is a key requirement for treating depression with Tramadol. Because you have to mentally accept that you are dependent on the drug to avoid hard withdrawals. And because the temptation to keep increasing the dose can lead to real problems.
I do not believe there is another opioid you could consider as a substitute. That's because much of Tramadol's antidepressant function comes via serotonin reuptake and norepinephrine reuptake, probably with unknown actions on dopamine since dopamine is tied to opioids, and add into the mix some opioid mechanism, and well, there just isn't anything else that does all that. Some claim it is the SNRI function of Tramadol doing the work. But if so, it must be somehow distinctly different than how other SNRIs interact at the receptors. Because it usually kicks in fast, like days, unlike other ADs. No doubt the weak opioid function is playing a role, but it is said to be weak compared to its SNRI function.
As for the smoking, I don't know what to tell you. Nicorette gum is obviously a better option than smoke. They have two good flavors I like. Cinnamon, and Fruit Chill. The unflavored stuff is kind of yucky I think. I don't like any of the generics either.
Posted by sam K on September 9, 2009, at 10:12:50
In reply to Re: tramadol and increased desire to smoke PLEASE, posted by bleauberry on September 9, 2009, at 10:02:43
i know that was kind of a strong statement with the no tolerance and addiction. But I have been on the medicine before and stopped and had normal withdrawal for like a day, like any other medicine.
This is the end of the thread.
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