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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by floatingbridge on May 29, 2010, at 16:52:53
I'm requesting my pdoc transition me to ultram.
I'd like input on switching from pristiq. (I'm sure my pdoc will have his own method. I want to be informed on my end.)
My assumption is that I would taper pristiq down to maybe 25mg. and initiate
tramadol IR at a low dose (and discontinue pristiq).Ultimately, I would like to be on the xr version.
Currently my cocktail is this:
Pristiq 50mg
Dexadrine 45mg
Xanax CR 0.5 mg
Hydrocodine 15mg
Lithium 300mg
Lunesta 3mg or sonata 5mg as neededWill the Xanax or zmeds pose a problem?
Lithium?
(The hydocodine would be reserved as emergency Med.)I have read and read and have finally
and officially been advised that my pain
could be well treated by tramadol.I have done well (in the past) on effexor.
Is there anything I've overlooked?
Has anyone done an AD transition like this before?
Your input is greatly appreciated.
Posted by Phillipa on May 29, 2010, at 17:05:35
In reply to need advice please, posted by floatingbridge on May 29, 2010, at 16:52:53
FB I really wish I knew. The withdrawal of pristiq leaves you ad free right? The hydrocodone would worry me. Love Phillipa
Posted by SLS on May 29, 2010, at 17:29:06
In reply to need advice please, posted by floatingbridge on May 29, 2010, at 16:52:53
Hi FB.
Good luck with your new treatment.
Benzodiazepines are sometimes prescribed to help with SRI withdrawal, so the Xanax should be okay. Hopefully, the tramadol will provide enough 5-HT reuptake inhibition to ease the withdrawal from Pristiq. Will you be cross-tapering? I'm sure you know that there are reports of serotonin syndrome resulting from the combined use of tramadol with a SRI. I would probably cross-taper and monitor for signs of SS. The short half-life of tramadol (7 hours) will work in your favor should symptoms appear and you need to temporarily discontinue it.
Do you plan to replace Pristiq with another antidepressant, or is the tramadol meant to act as one?
- Scott
Posted by floatingbridge on May 29, 2010, at 20:23:10
In reply to Re: need advice please » floatingbridge, posted by SLS on May 29, 2010, at 17:29:06
Hey Scott
Cross-taper, I imagine. I'm hoping the snri action of tramadol will be enough to stave off really unpleasant discontinuation affects.
That and the short half-life of tramadol. It could work.
Maybe no additional ad. I'll just have to see. Glad to know benzo could be useful. I'd take extra if needed--though I'm recently comfortable on a lower dose
Thanks for weighing in. How is marplan treating you?
:)
fb
Posted by Phillipa on May 29, 2010, at 20:28:19
In reply to Re: need advice please » SLS, posted by floatingbridge on May 29, 2010, at 20:23:10
FB that is great news!!!! Wow I'd love to do this also. Love Phillipa
Posted by floatingbridge on May 29, 2010, at 20:28:49
In reply to Re: need advice please » floatingbridge, posted by Phillipa on May 29, 2010, at 17:05:35
PJ, a chance of withdrawal of hydrocondine? Maybe taper that, too...
Just don't want to be w/o pain relief. My situation is a small amount of pain creates a cascade. Fear of pain. Lovely.
Pain psychology is fascinating--the little I know.
Take care!
Posted by Phillipa on May 29, 2010, at 21:25:08
In reply to Re: need advice please » Phillipa, posted by floatingbridge on May 29, 2010, at 20:28:49
Pain psychology? Not heard of that? If it's googleable you know I'll find it :)
Posted by SLS on May 30, 2010, at 7:19:07
In reply to Re: need advice please » SLS, posted by floatingbridge on May 29, 2010, at 20:23:10
> Thanks for weighing in. How is marplan treating you?
It's not. I responded for three days after taking Marplan for two weeks. This is how most of my drug trials end up - tachyphylaxis. It is a consistent pattern.
- Scott
Posted by floatingbridge on May 30, 2010, at 13:13:48
In reply to Re: need advice please » SLS, posted by floatingbridge on May 29, 2010, at 20:23:10
Scott, I'm sorry. How frustrating and disappointing. Yes, I remember your three day pattern. Now I know the name for that response. How much reading have you done about TMr? This was presented as an option for me, though I declined for the present. I'm unclear how invasive it may be. And I wonder if there would be any reset value for drug resistance. I know you're hanging in there--and myself and others are pulling for you. Best to you, fb
Posted by floatingbridge on May 30, 2010, at 13:51:13
In reply to Re: need advice please » floatingbridge, posted by SLS on May 30, 2010, at 7:19:07
Posted by Phillipa on May 30, 2010, at 19:21:04
In reply to Re: need advice please » floatingbridge, posted by floatingbridge on May 30, 2010, at 13:13:48
I still say there has to be something to this three day response. No idea what to google? Phillipa
This is the end of the thread.
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