I have been fighting with the ups & down of trams for 2 years, I do believe that they are a lot lowers than any other ones u mention. I was taking 10 a day.Then I became a prisoner in my own home, I didn't even want to answer the phone,And shut a lot of people anf function out.I started to drink a lot of tea and to sleep there are good natural pills out there that trust me will help you sleep. Tramadol is addictive don't underestamated.