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Tramadol hcl/Hydrocodone/Cymbalta/Zanaflex Withdrawls?
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Tramadol hcl/Hydrocodone/Cymbalta/Zanaflex Withdrawls?

I didn't realize until very recently (last few days) that I was taking so many pills to help manage my pain.

For over three years - Tramadol hcl 50mg tab -- up to 8 a day.
For a year -Zanaflex maybe 3 a day
For a couple years -Hydrocodone-Ibuporf 7.5 mg  normally 4 a day but sometimes more.
May 16, 20011 - June 8, 2011 - Cymbalta 60mg Delayed Release caps

I went to the hospital in April 2011 and was so sick. I couldn't eat, I was shakey (shaky), sweaty, vomiting, ok...I had it coming out both ends.  I was told then that it was a sinus infection and with the ER doctors knowing I was taking Ultram, they prescribed me Ciprofloxacin 500mg.

I had no clue that these pills weren't supposed to be taken together...guess I was too stupid to look up the info myself, but if I've learned anything from this hell I am going through...always know what you are taking and the effects it has on your body/brain and what to avoid.

Well I got sicker and lost about 25 pounds just from being sick...yeah I need to lose some more, but that isn't the way.

I went back to see a PA in may after being sick for over a month....I think I've been pretty sick all this year.

The PA gave me some hydrocodo and some Cymbalta to take along with the Ultram and I said I couldn't sleep and quit taking the Cymbalta on June 8, 2011.

Serious sweating...crying, confused...thoughts of suicide....faint feeling...and other flu like symptoms.

My PA is also a friend on Facebook, so I sent him a message and told him my symptoms...he said "I'm sorry your feeling bad, you should try an internal medcine doctor in another town".  
Well after a few days of getting worse I did a search and typed in my symptoms and the meds I was taking.

I found this link to the MAYO clinic:
First thing I found out was that taking Ultram and Cymbalta is a big NO-NO...
I read the symptoms of Serotonin Syndrome
(taken from the mayo clinic site)
Serotonin syndrome symptoms typically occur within several hours of taking a new drug or increasing the dose of a drug you're already taking. Signs and symptoms include:

Agitation or restlessness
Rapid heart rate and high blood pressure
Dilated pupils
Loss of muscle coordination or twitching muscles
Heavy sweating
Goose bumps

Severe serotonin syndrome can be life-threatening. Signs and symptoms include:
High fever
Irregular heartbeat

When to see a doctor
If you suspect you might have serotonin syndrome after starting a new drug or increasing the dose of a drug you're already taking, call your doctor right away or go to the emergency room. If you have severe or rapidly worsening symptoms, seek emergency treatment immediately


I had most of those symptoms other than Seizures and  Unconsciousness. I also had roaring noise in my ear and brain's like a small lightening bolt zapping my brain, but I haven't had that today. Thank God!

I don't know if I'm going through withdrawls or have serotonin syndrome but this "Ride" has been hell!

I understand now that this could have killed me....may still...but

Quit Cymbalta on 06-08-11
Quit all the rest almost 48 hours ago 06-13-11

I refuse to put anymore of that poison in my body!!!

Am I in pain.. Yes!  I just can't and won't take anymore poison!!


I'm worn out from searching and searching to find some natural stuff that will help me get through this.


Hopefully someone can make sense of my ramblings...


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10 Comments Post a Comment
Avatar f tn
I'd like to add that since I've lost faith in the medical community here where I currently live, that I have a major fear of going back to the hospital or unless I feel like death is serious about it's knocking....I wont go.
Avatar f tn
With the help of my husband, we finally got my PA to listen!

He called in a perscription for Valium this morning and I finally got 7 hours of Soild, Peaceful, restful sleep.

I'm Not feeling like a Knot.

I am so thankful and relieved!
547368 tn?1440545385
Hi Rachelle,

Welcome. Please excuse my tardy response. It sounds like you have been through the wringer. My heart goes out to you.

Cymbalta... like so many other medications should not be suddenly stopped. As you discovered Ultram and Cymbalta should only be taken together if the benefits out weight the risks. In your situation that was not true. Who prescribed these? Are you seeing the same PA for all of your medications?

Yes the prescribing medical provider should have know the interactions.... but where was your pharmacist? They are the experts in medications and their interactions. This information should have been presented to you at the time the Cymbalta was added to your regime.

I have to say that I agree with your PA. See another provider. If you have chronic pain please consult someone that knows what they are doing... someone that is very familiar with treating pain and the interactions of pain associated medications. In your state that may be a PMP (Pain Management Physician). Though this was a frightening experience you should not have to live with severe chronic pain. There are medications that can be safely taken together if needed.

Please let us know how you are doing. I'll look forward to your updates.

Take Care Rachelle.

My Best,
Avatar f tn
Thanks for your response!  I was feeling alone. LOL

While I don't want to "live" with pain, I really don't want to live on poison anymore.

I've now had over 15 hours restful sleep on this Valium.

I don't feel like I'm in hell at this pain level is alright at the moment and I don't feel like a big knot.

My plan was to quit taking the pain meds and try the diet and exercise I'm doing on my weight loss journey.

I've been in no condition the past several days to get on the treadmill, but I'm getting away for a few days and just relax.  I'm soooo looking forward to the big jetted tub at the hotel.  Calgon, take me away!

I'm hoping by Monday, I'll feel good enough to start exercising.

I threw away all my poison this morning....other than the Diazepam (Valium) which is really helping me with all this withdrawl (withdrawal) crap.

I took a pic of the basket I had all my meds in right before I trashed them, then took a pic of the stuff I'm replacing the poison with.  I'm fixin' to post it over on my profile.

Hopefully I won't need a PMP, but it's a great suggestion if I end up not being able to handle my pain with exercise and nutrition.

Thanks again for posting Truck!
Take care!
Avatar f tn
Yes, I was seeing the PA for all the medication.

Live and educating myself is the only way I'll avoid ever going through this hell again.
82861 tn?1333457511
I totally understand that you want to get off all the pills but I'm seriously concerned that you may be in big trouble having thrown away all your meds.  You've been on tramadol and hydrocodone long enough that you will have withdrawal, and it probably won't be pretty.  Tramadol withdrawal can cause seizures so please try to reach your PA and tell him what's going on.  You may need medical help to get through detox.  These meds need to be tapered as does valium.  That's another one that the body quickly gets used to.

I've dealt with chronic pain for many years and been on the pain med routine for about half that time.  At first, the meds seemed like a blessing.  Like you, I now want off them and I'm getting there - slowly.  One thing that made a big difference was therapy with a pain psychologist.  It won't cure your pain, but you can train your mind to better deal with it and the associated anxiety so that it doesn't impact your life so much.  It's just one more tool in the pain toolbox.  For most of us, there just isn't a magic bullet that will take away the pain, which leaves us in a mind-over-matter situation.  It's surprising just how much the mind can overcome physical pain if you really work at it until it's second nature.

PLEASE let your PA know that you're out of meds and talk to him about what to expect regarding withdrawal.  If you can't reach him, put in a call to your pharmacy and consult with the pharmacist.  He can at least look up withdrawal symptoms for you in the PDR so you'll know what to expect. And please stay in touch!
Avatar f tn
It has been a serious hell but, I finally got my PA to listen....told him how much I was taking and what I was taking. (Even though he has all that info). I sent him info on withdrawls as well as the serotonin-syndrome and also the info on how most everything I read about online said to give Valium to help.

FINALLY he listened and called in a perscription for Diazpam 5mg tablets (Valium).

I had taken one pill three times a day from June 15 - June 18.  I haven't needed any today (the 19th).

I realize now that what I did by quitting everything all at once like I did was stupid. It could have killed me, but it didn't and other than taking those valium to ease the withdrawl (withdrawal) symptoms, and I am now 6 days clean.

Most of the horrible, feeling toxic and like I was going to die symptoms are gone!

I'm going to work on the pain that got me on all that poison by exercise, nutrition, prayer and possibly a chiropractor or try acupuncture.

Mentally (why I quit all those pills) I am READY for a healthy me.  Pain pills can cause depression and depression can cause pain or make it worse.

So, I do think MIND over Matter can work....especially if you believe in yourself and really want to make a change.  

All I was doing was poisoning myself....I still had pain, but the pain meds were making me sick all the time and keeping me un-motivated.

Life is getting better for me and I am going to do everything I can do to keep a positive attitude, educate myself before I put anything food/drug in my mouth and start living...even if it is with some pain, but I am pretty sure I'm going to overcome the pain too.

It's there today, but I'm dealing with it and haven't taken an OTC pain pill.

Thanks for taking the time to write to me! (And anyone else going through this that is out here searching for help/suggestions and answers.
547368 tn?1440545385
Mind over Matter can work in some situations. As Jaybay said the mind is a wonderful tool in the pain toolbox. I encourage everyone to involve a pain therapist in their pain management regime. I know I have in the past.

However for those ppl that have severe disabilities and excruciating pain, "Mind over Matter" it is not usually effective in itself and/or alone. It can certainly depend on the source and severity of your pain.  

However no one should feel that they are weak or that their "Mind" is not strong enough if they require pain management medications. There is no shame in opiate therapy for ppl that have no other choices/options.

Yes what you did was not wise, nor advisable. Going "Cold Turkey" without a physician's supervision and advice can be life threatening.

I am not an advocate for pain medications when alternative therapy, treatments and similar things are effective. However when you have been the route unsuccessfully you have to make choices that are right for you and allow you some level of functioning.

I and may others require opiates to manage our pain. In fact I would venture a guess that the majority of our members on the Pain Management Forum do require meditations to control their pain. I don't feel that I am poisoning by body or that I am depressed.  No one can be positive 100% of the time but I have a positive attitude for the most part as do many of us pain management patients.

Unfortunately some ppl chose to leave this earth rather then continue with unmanaged and uncontrolled pain. That's a very sad and frightening situation to be faced with. So members please don't feel that there is anything wrong with you if you require opiates to manage your pain.

Rachellle, again I am delighted that you are happy and thus far successful with your choice. I wish you well. For those that have no other choices but to include opiates in their pain management regimen, I wish them well also.

Avatar f tn
Today is day 7 of being off all my pain meds. The 5mg of Valium up to 3 times a day helped with the withdrawls pretty good and allowed me to finally sleep.

I may indeed have to take something for my pain, but right now my pain isn't so bad and being off those pills and over the hell I was going through when I quit cold turkey....I feel pretty darn good....hopeful, and non-toxic.

Hot lavender epsom salt baths helped me too...along with a ton of water....lot's and lot's of water and gatorade.  

I gained some weight back I lost during hell week, but I'm getting back on track with my weight loss journey.

Thanks for the responses!
Avatar f tn
ST John's Wort and Green tea.
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