Avatar universal

Tramadol withdrawal and tapering

I just wanted to start at thread here and share what I have been going through, as well as what has helped me in order to hopefully help others who are trying to get off of tramadol. I am a male in my late thirties and have been on tramadol for 8-9 years, usually 100mg/day (occasionally 50mg but that was mostly in the beginning). I always thought to myself that since I'd managed to keep it to a relatively low dose, that I wouldn't have too  hard of a time coming off, but 9 years is a very long time and your body and brain becomes quite dependent on it. So even tapering from 100mg can be pretty difficult. Believe me, I know.

I am currently on my 7th day of 25 mg and will be making another drop soon. I have been slowly weening down 12.5mg at a time, each reduction occurring about 7-10 days apart. Honestly, by tapering myself off slowly like this (by reducing 10% -25% at a time), I have really been able to lessen the severity of many of the physical symptoms. I've had to quit nearly cold turkey a few times when I ran out, so I've experienced all of those typical opiate WD symptoms (hot/cold sweats, extreme restlesness, insomnia, anxiety, stomach issues and other flu like symptoms), and tbh, I haven't had to deal with too much of that so far). Actually, what has been most difficult for me has been the anxiety and depression. On certain days, even little things could set my anxiety off, things that would not typically cause anxiety under normal circumstances. Like temporarily not being able to find my keys or something fairly trivial. Loud sudden noises would set me off as well. Same for the depression. There were times where it felt like a dark cloud was just hanging over, and raining down. Other times it was more of just a feeling of melancholy, but less intense. Learning to control the anxiety and make myself think positively is something I've had to learn to make myself do, and it does help. The only physical symptoms I've been experiencing are minor stomach aches occasionally, minor insomnia, and increased sweating during sleep.

Anyway, here are some of the things I believe that have really helped through this so far.

L-theanine: This is just an amino acid found in green tea that is supposed to help with anxiety, and for me, I feel it helps quite a bit. It doesn't make me feel sleepy or drugged, just gives me this sorta calm state of mind. It's hard to explain. As far as supplements/drug interactions go, this is about as safe as it gets, so I highly recommend this supplement. I take 100mg 2-3 times a day, but it also comes in 200mg which can easily be taken 2-3 times per day as well. Sometimes I notice it takes effect 30 minutes after taking it, but I feel that it really peaks around 2-5 hours. I have heard others say that kava kava or gaba have helped them with the anxiety, but I cannot personally attest to those.

5-htp: I want stress that I am not recommending this for everyone on here who is tapering due to the fact that it has a moderate interaction with tramadol and other antidepressants. It is a precursor to serotonin and used to treat mild to moderate depression. Due to the fact that it increases serotonin levels (tramadol does as well since it partially acts as an SSRI), there is at least some risk for developing serotonin syndrome. Now this risk is less than it would be if using 5-htp with a strong antidepressant, or if using a higher dose of tramadol with an antidepressant, but it still theoretically exists, so talk to your MD first. I waited till I was at about 50mg of tramadol to start and had only been taking 50mg of 5-htp, then increased to 75mg when I dropped to 25mg of tram so I feel that the risk was minimized due to the low doses of each. I will probably up it to 150mg when I finally finish my taper. Anyway, I feel that it has been fairly effective in reducing my depression. I noticed that it did have a small immediate effect, but the primary benefit is more from a cumulative effect which I have slowly begin to notice over the past week or so. Only downside is that it makes me a bit sleepy for about an hour and a half after taking it. But that effect seems to go away the longer I take it, and also once I get up and get moving.

Exercise, fresh air, and sunshine: I make sure I go out and get some fresh air, at least do some walking or light jogging each day. Lately I have been going to play disc golf since the weather has been nice, and if nothing else, it helps reduce my anxiety and depression by keeping my mind off things. Plus, it's fun. But I truly believe that the of act physical exercise is very important due to the endorphins, and also in helping clean out your system. On the evenings and next day following those days where I would get little to no exercise, I would typically feel significantly worse. It doesn't need to be anything overly strenuous. Just go for a walk, or do whatever you can. I think it helps to try push yourself a little. And managing to at least break a light sweat seems to be beneficial as well.

Healthy eating: I know it can be difficult to eat while going through WD but eating good healthy foods certainly helps, so at least try and eat what you can along with drinking plenty of water. I feel that because our bodies really need all of the important amino acids during this time, good protein is essential. And obviously, fruits and vegetables as well. I've been trying to drink at least one protein shake daily, and believe that this has helped. I typically feel a lot worse if I miss a meal (this is somewhat normal for me anyway, but amplified since I started tapering), so I try to be consistent with my eating.

Vitamins and supplements: A good multvitamin along with a vit B supplement (especially b-12 and folic acid) are essential. \Also, I have been taking vitamin D3 and magnesium since they can help with mood and anxiety, and I do feel that they help, especially the vitamin D.

5 Responses
Avatar universal
Positive thoughts: Tramadol withdrawal not only wreaks havoc on you physically, it can mess with your mind as well. PAWS is something that can be experienced after stopping any opiate, but I believe a bit worse for tramadol due to the SNRI properties. The withdrawals can make you anxious, irritable, angry, depressed, and at times feel like you are going crazy. You might be subject to all kinds of irrational thoughts that you would not normally have, and might not feel like yourself for a while. It's very important to focus on positive thoughts, something I've had to learn to make myself do. Do not feed the anxiety when it kicks in by allowing those thoughts to take over your mind. It may be difficult, but you DO have some control over this. Fight it. You just have to keep reminding yourself that this is the drug withdrawal feeding you these thoughts, and making you feel this way and it is NOT you. It will slowly pass. There will be ups and downs, better days and worse days. You have to accept that you are on a bit of a journey, but that it will get better each day, and that each new day of tapering off or without the trams is another accomplishment!  Keep busy, and try to make little accomplishments each day, even if it's just cleaning out a closet or doing the dishes. You will feel better about yourself. Tramadol puts a veil over your emotions in such a way that it makes you feel like everything's going to be alright.. fine and dandy. It causes you to be less likely to feel the need or motivation to take action and fix the problems in your life because you have that warm fuzzy tramadol feeling. It gives you a sort of false sense of security, and emotional numbness.  So when that security blanket is lifted, you might begin experiencing all kinds of emotions that you have not felt in awhile, at least not in their full capacity. This can be both good and bad. Initially the lows may feel a little bit lower as they come out from under the tramadol blanket they've been hiding under, and suppressed for so long, but the highs will be higher, and most importantly, they will feel genuine and real. You will adjust, and things will slowly get better. You will have better days and worse days, but as long as you follow your path, stay off the drug, and do what you know you need to do, the overall trend will be towards improvement and getting back to being you. I really think that just doing your best to focus on things like love, kindness and positivity is very important. Wherever you can get those things from, whether it's movies, books, or family and friends, or support groups, I think it's a pretty important step in the healing process. I really hope some of this helps someone who is also struggling with this horrible drug and it's awful withdrawals. It's a journey, but it will continue to get better. You just have to keep reminding yourself of that. You guys can do this!

Avatar universal
It is so good to see someone finally writing about their taper and withdrawal that I can identify with. It's been about a week since my last pill (I had taken 200 mg +daily) for 4 years to manage severe migraines and the time came for me when I said I  was just done. Between tapering the tramadol and all the other drugs i am on, it's been a rollercoaster of a ride to say the least. These drugs mess with your brain chemistry so severely and for me, make me feel so incredibly unbalanced. Last week, I was severely depressed and anxious and I wanted to hurt myself. No plan, I just thought that it would take away this pain (not physical) that I am in. I went to the ER (which was an entirely humiliating experience in and of itself)  and met with a psychiatrist who listened and validated. He runs a women's mental health clinic and I see him tonight. My biggest issue right now is my lack of WILL. My head feels floaty (which had happened when I've abruptly stopped taking the tram before). I've always had a tendency in my life to be sort of "blah" and maybe this entire experience was the straw that broke the camels back to help me get the real help I need.
I've been drinking a ton of cold pressed green juices, taking a multivitamin, b-12 with folic acid... and in my moment of despair i ordered something called "restoritol" off Amazon. It's basically amino acids and herbs to help balance your body emotionally and physically. I'm trying to stay active even though I want to stay and watch "gossip girl" all day on couch but I am doing this because I know whatever sense of wellbeing the tramadol gave me was false and short lived and I know it can be replicated as I work out my issues. Please keep us posted. This blog is something the only thing that reminds me that I'm not alone.
Very good to read. Its nice to know that we are not alone!  Its been a month for me completely off of opiates.  I am still extremely depressed.  Will this taper as well?  I have always had clinical depression from as far back as I can remember but it seems to be so much worse right now.  Extremely anxious and depressed. Trying to work on things but I am having such a difficult time.
Hi Sadnessislife,

Sorry to hear you're having a rough time of it. But congrats on being off opiates for a month! That is certainly an accomplishment. Where you on tramadol? For me personally, I have learned to accept that I have good days and bad days during this time (or even good hours and bad hours), and I know it's easy to get wrapped up feeling like they are all bad and things aren't getting better, especially when I am having one of those bad days. I just try my best to keep busy, take it one step at a time, accomplish little things here and there, focus on the positive, and then just grit my teeth and try to push through it. I know it's not always easy, but it always does seem to get easier and a bit better as time goes on. Since you say you've had clinical depression in the past, are you currently on an antidepressant? I know that some people have had success taking one coming off of trams, or even other opiates, and especially since you mention having clinical depression. Obviously they don't always work great for everyone, but it might be worth looking into, or talking to your doc about. Be well!
I've been on more antidepressants than i can count.  right now I am on several medications. They dont seem to be working at the moment.  I wasnt on Tramadol.  I was on vicodan for 6 years then off for 2 (I was hospitalized to get off).  A doctor gave me 20 Tylenol with codeine for a cortisone injection 6 months ago and the addiction was on again for 5 months.    i decided i dont want to live like this and went off on my own. I did end up getting clonidine from my psychiatrist to help me after a week of hell trying to go cold turkey. it has been a month and I feel ok.  I dont want the opiates at ALL those pills are EVIL!!  I am more depressed than I have been in a long time and very short of breath.  Could the clonidine cause that or is it just because of the anxiety over the whole situation. Will i EVER be normal again?????? :/
new name Wonbyone    sadnessislife is too negative
Definitely like the new name better :)
Definitely like the new name better :)

I am certainly no expert on depression, but I do know that many who stop opiates after long term use experience PAWS to at least some degree. And depression is one of the hallmark symptoms. I'm sure it might feel like it is lasting forever, but it certainly will get better over time. You're also right in that timeframe where PAWS would be setting in. And yes, I agree.. although opiates do help people with chronic pain, they can definitely be bad news. I consider myself one of those people who has to stay away from those meds.

As far as the clonidine goes, it is really just a blood pressure med that is also used to relieve some of the symptoms from opiate withdrawal like pounding heart and increased blood pressure that come when our sympathetic nervous system (flight
or flight) goes into overdrive during opiate withdrawal. The most common complaint people seem to have on it is fatigue and tiredness, although it appears that some do experience shortness of breath and occasionally some depression, although less common. I'd definitely recommend talking to your doctor about the symptoms you are having ) and maybe consider doing a trail to lower or stop the clonidine if to see if it might be causing these problems (not sure of you blood pressure situation. Might me worth talking to your doctor about the depression as well. Hope this helps!
Thank you.  I am seeing the dr tomorrow.  I keep posting on here about the shortness of breath.  You are the first one who said mayb it could be the clonidine.  I havent taken it in over a week and I still feel very short of breath.  I dont remember having any PAWS when I got off 2 years ago.  Maybe I just didnt know what i was feeling.  i was very depressed then too but I have suffered clinical depression most of my adult life.  It usually comes and goes (the depression)  It has been here for a while now, (with and without opiates) I know I'll probs always be on an antidepressant but before the symptoms would subside and i would feel normal (whatever that means HA!) Then it would rear its ugly head again but sometimes it would be months or even years in between.    I am afraid this time the symptoms are not going to subside and I will be stuck here in the pit forever. I'm trying so hard to stay positive.  Its very very difficult.  Thank you for your kind words.  
Wonbyone, of course the depression wont last forever. I know it feels that way when you're in the thick of it, and just that thought by itself can make things more difficult. But you will get better. You just have to continue to stay strong and continue to remind yourself that this is something you just have to continue to work through.. but it will get better. I know you said that you didn't really get hit by PAWS last time, but doesn't mean that it wouldn't necessarily happen this time. To me, PAWS makes the most sense (plus combined with any history of depression). Not to mention, there are always different factors, various things going on in ones life at any particular time that can make things better or worse.

For me, there are so many things that can effect how I feel physically and mentally: Good diet, enough sleep, social interaction (even if it's just on message boards), exercise and keeping busy, making sure I'm at least making little accomplishments each day, not dwelling on the negatives, learning to work through my problems, and just trying to keep my focus on positive thoughts and improvement. Having a hobby can definitely hlp take your mind of things as well. None of these things are an instant fix. For me, I know that I have to slowly start working on these areas, and I will slowly begin to see improvement. The important thing is that you're staying off the opiates. Definitely bring some of these things up to your doctor when you visit tomorrow. Remember, it won't last forever!

Btw, as far as the clonidine goes, I'd be guessing if I were to say that it was this med causing the issues. You've been off of it for a week, so it's hard to say for sure, and  obviously I wouldn't be able to make that call.. I mentioned it as a possibility because I use a drug database for work, and it lists both depression and shortness of breath as possible side effects, although both 'infrequent', in this case meaning btwn 1-10% experience it. This is the reason I said it was a possibility.
Avatar universal
Hi there.
You are doing fabulous with the taper! I was prescribed Tramadol for 5 years @200 MG's per day. I tapered down very slowly and had no opiad withdrawals what so ever so keep going this way. However most but not all will have to deal with the SNRI withdrawals once it has left the body. I almost tapered down to crumbs but once I stopped for good it was all mental withdrawals from the antidepressant property. But I was taking 5 years @200mgs. Once I stopped the anxiety got the best of me. My Dr prescribed Clonodine at that point as BP increased  and especially heart rate (resting) was above 130 consistently
So my advice to you is have a prescription for the Clonodine a bp med that targets heart rate, hence lowers anxiety. Now I am extremely sensitive to meds and would be a worst case scenario. It took about a month to get over that part. I also googled "what to expect when stopping antidepressants) it empowered me to know what what was happening to my brain so I knew it was just normal for the course. SNRIs are the strongest antidepressants but SSRI withdrawals info helps all the same as far as symptoms and what to expect.
If you have a week once you finally stop the very las bit of Tramadol it would be wise to clear your calander. You are doing so well!
Avatar universal
Hi Leybeaux,

First off, congrats on being a week of tramadol! That's a huge step, even if it may not necessarily feel that way due to still feeling bad or depressed at times. It's shows that you do have the strength to do this! I can relate to a lot of what you said, especially the feeling 'blah' part at times. I think that's a big reason I liked tramadol, and probably stayed on it for so long. It took away the blahs, and really just helped to took the edge off things and created this shiny, happy illusion of a world. But like you said, it is all false.. not a TRUE reality. It's like you start living in this bubble, isolated from real feelings and reality. Next thing you know, months turn into years, and you get to the point where you just say enough is enough. You want to find the real you again. It sounds like you're doing a good job taking care or your body with the vitamins and juicing. I'd never heard of 'restoritol' before, but it looks like it has L-theanine in it, as well as ashwaganda, which I believe is similar to rhodilia. I've read on other boards that that rhodilia has helped others coming off tramadol. Please let us know if you end up trying it, and what you think. I agree that these boards, and especially just knowing that you're not alone can really help alot. Honestly, NOBODY can completely relate to what you go through with with tram withdrawals, unless they are going through it, or have already been through it. I read a lot of posts from another part of this board where other users were sharing there experiences and found it to be quite helpful. You may have already come across it, but it's kind of hard to find so here's a link: http://www.medhelp.org/user_journals/list/544292?page=1&personal_page_id=142&sort_by=date
Lot's of good info burried in those pages as well. Hope things go well with the P-doc!

Hi Ruthy,

Thanks so much for the words of encouragement! I remember reading many of your, and others' post on the 'Emily's profile' page. It was very encouraging to see how others were going through similar things as myself, especially on those more difficult days. I agree that tapering slowly will definitely minimize many of the opiate type of withdrawal effects, and I feel fortunate for that. I feel that the majority of what I've been going through is related to the SNRI withdrawal. Today has been a mostly good day, and so I'm thankful for that. As I'm sure you know, there are always going to be good days and bad days coming off this med, and that's something that you just have to accept for a while. Glad to see you're still on here, doing well, and of the Trams!
Oh you entered the sacred Tram room?
As we call it. Too bad it is hard it to access. It is the longest ongoing post I have ever seen. Big pharma had no business adding the SNRI property and it is never disclosed at time of prescribing. Drs don't really understand the pharmacology behind its lethal concoction. I was recently hospalited and they were practically begging me to take it home. I had a big fight with the assigned Dr over this drug. Then theytriex to prescribe Lyrica. Why? I no longer trust Drs and my son is almost one! I. so glad to hear you are over the worst. That is a proud badge to wear indeed! Keep going and on those bad days, hang on to the good ones that wil return then one day they wil all be good! God bless!
Yes, the sacred tram room haha. VERY long post, indeed. And that was just one of about 100 of them. I feel bad for anyone who was put on trams before it was a controlled substance, and was using it legitimately for pain, never abused it, and whose doctor told them it was easy to get off of, and non-addictive. Just to read stories about about people whose doctors told them it would be ok to quit cold turkey because it wasn't "addictive", and even at doses of 400mg+.  Yikes! At least it's a controlled substance now, so doctors have to at least inform patients about its potential for abuse and (also hopefully) potential for withdrawal and provide some kind of taper. But I agree that many are still not completely informed (especially about the SNRI properties) and simply prescribe it as a "safe" alternative to other opiates, downplaying the harm it can cause. And yes, I do my best to remember the good days, as that's usually the biggest thing that helps keep me going. Thanks again for the words of support!
Avatar universal
Well 8 days with no tramadol and I feel really good. My floaty feeling in my head I was experiencing is all gone. My meeting with the p-doc went really well, although they tend to be an odd bunch. We kind of uncovered in our visit that I have a long standing love affair with depression and anxiety and it rears its ugly head during major life changes. (I just moved, my husband and I are ready to have a baby and tapering off all drugs has been a major stressor, the holidays bring much sadness: I am estranged from my family).
We decided that we are going to start zoloft (really low dose) and I have a follow-up in 6 weeks. Seeing a women's health psychologist in a month.
I have been staying SO active: lots of barre class, cooking, baking, and just getting off of my couch. I am not that emotional wreck that I was just a week ago AND I know I am capable of running my life with the damn tram. Your body really does find a way to heal itself.
Best of luck
Leybeaux, that's great to hear that things are looking up for you. I've gotten that floaty head thing a few times as well. It all seems so to be so very random at times. I think that going to some type of counseling, as well as giving a low dose antidepressant a try both make a lot of sense (I guess the AD just seems like such a crapshoot since it appears to work so well for some, and not at all for others. I agree that a low dose initially seems like the best way to go). Both of those are things that I have actually considered doing. I was really feeling like I should consider starting an AD, but since I'm still tapering I knew that most doctors wouldn't want to prescribe one due to the risk (albeit fairly low at this dose) of serotonin syndrome. That meant I'd have to jump off at a higher dose than I felt comfortable with at the time, and then potentially wait a month for the AD to start working. So I just stuck with the slow taper, and the 5-htp which have served me fairly well so far (not that I haven't had my share of difficult days).

Other times I've felt that I could benefit from some counseling as well, even maybe walking into an NA meeting or something. I mean, I probably need to admit I'm an addict at this point, ya know? I've been taking a pill I don't need for way too many years. But for now, keeping busy, reading posts on this site, going for walks in nature, playing music, and allowing myself to do a lot of reflecting has been been helping, and has also been quite the experience in personal growth. Who knows, I might re-evaluate both after making the final jump.

I'm not working right now which is both a blessing and a curse. A blessing because I don't have to deal with all the stress of work on the more difficult days, a curse because I know it would help keep me busy. But I've been doing my best to keep busy with hobbies and what not. And YES, I agree.. keeping busy is definitely important. I'm on my 3rd day of 18.375mg right now (I know.. such a slow taper! but I had a couple of events to attend this week and was a bit concerned about cutting my dose in half, esp with the bad days/hours being as random as they seem to be. I really am SO sick of this taper, it drags on forever! Lol. But I'm just going to keep sticking to the plan. Anyway, best of luck to you as well.
When I was tapering the tramadol, for me personally, I felt like that prolonged all the misery that I knew was coming. My husband and I made the decision to just stop the taper and be done with it. For me, it was the best decision, but I know there are many people out there who cannot do that. I totally know how you feel with your mood being random and it probably will be for a while. All I can attest to is that the last few days (after I got over those HORRID 3-4 days) have really been the best days I have had in years. When I wake up, I am UP. I don't need a pill to get me going. I look forward to things. I feel I have mental clarity and I am becoming more emotionally stable. I would strongly consider seeing a counselor. It is always nice to talk to an impartial person about your issues and there is no shame. Work, as you said, can be a blessing and a curse. Thank god I coincidentally took time off this week otherwise I don't know what I would have done, but it sounds like you are in the right headspace and are keeping busy.
All my best.
I agree. The tapering certainly does prolong the misery. I've personally been back and forth many times, thinking CT might be best, than changing my mind and deciding to stick to the taper. It's a tough call. With this med,  you're going to have to pay the price one way or another. It's just a matter of whether you want your pain dished out slowly (and with less severity) over a longer period of time, or all at once with much greater intensity. Either way, you're going to have to pay the piper. I know that initially, I wasn't in a good enough spot to take it all at once. Depression, and mainly anxiety were too high. I do feel that over the past week or so, I've been feeling stronger and more ready to jump. As soon as I am done with my social events this weekend, I think I will go to 12.5 for a few days than make the jump. I do feel that although this taper has been long and drawn out, it has helped to at least begin the healing process, and feel I've grown quite a bit over the past month and a half or so. But I also understand that the real healing process begins when I make that final jump.

I'm very happy to hear that you are doing much better than you were a week ago. That's great news! Also very encouraging for all of us out there who are a little further behind than you. I know that everyone is different, but still very good to hear. Especially the part about feeling like your old self, being motivated and looking forward to things. That's what we're all doing this for, right?! Getting back to our old selves! If you don't mind me asking, what dose were you at when you finally made the 'jump'?
I agree Lebeaux.  Tram taper prolongs the agony! So glad you are on the othef side. May God bless you. The brain is an amazing thing! Mine is healed completely!
Believe it or not, I stopped at 50 mg because I literally could not take the mental agony of it all! It is awful! I had maybe 2 days of sweating, SEVERE restless legs (only at night), and major agitation. Stopping tram this time wreaked much more emotional havoc.
My headspace is much better now, I'm finding that even my energy is more even throughout the day (whereas when I was on the tram I would crash in the afternoon).
My one major issue now is the intense abdominal upset I have since starting zoloft. I know GI upset is up there with #1 side effects, so I'm guessing its something I am just going to ride out.
I went back to work today and it felt great (minus my tummy) and that definitely helps to make you feel more like a normal person.
You are doing such a great job with your taper and remember we are all here for you.

Amen to that sister!
Thank you, Leybeaux

You wouldn't necessarily think a 50mg drop would be all that painful, but it definitely can be! (And I'm sure even more when it's your final cut). I remember dropping 50mg at first and it was just too much at the time. Even 25mg was pretty rough, which is why I settled on 12.5mg for most of it. That has definitely been more manageable. I do feel that I've probably dragged it out a bit the past week or so, but overall, I can't say I regret the taper. I figure after 9 years, and nearly two months tapering, what's one more week? Haha : p

Yeah, zoloft is kind of notorious for having the most GI issues. I've never personally taken it, but am familiar with that medication. For many, those side effects tend to go away or at least dissipate after a few days or weeks. Hopefully that will be your experience as well!
Ruthy, yes the brain is an amazing thing! It's so great to hear that you are back to 100%. Very encouraging!
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