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Avatar universal

Depression from Tramadol withdrawal

I've been through Hell with Tramadol.  I made up my mind to get help and a Dr. Is helping me taper down.  I am now down to 135 mg a day.  Of course this is a great accomplishment from where I was 2 years ago.  However, I have fallen into a depression that is very serious.  I have read that this gloom cloud is a part of Tramadol withdrawal, and will pass.
I guess what I'm needing is a bit of reassurance that someone has been able to get themselves back to feeling good about life again.
I tapered way too fast at first and the depression landed right away. I've slowed down the tapering so that I won't fall off the deep end.  I now understand what real depression is, and I will never judge people who suffer with this again. (Not that I really did before,  but you don't really understand until you experience it)
I was told by someone that my ability to create endorphins has been compromised by using an opiate for so long, that my body has to begin to supply those natural chemicals for itself.
Is it possible that this ability will never return?  I think the worst part is thinking that this feeling will never change.  I take no pleasure in any of the things I used to enjoy in life.  This is a very scary place.
My understanding is that anti-depressants affect serotonin and dopamine.  These brain chemicals are not the same as the endorphins.
I know Tramadol is a complicated drug which is a synthetic opiate AND acts as an anti-depressant as well.
My main concern is for the depression; Can a person who has used this drug ever come back from this horrible dark place?
17 Responses
1684282 tn?1505701570
MEDICAL PROFESSIONAL
You are very well informed. When you take opiates for a long time like you have, your body's physiology has been altered. Your central nervous system has created a multitude of opioid receptors that all are screaming for endorphins (opiates) to fill them, but your body has now forgotten how to make them by itself.  It will takes weeks, for your receptors to down-regulate (for the brain begin to heal) and to start making its own endorphins. Brain heals pretty slowly, so it may take months to get rid of feelings of sluggishness, restlessness and depression. The best thing you can do is take good care of yourself, eat healthy food, stay hydrated, keep active and busy. Stay away from sugar, soda, and simple carbs. Do not consume caffeine at least 6 hours prior to bedtime.The reason for this longer depression and insomnia symptoms is because Tramadol, besides affecting the opioid receptors, has an effect on the serotonin receptors in the central nervous system.   That means you may also need an SSRI antidepressant to deal with some depression that may develop as the result of your withdrawal. But it does get better and better every day if you stick with it, so please don’t give up.  I encourage you to look at my blog on Tramadol misuse for more info  by clicking on my name and than "blogs", and please make sure you read the readers' comments to the blog. They are fascinating. You may  also be interested in taking a look at my clinic’s website, www.mdsdrugdetox.com since we often detox patients with Tramadol addictions.
Once you get through this residual depression, the only thing you should keep in mind is as people start to feel really good after a few months out; they forget how bad the withdrawal really was and think they can start using again.  Just once or twice....  and they get caught up yet again.  Please try to remember how bad it is right now and stay far away from all drugs in the future.  It is just not worth it.
Good luck to you and stay well.
1683709 tn?1370713201
Hi I just thought I would say hi to you since I'm coming off of Tramadol too.
I was on 500 mg for the last two years for my chronic back pain. When I started on Tramadol it really helped my pain, my mood and increased my energy.
During the last 6 months, the Tramadol stopped working for me, and since I couldn't increase the dose I needed to add another pain med. So now I'm taking a low dose of morphine as needed. (I hate morphine)

Since deciding to stop the Tramadol, I started taking Effexor to help with the depression, but it takes 6 weeks to get the full effect. I think it's helping, but my mood is pretty flat. I slowly tapered to 150 mg now, and I'm just starting to feel withdrawal symptoms. I'm waking up in the night, I'm nauseous and don't have an appetite.  I'm so tired, and feel like crap all day.

Coming off the last 150mg, will probably be the toughest part so I'm going to go slow. Good luck, we can cheer each other on.
You'll probably need an antidepressant, to prevent becoming seriously depressed.

Best of luck, Sue

Avatar universal
Sue, Thanks for writing.  I am sorry you've had to resort to morphine.  I hope things can get better with the pain.

I have begun to take a fairly low dose of Fluoxetine (generic Prozac).  It's been about 2 weeks and I'm still feeling very depressed.  By depressed I mean that I can't get enthused about anything, my thoughts are dark, and I can cry at the slightest thing.  To add to this, my husband is leaving for a week tomorrow, and I really don't want to be alone.  It's hard for me to reach out, but I am managing to try to go to a couple of groups for addiction.
The anti-depressant might take some more time to kick in, you're right about that.  I just want to feel better.  It's strange that after being on pain meds for 3 years, (Tramadol for 2 yrs) I am sticking to my tapering as if my life depends upon it.  In 5 days I will be reducing to 115 mg.  The physical symptoms are not too bad except the lack of energy and the hot flashes.  Occasionally I have trouble sleeping, but this is nothing like going "cold turkey", which I did once about a year and a half ago.

I want my life back.  I used to take Effexor too.  I thought that I didn't need it so I tapered off of that because there is a significant withdrawal from that as well.  I stopped the Effexor about 4 months ago after tapering down to 75 mg.  Between tapering off Tramadol AND the Effexor, I think I was really hit hard.  So, 2 and a half weeks ago, I gave in to take more anti-depressant.  I was beginning to be afraid of the way I felt, and I was miserable every second.

This isn't something I can talk to very many people about. Thanks for your support.
I hope you have some support and most of all INFORMATION to work with while you're relying on all of these chemicals to live your life.  I do not think Tramadol is a good drug; it is very complicated.  Glad you're getting off mostly because of the psychological effects.
Will you be able to ever stop the pain meds, or do you even know?

Thanks again,
Katy
1683709 tn?1370713201
Hi Katy,
I was in your situation last week, my husband was away on business.
It went ok, my 21 & 24 year old children still live at home, so they looked after the house. And made sure I was eating, and getting out of bed to shower!

I'm feeling sick now, nausea, migraines, restless nights, so my brain isn't concentrating on my back pain. This is good for now, I don't need the morphine so I feel like I can truly detox. The worst part is not having an ounce of energy

I came off Effexor last summer, because the Tramadol helped with the depression. We've had a long cold winter, and the Tramadol stopped working for my chronic back pain and the depression. My Dr. told me to get back on the Effexor because my mood was really flat and I had started crying and becoming overly emotional. That's when I knew I needed to make some changes with my meds.

I don't know what I will do for my back pain, once I'm off the opioids?
Hopefully I can manage with Tylenol and muscle relaxants. I can't take Aleve or other anti- inflammatory medicine, I was on them for 2 years prior to my first back surgery, and they ruined my stomach causing ulcers.  

Be careful with the Prozac, that drug didn't help me and actually gave me suicidal feelings (which I had never experienced before) but I know everyone reacts differently to antidepressants.

So right now I'm at 150 mg of Effexor, and 150mg of Tramadol. Hopefully I will be down to 125 or 100 next week. And I may increase the Effexor. I will see what my dr thinks.

Good luck this week without your hubby, you can do it.  Slow and steady, one day at a time :)
Take care, Sue
Ps. If you want to add me as a friend, I can give you my email or phone # for extra support.
Avatar universal
Sue, I feel as though I know what you're going through with the withdrawal.  I have a few more days of a "compounded" dose of Tramadol at 135 mg daily.  The capsules are each 45 mg, and I take 1 three times daily. Next week the dose will be lowered to 120 mg total daily.  I asked my dr. if I could taper more quickly and she said no.  I think she's worried about the mood changes that occur when the Tramadol decreases.
There is one certainty here;  I WILL get completely off Tramadol.
The anti-depressant question is another story.  I've been on the Fluoxetine for 21 days now, and I'm not that much better.  I'm tempted to change anti-depressants now, but the Dr who gave them to me thinks it's too soon to know for certain if it's going to do the job.  Effexor DID work for me, but I was only on 75 mg, and probably needed a little more.
I am amazed at how much taking this synthetic opioid, Tramadol has disrupted my life.  I feel as if I've lost the last 2 1/5 years of my existence.  We moved to another state about a year and a half ago, and of course the Tramahell helped me with the energy and gumption I needed to get that done.  I was more social and outgoing and made some friends in our new home.  But......Since I decided to stop taking Effexor, (because the Tramadol took my depression away) , and then I decided to get off Tramadol, I have descended into a place that's darker than I've ever experienced.  My husband is worried, and my new friends wonder where I've disappeared to.  I am just not the same person.  It makes me feel like that other person, the friendly, happy, talkative and energetic woman I was, is just a sham.  Now I have to force myself to get going every single morning.  I have a lot of responsibilities to look after and my beloved animals to think of, so I can't shirk at all.  I am doing it all totally from will-power!  I don't even want to talk to my best friends on the phone when they call.  It's horrible.  I read books and watch movies constantly, and make myself do the bills, the shopping and the housework.

The doctor who gave me the generic Prozac (Fluoxetine) advised that I take up a really vigorous exercise program and sweat like a pig to get the endorphins kicking in.  I was flabbergasted!  You don't tell someone who's suicidal to go jogging!  

I'm glad you have your kids to help you and that they are sympathetic, that's wonderful.  My husband is as well, but our kids know nothing!  They are all grown and live in another town.  I would be mortified for them to know, especially how long this has been going on.

I found a Group that I attend weekly which is a great help.  It's a mix of people from all walks of life who are and have had problems with addiction.  I think it's appropriate for me because I found myself taking the Tramadol for the "lift" it gave me, and I became addicted to that.

Lest this get to be too long, I will close for now.  I'd be glad to "friend" you, Sue.  I'll sign off for now, and try to find out how to do that.

Good luck and God speed.  I remember the time I woke up after going cold turkey off of Tramadol once, and it felt indescribably wonderful.  I was free!
Avatar universal
How did you accomplish your taper off of tramadol? I, too, am tapering. I am now taking 87.5mg down from 150mg. I am cutting 1/4 pill (50mg) every 10-12 days. How does this sound? Any comments? Appreciate any and all help.
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