opinions on tramadol

[spitfire2]

Two questions:
I have chronic pain resulting from a craniotomy (had brain surgery for refractory epilepsy and a brain tumor).  I see people recommending the drug tramadol....is it helpful?  I've tried many different meds, have been going to RUSH pain center in Chicago for 3.5 years (had surgery 8/07), but not tramadol.  Drugs have been a little helpful, but no riproaring successes.  If tramadol can cause seizures, though, as I might have heard, I won't touch it....I had 14 years of pretty bad refractory epilepsy, and I don't want to risk having seizures, despite terrible pain (squeezing/tight feeling across entire forehead, and somewhat on side of head close to the scar.)  
Also, has anyone tried deep brain stimulation, or recommend any place to go?  THanks

[spitfire2]

Thanks for your help--greatly appreciated.  I did recently ask my doc about tramadol (spoke on phone the other day), and he does not feel it is worth the risk. He also completely advised against it.   I really don't want to risk provoking seizures, especially since my surgery was intended to help me with control my refractory epilepsy, which I had for almost 14 years.  


Have you heard anything about decline in bone mineral density and lamictal XR?  I know bone density decline is an issue with many older meds....  

Thanks again, and best wishes to you--if you don't mind my asking, how is your epilepsy?  Have you also had surgery for your seizures?  In any case, I hope things are working out for you.  

Best wishes,
spitfire2
  

[Narble]

Tramadol does indeed lower the seizure threshold. Withdrawal from tramadol can provoke seizures in people who do not have a seizure disorder, as is also the case with many anti-convulsants used off-label in pain management but FDA-approved for seizure control.

My docs won't even consider tramadol or certain tricyclics for me since I have a history of seizures. However, in your case the benefit of pain relief might outweigh risk of seizure. Tramadol is quite helpful for many people (and even my elderly cat benefited from it late in his life), and has fewer side-effects and risks (other than seizures) than many other pain meds (e.g.: no decline in bone mineral density, as is often seen with many anti-seizure meds).

I don't have any particular experience with deep brain stimulation, so I hope someone else here will help.