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CarolineA: withdrawal help - too quick taper off Tramadol


CarolineA

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Hello, this is my first post on this site. Please forgive any errors I may make. I have been taking Lexapro 5 mg for approximately 10 years and Tramadol for roughly 2 years for Osteoarthritis and Anxiety/Mild Depression. At the beginning of October I began tapering Tramadol from 200 mg a day (4 tablets) to 150mg a day (3 tablets). I cut 1/4 of a pill a week for three weeks and after my last cut on 10/19 from 3.25 tablets to 3.0 tablets I began to have what I believe to be terrible serotonin withdrawal symptoms. For the past three weeks I have been experiencing intense anxiety/panic attacks, nausea and an extreme lack of appetite. The nausea has subsided quite a bit but the lack or appetite is very persistent and I have lost about 7 or 8 lbs. I am already underweight so this scares me. A few symptoms other symptoms that have waned a bit are burning skin (paresthesia?), leg muscle weakness, excessive urination and sweating. I have also had some mild flu like symptoms e.g. body aches but nothing requiring even a Tylenol or Advil. 

 

I had very mild symptoms until I made the 4th cut from 3.25 to 3.0 and I don't understand if it just put my nervous system over the edge or what may be happening. This most recent cut was made 10/19 and I am wondering how much longer I can expect these symptoms to persist?

 

I am very motivated to discontinue the Tramadol but I wonder if I should hold steady at 150mg until the symptoms resolve? 

 

I am very afraid of everything that is happening to me and I feel very out of control. Any advice would be appreciated. 

 

 

 

 

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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  • ChessieCat changed the title to CarolineA: Serotonin Withdrawal Help - Tapered Tramadol too quickly and having a terrible time
  • Moderator

Welcome @CarolineA

I am sorry you are going through this and are suffering, but relieved you have found us. I don't know Tramadol well, but there are others here who do. I understand it is a serotonergic and the withdrawal and tapering knowledge applied to antidepressants applies to Tramadol as well. Your symptoms sound like withdrawal:

 

What is withdrawal syndrome?

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

The Windows and Waves Pattern of Stabilization

 

This explains why tapering gets harder at lower doses: 

Why taper? Importance of gradual change in plasma concentration

 

We advise to not taper further until withdrawal symptoms subside then follow these guidelines:

Why taper by 10% of my dosage?

Tips for tapering off Tramadol

 

Please add the dates you tapered Tramadol and the dose to your signature: date/dose date/dose  

Also add the year you started Lexapro and the year you started Tramadol, so it's clear how long you have been taking them.

 

Aside from a high quality fish oil and magnesium, be careful with supplements. Your central nervous system (CNS) has become sensitized from  drug use and can react unpredictably. Alcohol, caffeine, nicotine and other mind altering substances can make the condition worse.

 

Important topics about tests, supplements, treatments, diet

 

Here is our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover. 

Important topics about symptoms

 

I found this post helpful to understand what is going on and why healing takes time:

 

How Psychiatric Drugs Remodel Your Brain

 

 

The search function on this site doesn't work very well.  The best way to search this site for specific information  is to use your favorite search engine. Type in survivingantidepressants.org then the symptom, treatment, supplement or information you wish to search for.

 

In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through. Please know that the brain is amazing in it's healing abilities. It takes time, but healing can and will happen. 

 

This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

Please stay in touch and let us know how you are doing.


 

Edited by Kiasofia

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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Thank you so much for your kind words and additional links! The information here has been invaluable. I have clarified my signature, hopefully, to be a little more clear about the timeline of all this. 

 

Today was a "window" day. I had a few moments of panic here and there but this is the most normal I have felt in the past 3 weeks. I did go out to eat but it was a little uncomfortable. I wonder if anyone else has noticed their social anxiety worsening during these periods? 

 

I am committed to tapering completely off this drug but wonder how long I should hold at this point. Is there a certain amount of time I should be in a window pattern before I attempt the next dose reduction?

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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  • Moderator

I'm glad it's been helpful! It's advised to have felt good for minimum 4 weeks before reducing further, because it can take time for withdrawal symptoms to show up.

 

I can definitely relate to social anxiety worsening and I'm sure many others can too.

 

Glad to hear you had a "window" day. I recommend journaling to keep track of how you are feeling. It can be hard to remember windows when one is having a wave, so it's good to look back and be reminded.

 

Please stay in touch and let us know how you are doing.

 

To make sure someone sees your post write @ and then start typing their username so it becomes blue like this @Kiasofia

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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Just posting to see if anyone out there may be able to relate to what I'm going through. Despite having some windows here and there my appetite issue has not resolved. I am still eating very little and losing weight. This has been going on for just over a month now and it's still the most disconcerting symptom I have. Everything else I have experienced before, e.g panic attacks, but this is new. Over the years stress/anxiety have always caused me to lose my appetite but never for an extended period of time such as this.

 

If anyone can offer advice or experience please share. I have no idea what to do at this point.

 

 

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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@CarolineA, i can offer only sympathy i think, i am very sorry this is happening to you, hope you will get better very soon. Can you force yourself to eat or is it unbearable? My extremely unprofessional opinion is maybe you should try to eat foods with more calories. Feel free to get mad at me if this is sh*tty advice, lol. Also journaling about your problem can be helpful, getting feelings out and all that

2018 - july 2019 - Paxil plus atypical AP

July 2019 - November 2019 - Velofaxin

November 2019 - December 2019 - AP that made me active and productive and then anxious and ahedonic

January 2020 - Anafranil + Aripiprazol

July 2021 - stopped cold Turkey

Late october 2021 till now - Zoloft 100 mg + Aripiprazol 5 mg

 

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@Anna42Thank you so much for the kind words! I am able to eat some it's just that nothing is appealing and I can only get small amounts of what I am able to eat in. I've been making sure to drink a nutritional shake every day but that only has so many calories. 

 

I've always enjoyed cooking and eating so it's very frustrating to have this problem. I spend so much time trying to think of something that would be good to make/eat and come up with nothing. 

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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@CarolineA You are welcome! I guess good strategy for now would be to just accept it best you can and hope for the best. You can still cook for others and read cookbooks and engage with your hobby that way I hope :)

2018 - july 2019 - Paxil plus atypical AP

July 2019 - November 2019 - Velofaxin

November 2019 - December 2019 - AP that made me active and productive and then anxious and ahedonic

January 2020 - Anafranil + Aripiprazol

July 2021 - stopped cold Turkey

Late october 2021 till now - Zoloft 100 mg + Aripiprazol 5 mg

 

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@Anna42 Yes, you are absolutely right. There is no reason I can't still meal plan and prepare food. Energy has been a bit of an issue but maybe I just need to get started somewhere and the motivation will come later.

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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@CarolineA That is actually a really good strategy - motivation comes after action! If you struggle with procrastination or anything just tag me - I will try to offer some solutions. I even wrote a post about it here for some reason, hope it is allowed, lol

2018 - july 2019 - Paxil plus atypical AP

July 2019 - November 2019 - Velofaxin

November 2019 - December 2019 - AP that made me active and productive and then anxious and ahedonic

January 2020 - Anafranil + Aripiprazol

July 2021 - stopped cold Turkey

Late october 2021 till now - Zoloft 100 mg + Aripiprazol 5 mg

 

Link to comment

@Anna42   You are so right. I often find that when taking on a big project I just have to start somewhere and then I have no problem continuing on. Typically I am a planner who enjoys organization and taking care of others so this whole experience is out of the norm for me. 

 

 

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

Link to comment

@CarolineA very good then, good luck with everything!

2018 - july 2019 - Paxil plus atypical AP

July 2019 - November 2019 - Velofaxin

November 2019 - December 2019 - AP that made me active and productive and then anxious and ahedonic

January 2020 - Anafranil + Aripiprazol

July 2021 - stopped cold Turkey

Late october 2021 till now - Zoloft 100 mg + Aripiprazol 5 mg

 

Link to comment

Wanted to post an update for anyone who might be dealing with a similar appetite issue. As of 11/22 I have been back to eating normally. I am experiencing cravings again and no longer have the stomach pains and nausea that had been going on for weeks. I don't know if this is permanent but I'm excited that for now I am tending in the right direction. 

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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  • 3 weeks later...

Hi ,i’m in the same boat.i’m down to 30 mg now and thru this process my weight has dropped low.i was able to get into the trip digits again but each time i cut it dips. so frustrating feel for you 

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  • ChessieCat changed the title to CarolineA: withdrawal help - too quick taper off Tramadol

@fionaofftramadol Thank you for sharing that. It's comforting to know that someone else experienced the appetite loss as well. 

2010 to Current Lexapro 5mg (Holding)

December 2019 to June 2021 Tramadol 100 - 200 mg

June 2021 to September 2021 200 mg

October 2021 Began Tapering Tramadol by 12.5 mg per week

Current Tramadol Dose 150 mg - Last Dose Reduction 10/19/21 (Holding for now)

 

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