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Should Tramadol Be Discontinued After The Pain Subsides To Avoid Adverse Effects Towards Fibromyalgia?
Question: Dear Doctor,
Weight 95 kg Height 175 cm Age: 54
Diagnosed conditions: Fibromyalgia, C2/3 facet joint damage (MVA), C6/7 nerve root impingement (MVA), RSI right wrist (35 years), plantar fasciitis (comes and goes), sacro-iliac pain (comes and goes).
Recent blood test: bit low in Vitamin D. Mobitz type I arrhythmia brought on by using certain medications.
Medications: Tramadol 100 mg/day, Codeine 30 mg day PRN, Citalopram 10 mg, Oxazepam 7.5 mg Piroxicam 100 mg PRN
Hi – I feel very breathless on little exertion and my heart rate increases a lot – for example just bending down to do up shoelaces. However, I can go for a 50 minute walk and not get too out of breath (except on hills). Having trouble sleeping for last four months as came off Stillnox after eight years on it. Sometimes used codeine, Temazepam and periactin to sleep. Doctor has listened to chest – all ok. Might have a bit of reflux at night – not sure – but I think morning coughing could be due to that. Put on 15 kg in a nine month period recently. Also feel pretty exhausted and tired and lacking motivation quite a bit of the time. Thanks
I gave up Tramadol – ¼ of 50 mg each four days. But three days after the last dose I was in a lot of pain and it lasted over a week – my neck got particularly bad. Flare up of everything – so I decided it was too risky in case it made the fibromyalgia flare up and make it worse in the long term. So my GP told me to go back on as much Tramadol as I need to get rid of the pain – which is 100 mg. I have been taking this about a week and things are starting to calm down.
I am now not sure whether to give up Tramadol or not. Do you think I should persist? Is there an easier way to come off it without flaring everything up?
Thanks, Louise
Weight 95 kg Height 175 cm Age: 54
Diagnosed conditions: Fibromyalgia, C2/3 facet joint damage (MVA), C6/7 nerve root impingement (MVA), RSI right wrist (35 years), plantar fasciitis (comes and goes), sacro-iliac pain (comes and goes).
Recent blood test: bit low in Vitamin D. Mobitz type I arrhythmia brought on by using certain medications.
Medications: Tramadol 100 mg/day, Codeine 30 mg day PRN, Citalopram 10 mg, Oxazepam 7.5 mg Piroxicam 100 mg PRN
Hi – I feel very breathless on little exertion and my heart rate increases a lot – for example just bending down to do up shoelaces. However, I can go for a 50 minute walk and not get too out of breath (except on hills). Having trouble sleeping for last four months as came off Stillnox after eight years on it. Sometimes used codeine, Temazepam and periactin to sleep. Doctor has listened to chest – all ok. Might have a bit of reflux at night – not sure – but I think morning coughing could be due to that. Put on 15 kg in a nine month period recently. Also feel pretty exhausted and tired and lacking motivation quite a bit of the time. Thanks
I gave up Tramadol – ¼ of 50 mg each four days. But three days after the last dose I was in a lot of pain and it lasted over a week – my neck got particularly bad. Flare up of everything – so I decided it was too risky in case it made the fibromyalgia flare up and make it worse in the long term. So my GP told me to go back on as much Tramadol as I need to get rid of the pain – which is 100 mg. I have been taking this about a week and things are starting to calm down.
I am now not sure whether to give up Tramadol or not. Do you think I should persist? Is there an easier way to come off it without flaring everything up?
Thanks, Louise
Brief Answer:
Please get your thyroid profile done
Detailed Answer:
Hi,
I read your query and understand your concerns.
First of all I feel your doctor is right in stating that go back to tramadol as having pain is never a solution for anything. Although considering fibromyalgia I will recommend SNRI (duloxetine to be precise) as all other medications indicates for fibromyalgia need to be avoided due to your heart condition. Once you are stabilised over it a second call can be taken to taper off tramadol in future.
Considering few of the current symptoms I feel you need to go for thyroid profile. Presence of breathlessness, putting on weight, low motivation, lethargy could be presenting symptoms of hypothyroidism and I feel this should be considered as first line cause for the above symptoms.
I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
Please get your thyroid profile done
Detailed Answer:
Hi,
I read your query and understand your concerns.
First of all I feel your doctor is right in stating that go back to tramadol as having pain is never a solution for anything. Although considering fibromyalgia I will recommend SNRI (duloxetine to be precise) as all other medications indicates for fibromyalgia need to be avoided due to your heart condition. Once you are stabilised over it a second call can be taken to taper off tramadol in future.
Considering few of the current symptoms I feel you need to go for thyroid profile. Presence of breathlessness, putting on weight, low motivation, lethargy could be presenting symptoms of hypothyroidism and I feel this should be considered as first line cause for the above symptoms.
I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.
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Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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