Originally Posted by Mindless
TRAMADOL DOSING GUIDELINES
The total daily dose should not exceed 400mg.
I understand the urge to increase dosage, especially where tolerance has become an issue. However, high doses are extremely risky. Anyone who needs to take more than 400mg daily would be well advised to taper down their daily dosage to a maximum of 400mg.
Absolutely!!!! This advice could not possibly be taken seriously enough. Tramadol
is seriously dangerous stuff, abuse of it is far more likely to lead to dangerous health crises than the other, more recreational and more restricted narcotic analgesics
. I would even go so far as to say that abuse of it should basically not occur, but seeing as how it is dispensed with an almost negligent ease (to be fair the good doctors are wising up, when I had a huge prescription 3 months were dispensed at a time with 90 50 mg tabs per month, enough to kill many many people... And I was assured that it did not have much potential to cause dependence or serious withdrawal
although at that point it was already common knowledge amongst chronic pain sufferers that having an ultram monkey riding your back was just about the worst condition possible to achieve via opioid
agonism. A seriously protracted half life in a drug
that functions both as a SNRI and a mu agonist... Thats not a monkey, it's a drunken, mangy, incontinent bonobo (yeah, the ones with the sex...) desperate to give everyone it encounters SIV an followed by a handful of poop flung at major league pitcher velocity which it stealthily tosses when you think it's stepped outside for a post coital smoke.)
Anyway, yeah it's still unscheduled although this will most likely change soon, and for good reason but until then for those addicted to opiates
and desperate (like there's ever a without b...) it is a viable option. But from personal experience I want to be sure to reinforce the seriousness of this warning. I experienced it once when I was a teenager and had enjoyed it up to 600 mgs spaced out. I hated the edgy anxious comeup which felt a lot like the first hour of a DXM
trip with giant pupils and the obligatory vomiting episode. Basically coming up from more than 100 mgs at once is probably gonna make you barf. Just saying from personal experience and its really frustrating to power through the sweaty jittery "fuck this kinda feels like a roll but judging from the fact that I hate it; fuck I'm betting pipes once again..." only to eject the majority of your dose and be rewarded with a mediocre high that makes one nostalgic for the codeine
with guafenesin garbage they give little kids. However if one can hold on while that pesky methyl group gets chopped it will transition to a pleasant and powerfully clean opiate
euphoria that lasted for HOURS...
Please do not stop here and go get tramadol. The love affair is not a happy one. Anyway, so later on I got a more chronic prescription as stated above, and this was when I was older, more "hard headed" and already tolerated/addicted to moderate doses of hydrocodone
due to a serious cluster headache problem. I quickly learned that the fact that tramadol relies so heavily on cytochrome p450
metabolism (like codeine) to not totally suck a fat one, means that you can never really be positive what you will get from it day by day (it also means sniffing it is unwise, unspeakably painful, and carries no benefit other than rapid onset of the shitty too much espresso and I'm feelin myself effect, it still means you gotta wait for the same amount of time for it to start to feel better. In addition studies and my experience indicate that the best way to get a good ratio of swimming to sick is to take small doses slowly. The time release form of this stuff is apparently known to be more a abusable, because the prodrug never peaks in your bloodstream in levels that cause effects that, for many people, are actually a fairly aversive stimulus. So I concur with the above, don't do it!)
But the real reason I felt justified in basically repeating everyone elses answers is that I suffered a seizure following a 600 mg dose of Tramadol over the course of 6 hrs. As stated above, I was tolerated and hooked on opiates and was not at all satisfied with what I was getting from the recommended dose, so I pushed it up to 400 mg and got a good amount of relief, although I did feel a little strung out and nasty. Anyway, after a while I stopped feeling relief and just felt strung out and nasty, and so I decided to take an extra 200 mgs, thinking that having never had a seizure, serious head injury, history of any significant alcohol
abuse (truth be told I fucking hate that shit and wore it out from middle school to the beginning of highschool. Gotta love a decent high that you probably wont remember if you reached a level of altered that everything else does as a matter of course, paying you a dividend of the worst possible after effects a drug can induce. Nothing is as toxic as alcohol, I would say its probably the nastiest poison that humans willingly ingest in any significant quantity with the possible exception of the midwestern emo teens and their hydrocarbon gases.) or the concurrent use of any other drugs
, and the fact that it was only my second time using it should effectively keep me safe. Nope. I came up again but felt really really unpleasant, dysphoric, edgy and sweaty. I retired to my bed and as I lay there my leg began to twitch involuntarily. I got a rush of panic/adrenaline
, my vision became reddish, and I felt a tingling sensation throughout my head and face. It was like my brain was being zapped repeatedly with a cattle prod, which kinda makes sense I guess. Anyway the next thing I know I'm laying in a different position, my body feels like I had just survived a Pantera moshpit with a pink TRL v-neck muscle tee being my only protection from the angry sweaty rednecks high on acid and Wild Turkey 101 determined to make me think twice before I tried to out gonadotropin them in the future. Anyway I was alone at the time in my apartment so I cannot verify that it was without a doubt a genuine tonic clonic event. But I can think of no other explanation besides way too much inhibition of norepinephrine reuptake causing a massive panic attack
(I did have severe depersonalization for the rest of the night so I guess it's possible) and I can only be extremely grateful that another medicine I took for the nerve pain of my clusters, gabapentin
was both an anticonvulsant and had a very long half life because I had taken some 10 hrs or so earlier and I'm sure it prevented me from lighting up like a Christmas tree and awakening to find myself with serious memory deficits or my tongue sitting in my lap. Honestly, seizure or not the episode scared me enough that in the future I accepted tramadols limitations and never exceeded 400 mgs in a day (usually not even 300 because the anxiety was significant at this level.) I eventually developed the habit of using it to potentiate my hydro script along with my supplementary flower arrangements and, when I spent a quarter in Washington DC (aka analgesic nirvana), the medicine that an OG I often smoked cigarettes with on F Street outside my job named "Boogie" prescribed me (true story, he was even almost legally blind and walked with a pimp limp. He had spent a lot of time talking to Chandra Levy and was really articulate and full of fascinating experiences to draw upon for someone who's circumstances had understandably limited the scope of his universe to a large degree. Anyway I digress. He scorned tramadol as codeine with a personality disorder, and I think there's no more fitting description than that.
So yeah, I know that the fact that a lot of times you can literally request this medicine from doctors and they will think you are being concious of the risk of dependence "real" opioids
have, as opposed to taking advantage of what was almost certainly the result of a great deal of free stationary and lunches being distributed by ex-cheerleaders to aquire a powerful narcotic before the FDA caught on the their latest "whoopsie" and began the lumbering decade long process of protecting the public from the number one cause of precipitated seizures in the developed western world (I assume that this qualifier is a nod to malaria, so do you really want to take a drug that falls just behind the #1 most deadly natural threat to human life on the planet in sheer ability to make you tesla out? I'll stick to poppy
seed tea if I ever decide to go down that road again, which I won't. But getting an exasperated sigh from a grocer when they ring up your restocking purchase for your bagel shop is better than a tragic sigh from your loved ones when you wake up covered in piss and sweat and cannot recall who they are for a few days.