Advice on tramadol/concerta combo needed

[hh339]

Ok SWIM knows better than to mix opiates with stimulants, but SWIM is in pain and would REALLY like to take a couple o' tramadols. He did take his concerta (XR) this morning though, but the pain is fucking irritating and he just wants to lessen it. He only took 36 mg concerta today, and 100-150 mg tramadol would suffice for the moment. SWIM would normally not ask this type of question since he would never mix uppers and downers recreationally, but this crap-pain's got to end. What do you dudes think? Ok?

[Forthesevenlakes]

EDIT: after reading up on some of tramadol's interactions, swim wouldnt really reccomend this combination. with a normal opiate, a therapeutic dose might be fine, but due to the SSRI action of tramadol, in combination with the dopamine reuptake inhibitor action of methylphenidate, there could be some potentially nasty side effects such as reduced seizure threshold or elevated heart rate. swiy may want to try something else for pain relief if anything is at hand.

Reputation Comments on this post:

	Good advice
	Great advice

[Fantasian]

Once again good advice by Forthesevenlakes, the SSRI part of Tramadol will present real issues. It's best to use an opiate alone like codeine or simply paracetamol. Although mixing the codeine would present issues i dont believe it would lower you seizure threshold enough to present danger especially if taking below 100mg. It would be alot safter than using tramadol anyway.

Feel free to ask anything further.

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	Appreciated
	always with the good advice! your posts are always my favs to read.

[hh339]

Thanx dudes. SWIM takes your advice seriously but...actually he did it anyway, because the pain got even worse, otherwise he would not have done it. I'm guessing it would have been worse to take it earlier on the day when the concerta was still working hard. It's the piss-tests that prevent SWIM from taking other painkillers, he can't even take them with a prescription. It's fucked up. No discomfort was felt with the tramadol (100mg), and this morning after another 36 mg of concerta was ingested he also felt fine. If SWIM wasn't under such pressure from his doctors and in such pain he is (or was) in now, he would just skip the concerta and go for the tramadol, but it's a complicated situation right now. Paracetamol did not work, but maybe there's something else. Any kind of advice would be appreciated.

Btw: Other dudes on the same program as SWIM get concerta + SSRI's daily by the doctor, some even get risperidal or subutex in combination as well. Any thoughts on this? If my memory serves me right, they take SSRI in the evening and concerta (XR) in the morning.

[Micklemouse]

Originally Posted by hh339

Btw: Other dudes on the same program as SWIM get concerta + SSRI's daily by the doctor, some even get risperidal or subutex in combination as well. Any thoughts on this? If my memory serves me right, they take SSRI in the evening and concerta (XR) in the morning.

Do they ever sleep, or are they prescribed a z drug or similar to help them? This just seems like crazy prescribing to me, although I've seen amazing results from risperdal & fluoxetine in combination for psychosis with ocd features. With regards to the concerta & ssri, this sounds like a fast track to insomnia if lucky, hypomania or psychosis if not, with potential for Serotonin Syndrome heightened too. Subs shouldn't be problematic though.

As for the pain management, a lot will depend on the type of pain - talk to your doc would be my advice to Mr SWiM.

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Knowledgable post

[Fantasian]

Most likely that fact is that in clinical dosages the tramadol wont be a massive issue but still presents a danger. Like Mouse says though to me it seems like crazy prescribing.

What causes the pain?
How severe is it?

[hh339]

Originally Posted by Fantasian

What causes the pain?
How severe is it?

Well it's somewhat better now, but the pain is in the throat. SWIM was supposed to rest his throat for some time due to some infection in there, but he couldn't keep from swallowing all the time so it started to swell up and hurt a lot. Ya know kinda like a dog scratching his wounds only making them worse. Sounds a little lame but eventually it hurt so much that he could hardly even sleep. Tramadol and LOTS of tea for 2 days helped a lot, and now it feels like it's heading the right way. No nasty side-effects were noted.

[Fantasian]

Originally Posted by hh339

Well it's somewhat better now, but the pain is in the throat. SWIM was supposed to rest his throat for some time due to some infection in there, but he couldn't keep from swallowing all the time so it started to swell up and hurt a lot. Ya know kinda like a dog scratching his wounds only making them worse. Sounds a little lame but eventually it hurt so much that he could hardly even sleep. Tramadol and LOTS of tea for 2 days helped a lot, and now it feels like it's heading the right way. No nasty side-effects were noted.

SWIF would have used a Local anesthetic for that, once SWIF couldnt swallow because of an infection and they gave him an anesthetic spray but it was wierd because he couldnt feel himself swallow.

Some of the dissaccociatives might of worked too particularly locally on the area. SWIF might have tried swallowing Ket or breathing nitrous. But that said the nitrous would be very short acting.

If SWIF has to use something he'd use codeine for something like that because opiates would also supress the coughing that is undoubtedly caused by a blackage of the throat.

[thadj]

A strong NSAID (i.e. diclofenac) usually works too to to relieve pain from infection in the throat.