Combinations - Amitriptyline + Tramadol/Ritalin

[Mish]

SWIM has just been prescribed 20mg of Amitriptyline to be taken at night for insomnia.

SWIM also occasionally takes recreational doses of Tramadol (250mg).

SWIM also occasionally takes recreational doses of Methyphenidate [Ritalin] at doses of 20mg.

SWIM only plans to take the Amitriptyline at nighttime when needed, but was wondering whether it stays in the blood long enough to have an effect on:

a) 250mg Tramadol taken approx. 10hrs after Amitriptyline ingestion
b) 20mg Ritalin taken approx. 10hrs " " " "

Would this be reasonably safe? SWIM is aware of the contradindications between SNRI's (Tramadol acts as a short-acting one), and stimulants such as Methylphenidate, but was wondering whether - considering the time at which the respective drugs would be ingested - if it would present any problems?

SWIM has found some information on the 'net regarding this situation, but would be grateful for any further interpretations/personal experiences:

Originally Posted by Wikipedia

By itself, it can decrease the seizure threshold. When combined with SSRIs, tricyclic antidepressants, or in patients with epilepsy, the seizure threshold is further decreased.

^^ SWIM does not consider this a problem seeing as the Tramadol dose he takes is quite below that of the prominent seizure threshold-reducing effects, and the Amitriptyline dose is small as well. Tonic-clonic seizures seem to have only been cited with doses of ~500mg+ (Tramadol) and SWIM never takes this much.

also...

Originally Posted by Wikipedia

Contraindications of Methylphenidate:
Use of tricyclic antidepressants (e.g. desipramine), as methylphenidate may dangerously increase their plasma concentrations, leading to potential toxic reactions (mainly, cardiovascular effects).

^^ Again - with the comparative doses - this wouldn't seem like a problem. And, if it was to increase plasma concentrations then would this not just potentiate the stimulant effects of the Ritalin, meaning less could be taken...?

SWIM realizes that Amitriptyline has a half life of 12-24hrs, which means that interactions with both this Pharmaceuticals could be possible, and hence wants to be careful before going ahead and mixing any prescription medications with anything recreational.

Thank you.

[wespawloski]

The anti-depressive therapy takes weeks to kick in for a reason, its a buildup. Hypothetically what was boring before S_RI could be a blast a month later. Because you are using it interspersed with some days, SWIM assumes...

" In terms of its mechanism of action, amitriptyline inhibits serotonin[1] and noradrenaline reuptake almost equally." -Wikipedia

20mg of Methylphenidate is relatively low, in SWIM's experience, ritalin was so mild SWIM wouldnt be too scared. But does SWIY get a stellar recreational boost from amitriptyline solo? As that would be cause for concern. If amitriptyline makes you sleepy, SWIM would be less worried.

If you get sleepy after amitriptyline has gone through your liver (1-3 hoursish) and you wake up in the morning awake, SWIM would feel safe.

Things to watch out for : Throbbing head and or visuals = Calm yourself down and stay away. Do not insuffilate the Methyphenidate, at least on your trial.

****

"There is an increased risk of serotonin syndrome when tramadol is taken in combination with serotonin reuptake inhibitors (e.g. SSRIs) or with use of a light box, since these agents not only potentiate the effect of 5-HT but also inhibit tramadol metabolism. Tramadol is also thought to have some NMDA-type antagonist effects which has given it a potential application in neuropathic pain states." - wikipedia (Tramadol). Ritalin is a monoamine reuptake inhibitor, but also inhibit tramadol metabolism <<< really scares me. Make sure you know about that before any attempt. It appears 5-HTP overload is on the radar, so know how serotonin affects you :/

[Abider]

SWIm took 150-300 mg Amitryptiline in the evening...
and in the day 30-120 mg methylphenidate .. for about 3 months..
he is still living.. but this combination is not the healthiest!

MPH +amitryptiline +tramadol ??
SWIM has no experience !

[rocknroll714]

I do not recommend it at all. Amitriptyline acts as a serotonin and norepinephrine reuptake inhibitor, as does tramadol, and methylphenidate acts as a norepinephrine and dopamine reuptake inhibitor. Combination with tramadol could very possibly cause serotonin syndrome and combination with methylphenidate could cause a hypertensive reaction. I've heard of people mixing these before without problems but I've also heard of people mixing these and experiencing horrible effects. I would highly recommend against it. Especially the tramadol. Furthermore do not, I repeat, do NOT take all three at once.

[Abider]

I've been prescibed Pain Killers and Stimulants for the past couple of years...
I've always had fun with Percocet and Ritalin Together...It is one hell of a Speed-Ball. But I digress...

I asked my Doctor for a prescription for Ultram, which he gladly filled. I decided that night to try Speed-Balling with the Ultram and Ritalin -- Big Mistake. Within one hour of taking the 10 ultram tablets and 3 ritalin, I remember standing up to change the channel of the TV, and the next thing I knew, I had Doctors and Nurses standing all around me. I though 'WHAT THE F*CK IS GOING ON?!?!?!?'

It turns out that after standing up to fiddle with the TV, I suddenly fell over and went into a grand-mal seizure from what I am told. Since that night, My left hand's Dexterity and Manuverability has been severly impaired. (Good thing I'm right Handed, Right?) I am told that since the seizure lasted about 6 minutes, Oxygen flow was impaired in the part of my brain that controls my left hand and arm for too long -- Dain Bramage errr... I mean Brain Damage.

BE aware of drugs you mix that lower the seizure thresh-hold... You just might end up a vegetable.

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