Follow
Share

My mom is on lexapro, remeron and a very low dose of klonopin. Psych APRN wants to discontinue the Klonopin and add Tramadol. Does anyone have any thoughts?

This question has been closed for answers. Ask a New Question.
I have taken Tramadol for years PRN for pain, it works very well for me
Helpful Answer (1)
Report

Klonopin (0.25mg -0.5mg are the general doses) is not generally used for pain. It is a medication for anxiety and wonderful for people with dementia. Tramadol is a mild pain medication but stronger than "over the counter" medications. Does your Dr think that her anxiety is due to pain?
Helpful Answer (1)
Report

Sorry, I meant trazadone.
Helpful Answer (1)
Report

Babalou: Tramadol is a "narcotic like" pain med. For elders, any narcotic meds are very bad because they can't handle them due to their age. E.g., my mother was given morphine at the hospital. Then when she was sent to the NH, the drug manifested into EXTREMELY bad hallucinations...thoughts and actions.
Helpful Answer (1)
Report

This is a very confusing conversation. The topic is a question about the use of Tramadol (brand name, ULTRAM). Some of you are discussing Trazodone, an antidepressant medicine (also used for other reasons), that is an entirely different class of medication and another subject altogether.
With respect to this discussion...I have taken Tramadol for nearly 20 years, well before it became generic.
Tramadol is a "synthetic" (man-made) narcotic and it affects the same area of the brain as a narcotic medication. Tramadol was designed to use as a long-term treatment for moderate to moderately severe pain. Tramadol is NOT effective if taken PRN (as needed). It takes around a couple of weeks of continuous, daily use (as prescribed), for the medication to reach a level in the bloodstream to truly become an effective pain reliever.
Tramadol is an analgesic medication, but is NOT helpful for the pain from inflammation. In general, analgesics ease surgical pain, muscle pain, body aches from fever and headaches. Tylenol (Acetaminophen), is another analgesic and used for mild to moderate pain.
To boost the effectiveness of Tramadol, for more severe pain, you can take Tramadol with a dose of Acetaminophen (Tylenol or generic). For inflammatory pain, you can also take Tramadol along with a dose of an anti inflammatory medication (Mobic, Celebrex, Aleve, etc. or their generic versions).
Years ago, I took the prescription medication, Ultracet, a combination of Acetaminophen and Tramadol. However, I prefer to not take Acetaminophen on a regular basis unless it is absolutely needed.
Sometimes I wonder if Tramadol is truly relieving my pain, but realize how much pain relief IS present if I accidentally miss a dose. Since I suffer with Arthritis along with Fibromyalgia pain, I must also take anti inflammatory medication along with the Tramadol for more complete relief.
Nonetheless, the strength of any pain medication that Doctors prescribe for us to use at home, will never relieve the pain entirely.

HERE IS A QUOTE FROM MedicinNet..
GENERIC NAME: tramadol
BRAND NAME: Ultram
DRUG CLASS AND MECHANISM: Tramadol is a man-made (synthetic) analgesic (pain reliever). Its exact mechanism of action is unknown but similar morphine. Like morphine, tramadol binds to receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain from throughout the body to. Tramadol, like other narcotics used for the treatment of pain, may be abused. Tramadol is not a nonsteroidal antiinflammatory drug (NSAID) and does not have the increased risk of stomach ulceration and internal bleeding that can occur with NSAIDs.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets (immediate release): 50 mg. Tablets (extended release): 100, 200, and 300 mg.
STORAGE: Store at room temperature, 15-30°C (59-86°F). Store in a sealed container.
PRESCRIBED FOR: Tramadol is used in the management of moderate to moderately severe pain. Extended release tablets are used for moderate to moderately severe chronic pain in adults who require continuous treatment for an extended period.
DOSING: The recommended dose of tramadol is 50-100 mg (immediate release tablets) every 4-6 hours as needed for pain. The maximum dose is 400 mg/day. To improve tolerance patients should be started at 25 mg/day, and doses may be increased by 25 mg every 3 days to reach 100 mg/day (25 mg 4 times daily). Thereafter, doses can be increased by 50 mg every 3 days to reach 200 mg day (50 mg 4 times daily). Tramadol may be taken with or without food.
Recommended dose for extended release tablets is 100 mg daily which may be increased by 100 mg every 5 days but not to exceed 300 mg /day. Extended release tablets should be swallowed whole and not crushed or chewed.
DRUG INTERACTIONS: Carbamazepine reduces the effect of tramadol by increasing its inactivation in the body. Quinidine (Quinaglute, Quinidex) reduces the inactivation of tramadol, thereby increasing the concentration of tramadol by 50%-60%. Combining tramadol with monoamine oxidase inhibitors (for example, Parnate) or selective serotonin inhibitors [(SSRIs, for example, fluoxetine (Prozac)] may result in severe side effects such as seizures or a condition called serotonin syndrome.
Tramadol may increase central nervous system and respiratory depression when combined with alcohol, anesthetics, narcotics, tranquilizers or sedative hypnotics.
PREGNANCY: The safety of tramadol during pregnancy has not been established.
NURSING MOTHERS: The safety of tramadol in nursing mothers has not been established.
SIDE EFFECTS: Tramadol is generally well tolerated, and side effects are usually transient. Commonly reported side effects include nausea, constipation, dizziness, headache, drowsiness, and vomiting. Less commonly reported side effects include itching, sweating, dry mouth, diarrhea, rash, visual disturbances, and vertigo. Some patients who received tramadol have reported seizures. Abrupt withdrawal of tramadol may result in anxiety, sweating, insomnia, rigors, pain, nausea, diarrhea, tremors, and hallucinations.
Last Editorial Review: 7/16/2007
Helpful Answer (1)
Report

OOps--the sidebar on my computer said "Trazadone"..so I barely skimmed the OP. Tramadol is just what sheridui said. I was thinking that it did make sense to take out a benzo and add a drug that causes sleepiness. Tramadol, for me, is just meh. My mother had it after her hip surgery and LOVED it, for pain. HOWEVER, it can cause hallucinations, esp in oler people. Mom suffered from those and she has to stop taking it. Too bad, b/c it really worked for her. Again--sorry!
Helpful Answer (1)
Report

The confusion between Tramadol and Trazadone is because Babalou originally asked about experiences with TRAMADOL, an analgesic (pain killer). Two days later (on June 26) Babalou changed her posting, correcting herself. She intended to ask about experiences with TRAZADONE an anti-depressant of the "old school", not usually prescribed any more for depression --there are more modern and more effective antidepressants on the market but, very low doses, say 1.25 mg or 2.5 mg, of Trazadone can be prescribed for a person with dementia to help with sleep.
Helpful Answer (1)
Report

Dear all, so sorry for the confusion. The psych nurse practitioner agreed to stick with mom's current antidepressant regimen and a small dose of klonopin each day. Melatonin is being given for her sleep issues and is working well.
Helpful Answer (1)
Report

Thanks Bablou...I was thinking that I answered one question pretty well---when you are following several posts...gets confusing (maybe helps us to understand what our "patients" feel.

Glad you are finding a good combo for your mom. Glad that melatonin works for her, mt mother takes 4 things to help her sleep--and she does, very well, and that's important. (Wish I could find something that consistently works for me!)
Helpful Answer (1)
Report

Thanks ALL for helping to clarify the confusion!!!

Babalou~ I truly hope this medication regemin works for your Mom. I must express a concern about you Mom's medication; however. Why is she being prescribed 2 types of antidepressants (Lexapro and Remeron)? Thinks I would ask the prescribing MD to be sure this combination is safe. By no means do I profess to be a MD and I certainly do not intend to frighten you, but there is a possible issue regarding Serotonin Syndrome. In other words...When a person takes more than one drug known to increase serotonin levels. Please, see the article from the link for Drugs.com regarding...
http://www.drugs.com/mcd/serotonin-syndrome
The best to your Mom and you.
Helpful Answer (0)
Report

See All Answers
This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter