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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by paxvox on August 5, 2002, at 20:46:53
OK, I know similar post regarding opiate and opioid therapy for depressive illness have been made. But having just recently been scribed some Ultram for pain, I read where it is an inhibitor of serotonin reuptake and norepinephrine....hmmmm......me thinks there is some sort of connection here. Anybody? Anybody?
PAX
Posted by Sunnely on August 5, 2002, at 23:51:10
In reply to Ultram as antidepressant, posted by paxvox on August 5, 2002, at 20:46:53
Tramadol (Ultram) is a central nervous system acting pain killer that activates the mu receptor and enhances the action of serotonin and norepinephrine via reuptake inhibition. Incidentally, like codeine, it is a "pro-drug" and it needs to be converted to its active metabolite called M1 to be an effective analgesic (pain killer).
It has been suggested that Ultram may have antidepressant effect. It shares a number of molecular and pharmacological features with venlafaxine (Effexor), an antidepressant.
In view of Ultram's serotonin and norepinephrine reuptake inhibition, theoretically it may induce manic relapse in patients with Bipolar Disorder; may induce serotonin syndrome if combined with an SRI (Prozac, Paxil, Zoloft, Luvox, Celexa, Effexor, Anafranil, etc.). The combined use of Ultram and SSRIs may also increase the risk of a seizure episode.
On a related note, sibutramine (Meridia), a weight-loss agent, has similar pharmacological make up as Ultram and Effexor (i.e., serotonin and norepinephrine reuptake inhibition). Theoretically, Meridia could be an effective antidepressant. This could also be true with ziprasidone (Geodon), an atypical antipsychotic with both serotonin and norepinephrine reuptake inhibition.
Ultram may also be useful in the treatment of obsessive-compulsive disorder (OCD). Also, a case of anorexia nervosa treated with Ultram has been reported.
Finally, duloxetine, an antidepressant soon to be released has both serotonin and norepinephrine reuptake inhibition, similar to Effexor. Unlike Effexor, its serotonin and norepinephrine reuptake inhibition is achieved at any dose, hence immediate dual-action. It has been suggested that it is particularly beneficial in patients whose depression is accompanied by pain syndromes (i.e., analgesic effect like Ultram).
> OK, I know similar post regarding opiate and opioid therapy for depressive illness have been made. But having just recently been scribed some Ultram for pain, I read where it is an inhibitor of serotonin reuptake and norepinephrine....hmmmm......me thinks there is some sort of connection here. Anybody? Anybody?
>
> PAX
Posted by velaguff on August 6, 2002, at 14:48:30
In reply to Ultram as antidepressant, posted by paxvox on August 5, 2002, at 20:46:53
Also, see my post RE: A. G. Scientific/Memantine of today (Tues. 8/6/02). Tramodol (Tram) A/K/A Ultram knocks my depression right out, but I have to take too much (250mg) and tolerance limits effectiveness greatly, even as soon as the 2nd day. Tramadol is a sort of quasi-opiate, I think. I think that's why it works for depression, not because of serotonin or norepinephrine effects, but I'm just guessing. I haven't ever tried a "true" opiate, so I can't compare the two. I guess it'd be hard to find people who've used both. Opiates nearly always cure depression, because emotional pain and physical pain are BOTH knocked out by opiates, using the same mechanism. Pain is Pain, emotional or physical, it's really just about that simple.
> OK, I know similar post regarding opiate and opioid therapy for depressive illness have been made. But having just recently been scribed some Ultram for pain, I read where it is an inhibitor of serotonin reuptake and norepinephrine....hmmmm......me thinks there is some sort of connection here. Anybody? Anybody?
>
> PAX
Posted by paxvox on August 6, 2002, at 15:29:30
In reply to Re: Ultram as antidepressant » paxvox, posted by Sunnely on August 5, 2002, at 23:51:10
Wow, that was a pretty nice report. I guess we can look for some others to consider if that treatment might be of use to them, especially with pain along with depression. As I take Wellbutrin as my AD, I don't think I have to worry about SSRI overload. Interesingly, after taking just 50mg of Ultram last night, I slept for 6 hours straight, which for me is a near miracle. Will see if it works the same tonight.
SIDEBAR: anyone who knows me probably has heard my posts about sleep disorders, etc...Thanks for your follow-up!
PAX
Posted by paxvox on August 6, 2002, at 15:32:13
In reply to Re: Ultram as antidepressant, posted by velaguff on August 6, 2002, at 14:48:30
I have had similar effects from both opiates and opioids. For many people, they are too sedating, for me,they are mood-lifters. Still help me sleep as long as dose is low. At higher doses, actually negatively affects my sleep. Is that a paradoxical effect?
PAX
Posted by velaguff on August 6, 2002, at 17:40:57
In reply to Re: Ultram as antidepressant » velaguff, posted by paxvox on August 6, 2002, at 15:32:13
Don't know if you're asking me about the Ultram/Sleep thing, Pax, but my name was in subject line. I didn't notice any effect on my sleep one way or another. I get the impression from reading around a bit that opiates really aren't sedating for people in pain. Whether it's a bad back, or depression, they just make the pain go away. For the depressed, this would constitute mood elevation. I think they tend to be sedating when people take them who are NOT in pain. Interestingly, I get the idea that nobody cares much about alcohol when they're "opiated". Life can be a struggle, and I guess stress relief is also a form of pain relief, and that's what a lot of people turn to alcohol for after their jobs and other hassles stress them out.
>>> I have had similar effects from both opiates and opioids. For many people, they are too sedating, for me,they are mood-lifters. Still help me sleep as long as dose is low. At higher doses, actually negatively affects my sleep. Is that a paradoxical effect?
>
> PAX
This is the end of the thread.
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