Ultram and Prozac

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Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/27/2009 11:37 AM (GMT -6)   
Has anyone here taken these drugs together? I have heard both.
 
My pain isn't going away, and after over 3 1/2 years of pain and the ups and downs of it--meaning, some days it won't be as bad, then I'll think I can work and it will come back strong.
 
This is really depressing me. We moved because we thought my son was being stationed on the west coast and he wasn't. Missing him, combined with both myself and husband not well, is leaving me quite miserable. I've heard people say they have taken ultram with prozac or another anti depressant. I didn't want to go there, but I am feeling pretty low everyday and scared.
 
Any answers would be appreciated.
 

Chutz
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Date Joined Jan 2005
Total Posts : 9090
   Posted 1/27/2009 12:18 PM (GMT -6)   
Hi Denim!

I don't take those specific meds but I do take narcotic pain meds and an antidepressant. Partly for depression and partly for fibromyalgia. It seems to help elevate the serotonin levels which many people with fibro need. I don't have any problems with taking the two together but it did take a while to find the right combination. Just let your doc know about your concerns and never be afraid to back off or stop taking a new drug if it's bothering you. Make sure you call your doc if you do stop any prescribed medication.

Chutzie
Co-Moderator Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, PTSD, dermatitis herpetiformus, osteoarthritis and a few other side dishes.
***************
Happiness is something to do, someone to love, and something to hope for."


Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/27/2009 12:32 PM (GMT -6)   

I know when I put in a check for the two I mentioned there was a big warning but I thought I remebered others saying they took it and it didn't bother them. I just feel I can't go on this roller coaster any more. Everytime I feel a little better, I revert back and time is passing and it's better than when I first hurt myself, but it isn't good. I heard my old doctor is coming back and I hope so, I think he has more experience. I am limited in who I can see and the nueros and orthos say they don't see anything terrible, yet I feel terrible.

Thanks


Scarred_for_life
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Date Joined Jul 2008
Total Posts : 1559
   Posted 1/27/2009 1:20 PM (GMT -6)   
Denim; I too am on a combination of narcotics and Antidepressant medications and from experience I can tell you that it does help with the depression I feel from not being able to do what I feel should be done or what I wanna do. I agree with Chutzy that you should relay to your Doctor your concerns and feelings about being on these medications so that he/she can adjust them as needed. Just remember that if your feeling any side affects to let your doctor know about them cause he can't read minds :-)

Hugs and good luck. Hope you are having a lessen pain day.

Scarred
HEALTH ISSUES: Herniated discs at S-1-L5, L5-L4, L4-L3. Two level fusion (2000); one level fusion (2002); Revision at L4-L3 (2003). Slight herniation at L2-3 but Neurosurgeons will not operate because of previous failed surgeries. Diagnosed with Failed Back Syndrome, Permanent Nerve damage and Chronic Pain

Medications:

Kadian, Lexipro, Percocet, Lunista, Topamax and Robaxin.


Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/27/2009 1:33 PM (GMT -6)   
Thank you Scarred. My best to you.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11182
   Posted 1/27/2009 4:21 PM (GMT -6)   
Awe Denin, its a tough life for sure. But as the others have said alot of times the antidepressants can help with some of the pain. I need it for my on emtional state more than anything. I don't function to well w/o. It helps my mental attitude alot. But it also takes finding the right one for you too. Not all are created equal... Hugs, Susie


Dagger
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Date Joined Apr 2008
Total Posts : 1522
   Posted 1/27/2009 7:17 PM (GMT -6)   
The reason for the warning about Ultram and SSRI antidepressants is because Ultram had an effect on your seratonin levels. It acts like a very mild antidepressant. Combining the two can result in something called Seratonin Syndrome which can be fatal. It greatly increases the likelihood of seizures.

This warning is about Ulram/tramadol specifically, it doesn't apply to narcotics.

I think you can safely use Ultram with tricyclic antidepressants, your doc and pharmacist would know.

I hope this helps.

Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/27/2009 9:08 PM (GMT -6)   

Thanks Susie and Dagger, this is such a nightmare, it is so much like the book of Job, what I feared the most has come true. Though I know I am not taking these pills for fun, I can't help but feel bad about it and I know it goes back to a misspent youth. Yes, you would think that was so long ago but I never wanted to take a drug ever and now I need to.

My doctor made sure to write on the prescription not to fill till the day due. I went in anyway, just to ask and felt like a child. One day early, you would think, what's the difference but they have to do that now, supposedly.

I know ultram has ssris in it, and don't know why they had to do that, so I would have to get off of that to even try an anti-depressant.   

I never heard of tricyclic antidepressants, but will look it up. I just know, this isn't working. It was for awhile but I admit, I need help.

Thanks so much and bless you all.


Swallow your pride, you will not die, it's not poison.- Bob Dylan 


Dagger
Veteran Member


Date Joined Apr 2008
Total Posts : 1522
   Posted 1/28/2009 2:33 AM (GMT -6)   
Tricyclics are drugs such as Elavil and Pamelor. They are antidepressants but they are sometimes used in low doses to help with pain and sleep. They also have a lot of side effects but have been in use for a long time. I just checked and it looks like you shouldn't take Ultram with tricyclics either. Hopefully, your antidepressant will also help your pain so you won't need a prescription pain med.

Your doc wrote that on your Ultram prescription? You may want to ask him why. I've been taking it on and off for a few months and haven't had a problem filling it a few days early.

Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/28/2009 11:04 AM (GMT -6)   

Hi Dagger, No it was a morphine prescription. The pharmacist explained to me why. It's because he wants to make sure you don't take extra. I was asking for one day early and they couldn't do it. Fine. The insurance wouldn't let it go through if it was too early anyway, but I've had ultram and other meds filled maybe 5 days early. I just thought he was being picky by writing that. I know enough not to bring it in too early but I wanted to hear what they would say about one day. Now I know. I wish they came out with a drug that targeted the pain. In my opinion, the choices we have aren't that great and I don't know if there is anything on the horizon. I don't hear much about it, I hope they would come out with other choices and I'd like to know why they had to put the ssris in ultram anyway. When your pain level is high the ultram doesn't do much. Chronic pain seems complicated. Why can I have a run of doing ok and revert back to pain? It has been a pattern. I have no clue, and I can't be the only one going through this.

Thanks for writing back, hope you have a good day.


Swallow your pride, you will not die, it's not poison.- Bob Dylan 


CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 1/28/2009 9:25 PM (GMT -6)   

I take both prozac and ultram on a regular basis with no problem at all.  Ultram really isn't seen as a "true" narcotic anyway, and doesn't have all the tiered medication requirement of true narcotics.  Ultram certainly doesn't give you the same bang for the buck as a hydrocodone or oxycodone.  Ultram can help ease things between prescriptions of narcotics, but certainly does not have the same pain managing abilities.  I always have an ultram prescription to fall back on when my Lortab runs low and I have several days to wait for a refill.  Never had any conflict with my prozac, and I take a fairly high dosage, 40mg, per day.

 

Good luck.  Let us know how things work out.

Leigh Ann cool


Basic info:
  • On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ, stomach problems 
  • Divorced, 43, spawn-free 
  • Surgeries: Gastric Bypass, Gallbladder Removed (followed by a week in the hospital for a Blood Clot), Impacted Kidney Stone Removed, Broken Ankle, Major Dental work(ten molars pulled, multiple cavities, root canals) Tubal Ligation/D&C/Uterine Ablation 
  • Current Meds: Prozac, Klonopin, Atenelol, Lortab, Trazadone, Buspar, Nexium, Tramadol, Hydroxizine, Vitamin D, Axert, Zonegran, Seroquel 
  • PROHIBITED FROM ALL NSAIDS
  • Current Problem: Mysterious Internal GI Bleeding, possible ulcer in location of Gastric Bypass
 
"The weather is here, I wish you were beautiful."
                                             - Jimmy Buffett
 
 


Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/29/2009 2:11 AM (GMT -6)   

Thanks Leigh Ann, for your reply. Every site I've been to gives a huge warning of drug interactions between any anti depressent and ultram, but I do recall people on here saying they do take both. I know my doctor would never give it to me unless I was off the ultram. He did give me morphine sulfate er also.

May I ask you, do you like the prozac, do you notice the difference? I am not normally a depressed person at all but having this injury come upon me and not leave has really taken a toll and sometimes its so hard to shake the blues from going from an exercise non stop person to this.  I go throught periods of feeling pretty good and others where I'm in pain and just plain down.

Your doctor never gave you a warning about the combination? I had other doctors offer me cymbalta but was afraid to continue because of what I read and it made me feel weird.

Thanks for taking the time to respond to me, I really appreciate it and I wish you the best.  


tonijo2
New Member


Date Joined Jan 2009
Total Posts : 7
   Posted 1/29/2009 12:47 PM (GMT -6)   
hello all I am new to this form but the ultram topic hit me I take alot of meds but seams all doc will give me is ultram .the doc wants me to go to a pain managment but I am suffering every day but dont want to give in, it is scary to me as I know the sick feelings and the being unstable I like to have a sence of control and the biggie is I know once I go down that road there no coming back and I suffer is this not a good way to look at things I am seeing that the pain it changing the way I look at alot of things and wouldnt know what a day without pain feels like but afraid of getting dependent on stroung pain meds, my sis has morphine pump and she feels as if she would die if they took her off it have seen her when pumps dry and going through withdrals not a site you want to see and I dont want to walk in them shoes but a day with out pain I am getting closer to going to pain managment but just dont want to giive in to it either been fighting to long I am afraid   I have just gotten a new dx with pain with it and it being compounded 3x now to what I was tolerating and now am feeling anxiety of the pain I am afraid of it . see stuck between feelings and sooo confused now I take clozapam,soma,zanaflex,nerotin is maxed out .siniment,ultram,compazine,think thats most of them  but I need to know how long to fight before I give in  suffering daily and at wits ends.my main dx is multi focal myoclonus with et's and at rest tremors and alot of spacity and pain  now newest one is leukoplakia in both sides and with pain doc say shouldnt be there I dont get it I know pain when I feel it , thanks ,any commets would be good I need help and more understanding as to do the right thing it there is such a thing. tonijo2    confused

Lindaloo
Veteran Member


Date Joined Sep 2006
Total Posts : 1711
   Posted 1/29/2009 1:31 PM (GMT -6)   
Welcome to the forum tonijo2. I don't understand. Pain management is a good thing. There are various modalities that are used for pain management , not just drugs. Go to a pain management doctor and get evaluated and see if there is something they can do for you. No sense suffering the way you are. And please keep posting. Start a new thread next time and let all of us get to know you. You will get more responses as well.

Denim, to you I would say, talk to your doctor, maybe there is something other than ultram that can be prescribed for you since your main concern is with that drug. I too take three antidepressants and a narcotic for pain and have for years. I do just fine with my pain management.

The best thing to do is to talk earnestly with your doctor and let him or her know your concerns and your pain level and together devise an adequate plan that will both target your pain as well as put your mind at ease.

Hope this helps, ladies,

Gentle hugs.

Lindaloo
Moderator Chronic Pain
 
Believe in yourself.  Be kind to fellow humans and animals.  Take time to smell the flowers and the coffee.
And by all means, when you are down, ask me for help.  I will be there.
 
Linda


Denim
Regular Member


Date Joined Apr 2007
Total Posts : 428
   Posted 1/29/2009 3:13 PM (GMT -6)   

Linda, thanks for your reply. I am taking morphine sulfate also now. I know he would gladly give me an anti depressant if I wanted it, I have been against it. I go through periods of doing pretty good. I know where my hatred of drugs stem from and I am just tired of not feeling stable.

If I knew a good pain management doctor I'd go. tonijo2. Ultram is super addictive. Just because it says "non-narcoric" means nothing. You have to get off of that very slowly and I'm hearing it's harder than others. I took myself off of meds and recently the morphine and it wasn't bad. For heavy pain, ultram is not the best, but possibly just as if, not more addictive than others. I would go to the pain management for sure, rather than suffer.

I was questioning the anti depressant because, feeling up and down on pain is really getting to me and would love to hear sucess stories.

Linda, may I ask why you take 3 anti depressants? If it works for you great, I just never heard of that.

I wish u both well.


Swallow your pride, you will not die, it's not poison.- Bob Dylan 


CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 1/29/2009 11:57 PM (GMT -6)   

Hey Gang,

Let me clarify a couple of things.  First of all, Ultram is NOT a narcotic, it merely mimics some narcotic behaviors.  One of these behaviors is a mild "addictive" nature, but because the medication is not strong in and of itself, the addiction is not as hard core as stronger, true narcotics like hydrocodone, oxycodone, or morphine.

Second, chronic pain sufferers often need the support of antidepressants to help deal with the realities of life that come with being in chronic pain.  Changes in abilities, inabilities to pursue or fulfill goals, the ability to maintain or participate(or not) in regular activities, etc... can be very waring on the psyche.  Often an antidepressant is prescribed to the patient, but it fails to balance out the highs and lows that comes with the daily swings in emotions.  More commonly, a patient ends up being prescribed a "cocktail" of antidepressants/anti-anxiety meds that give a better, more even balance of coverage than just one single medication can provide.

In addition to my chronic pain issues, I also have chronic moderate depression and panic/anxiety disorder, a fairly common situation.  I personally take Prozac, Trazadone, Buspar, and Klonopin on a daily basis.  These medications keep me on an even keel, allow me to function the best I can, and not freak out when I have a rough patch.  They also help me sleep, which really gets me through through those long miserable nights. 

Some people still feel a stigma about taking "mental health" medications, but I say heck, whatever helps get you through the day is alright by me.  I'm already in pain, so what good is constantly worrying about it going to do?  Pain sucks... being irratible on top of it just make the pain worse and the situation seem more desperate.

Leigh Ann cool


Basic info:
  • On Disability for: Chronic Migraines, serious Back and Knee problems (will need surgery eventually), moderate Depression, Anxiety/Panic disorder, TMJ, stomach problems 
  • Divorced, 43, spawn-free 
  • Surgeries: Gastric Bypass, Gallbladder Removed (followed by a week in the hospital for a Blood Clot), Impacted Kidney Stone Removed, Broken Ankle, Major Dental work(ten molars pulled, multiple cavities, root canals) Tubal Ligation/D&C/Uterine Ablation 
  • Current Meds: Prozac, Klonopin, Atenelol, Lortab, Trazadone, Buspar, Nexium, Tramadol, Hydroxizine, Vitamin D, Axert, Zonegran, Seroquel 
  • PROHIBITED FROM ALL NSAIDS
  • Current Problem: Mysterious Internal GI Bleeding, possible ulcer in location of Gastric Bypass
 
"The weather is here, I wish you were beautiful."
                                             - Jimmy Buffett
 
 


Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2147
   Posted 1/30/2009 1:46 AM (GMT -6)   
Denim,
Because of my own experience with Serotonin Syndrome, I think it can be valuable to know what to look for (since most docs have never seen a live case). Narcotics & anti-depressants both affect serotonin levels & have the potential when taken together to cause Serotonin Syndrome. However, it is so rare that I still encourage my own family & friends to try the combination if their doctor is recommending it. Even if you do get really sick & go completely crazy from serotonin overload, it is a progressive illness so there is time to get to the doctor's before it dangerous & is it easily treated and reversed. I wouldn't worry much about the warning. They really are pretty safe together in most cases and have a well-documented history of helping many people.

Here's some info that may be of help:

First, pursuant to the information put out by Ultram's own manufacturer (Ortho-McNeil)

"ULTRAMĀ® is a centrally acting synthetic opioid analgesic"
http://www.ortho-mcneil.com/ortho-mcneil/products_list.html

This same information is repeated in the 2009 American Chronic Pain Association Consumer Guide to Pain Medication & Treatment
"Tramadol is a weak opioid analgesic"
http://www.theacpa.org/news.asp

in other words -- Ultram is a narcotic. It is not as strong as other narcotic pain meds, but it is a narcotic. Plus, I'm pretty sure that it is an urban legend that they put ssri's in the Ultram. They don't seem to list that anywhere in their literature. Best to ask your pharmacist to be sure.

Second, Serotonin Syndrome is exceptionally rare. Even the neurologist I finally saw from Mayo Clinic didn't need a full hand to count the number of times he had seen it in all his years of practice, including my case. It is life-threatening, that's why they put it on the label, but almost nobody gets it -- though they may experience the normal less severe side effects. It definitely is not limited to Ultram -- I can say this with confidence since I was not on Ultram at all & had been off it for years when I developed Serotonin Syndrome.

Again, you can reference the APCA Guide for more info, but here's the gist:
'More than 50 commonly prescribed medicines boost the amount or effect of serotonin in your system. When you take two or more drugs that affect serotonin levels, they can increase the amount of serotonin and may lead to bothersome or dangerous symptoms. This is called "serotonin syndrome."'

They go on to list specific categories of meds -- including most narcotics & many anti-depressants, plus a whole bunch of other meds from anti-emetics to diet pills to migraine meds, etc. -- that when taken together have the potential to cause problems.

Anyways, I hope that provides you a measure of peace. The risk really is very low & the potential for benefit reasonably high.

take care,
frances
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