(Sorta answering both your topics in one here..)
I'm using the Tramadol (for maybe 8 years) and found that after the first few years (with some relief) i had to up it to. Took max allowed 6-8 50mg/day and got enough relief to work and live my life, even danced.
Since starting the Cymbalta (I think I posted about
this in more details somewhere--or maybe just in my blog) after 2 months it kicked in. I'm maybe at month 4 and take the tramadol only 4 -6 tabs, usually 4 tabs a day (2 in am, 2 at bedtime.
This has helped with the depression, though I'm still having suicidal and violent ideation (which I let pass as just garbage spouting from my psyche) from time to time, but not as much. My experience with these 2 in combo is that it has DEFINITELY made a difference in my ability to manage my CP. Good luck, and as you know, we're all different in how we respond to things. take care,
Post Spinal Fusion chronic pain since 1984;Polyneuropathy;Meniere's Disease, Left ear deafness & severe tinnitus on both sides, Left; Intmt Anhedonic depression;Hx,Meds: donthearishoutyou.com/blog/