Bomba, Please see my very detailed response to your question about
Tapentadol. Tapentadol has much less effect on seratonin levels than tramadol does and would be much better to use if you are having libido problems.
Tramadol is really as much of a problem solver as it is a problem creator sometimes.
Tramadol is actually an analogue of codeine (a T3 replacement in sense), and it undergoes a very similiar process in the liver. Codeine turns into 5 percent morphine, whereas about 20 percent of tramadol is turned into an m1 metabolite that is opioid receptor active (though fairly weak). Only about 1/3 of tramadol's pain killer ability comes from its opioid activity though. What makes its more potent than Codeine is its weak reuptake inhibition of both Norephedrine and Seratonin. SNRIs are known to alter our response to pain. Theres also some evidence that shows that tramadol inhibits dopamine, but to a lesser degree than it does NE and SE.
Anytime you have a medication that inhibits SE, theres a risk seratonin based effects logically. However, medications that raise NE or DP along with SE run a higher risk of SE related effects, since increased levels of NE and DP have the potential to increase seratonin levels as well. With tramadol you have just that, 2 additional reputake effects that can indirectly raise SE levels. The other issue with tramadol and its seratonin effects is that tramadol has a long half life. Tramadol is generally given every 6 to 8 hours vs 4 to 6 hours for other pain medications, and this is because it stays in the system longer. Therefore its SE effects linger on hours after the medication is taken. Good for keeping pain away, but bad for side effects.
I really think the only way to combat the libido issue is to limit the use of the medication or to create a scheduled use that allows time for full system elimination. There does exists some anti-physcotic meds that have seratonin blocking properties, but in my opinion a lot of those medications are risky.
MRI revealed a bulging disc w/gel lost at L5 and showed the bulge touching nerves, causing sciatica. Diagnosed w/ Arthritis which is responsible for joint inflamation pain. Treatment: Nucynta 50-150 mgs every 6 hours (schedule II narcotic, Mu Opoid agonist and NE reuptake inhibitor), Celebrex 100 mgs, Klonopin .5, Epidurals, Radio Freq nuerotomy (sept 8th, 2010)
Post Edited (grainofsalt) : 10/9/2010 10:23:35 AM (GMT-6)