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Something weird going on - need to roll head, shake hands, pace. badly

(35 Posts)
TheNameTaker Wed 24-Apr-13 19:28:57

and rock back and forth, move head up and down to releive a horrid feeling, and kick my legs. it's almost involuntary. I can't stop it. It started this evening but hands been feeling funny all day like I been typing too much at work. Awful pain in fingers of one hand.

Background - been taking tramadol slow release capsules forever (for back pain) been on just 100mg slow release (or modified release also known as) in the morning, to tide over the pain and manage without at night time (used to take one in evening and one at night).

If I miss a dose, I sometimes get 'withdrawal' which involves sneezing (for some reason) and some vague flu like feelings. I have tried to withdraw completely before when I was stubborn and would not accept I still have pain. And then I got 'restless legs' but that was after like 3 days.

Anyway, been on 100mg and manage fine on this. few weeks ago, I was given tablets not capsule by pharmacist. Not deliberately, I guess that was what they had in. Since then I have felt it has not been right, it has not felt as strong, so pain crept back in a little, and it runs out before 12 hours so I start to get a bit withdrawn by the morning (24hrs) and in fact by 12 hours feeling it's running out. This is not a problem on the capsules, I can take those one dose in 24 hrs, or sometimes as long as 36 hours without any withdrawal at all. But these tablets don't feel right.

So this evening I came home early as I felt horrible, tired, lethargic, increased back pain. I didn't want to take any more as it makes me very awake at night which is why I don't take it then. So, I cut into half, and took the slightly smaller half (will take the other tomorrow morning instead of normal dose). And within 30 mins (bearing in mind it is slow release) I suddenly started feeling like this.

I can't sit, stand, move, nothing is comfortable or stops me wanting to rock. Even typing this, I am on my knees lent forward and rocking forward.

It's actually starting to hurt.

Is it the tramadol? Never had this before ever while on tramadol (been on it about 8/9 months and at times up to 400mg of normal release when pain has been bad).

Name changed as it's a bit embarrassing.

DeafLeopard Wed 24-Apr-13 19:30:37

I'd be calling OOH / 111 if I were you.

It is possible that it is the tramadol as it is strong stuff.

TheNameTaker Wed 24-Apr-13 19:31:00

I've tried googling but not come up with anything that makes sense, apart from opiod withdrawal, but I should not be withdrawing as I have not missed any doses.

Ring ooh

TheNameTaker Wed 24-Apr-13 19:32:53

deaf thing is though, what I took, the half of it, I am prescribed to take the full amount of it. I just haven't been. I have not exceeded by prescribed dose. I am prescribed 100mg x 2 daily. and I normally take just one, I did use to take the full dose but felt I no longer needed it. So, this half is just under 50mg of the 100mg I am ok to take...

it doesnt make sense.

I have thought of OOH as I feel a bit anxious about what the hell is going on.

MrsLettuce Wed 24-Apr-13 19:33:16

Yes, it'd be best to get in touch with the OOH service, really doesn't sound right.

TheNameTaker Wed 24-Apr-13 19:45:09

I am going to give it half hour. I feel hot, skin is hot to touch, but I suspect no fever. headache now, The feeling is subsiding a little. Not much, but just been still enough to tuck children into bed and ignore the sensation and anxiety that it's something really serious is abating a little. Which probably means the slow release has released a little?

That's withdrawal isn't it? Do you think that means the meds have been flawed? Is that even possible to get a bad batch? I took my usual dose this morning, but, given how I feel, it would make sense that it would be around 24hrs since last dose and given how these tablets (rather than the capsules with the tiny balls of medicine inside) have been they don't seem to work as well?

Jeez. I can only imagine what the drug users I work with must experience giving up their drugs of choice, when they take much higher doses than this shock

You need to ring ooh ASAP

stomp Wed 24-Apr-13 19:48:28

are they 'slow release' and you've overdosed by cutting one up?

TheNameTaker Wed 24-Apr-13 19:49:19

heart is pounding now! can feel it in my throat! think I had a panic attack with whatever the hell has just happened to me blush.

ok, i can sit ok now. the feeling is still there, the urge, but I can manage it now. Before when I posted, I had been like that for about an hour! and I had no control. It was like my muscles had to stretch or something and I could not stop it, even my eyes went weird. It looked a bit like I was having a fit or something for about 10 mins at it's worst! blush

TheNameTaker Wed 24-Apr-13 19:53:02

stomp no, I took my last slow release this morning as usual, just 100mg. If I choose to take the second dose, I would be due to take it when I did at 100mg, so I actually took half the dose or less by cutting it. If that makes sense. I know cutting is not an exact science as the meds would not be evenly distributed around the tablet, but it would be no more than the normal 100mg and certainly less. I just normally miss the evening dose, unless I am in a lot of pain and then I will add it back in.

I have to date been able to increase and decrease that second dose as I have needed. I sometimes even take an additional normal release dose too as I can take up 400mg in a day. I have rarely ever gone that high, but when I have, reducing back again has been no problem, perhaps a little groggy for a day or so if I have been that high for several days, but nothing like this.

Leverette Wed 24-Apr-13 20:18:15

Have you phoned for advice/help yet?

How are you now?

Do you take any antidepressants or St. John's wort? I just ask because these can interact badly with tramadol causing symptoms just like you describe.

TheNameTaker Thu 25-Apr-13 07:31:46

Hi. Ok no I didn't call ooh, as the symptoms eased. I then felt tired and my muscles hurt! Slept til prob 2am then awake for ages.

Dh thinks that maybe me cutting the tablet messed the 'slow release' he said perhaps they have a coating on them that promotes the slow release of them and I broke that and therefore it all released straight away. That makes sense as I did read it can be as a result of something called 'seretonin syndrome' which is basically on overload of serotonin. Usually caused by taking too much or multiple meds that are serotonin reuptate inhibitors.

Serotonin syndrome is actually really really dangerous, so, what I should have done is as the symptoms started, called 999. I didn't do that, as by the time I read about it, I was on the downside and feeling ok.

I am not going to take the other half. I am going to miss these tablets completely this morning and see my gp have a chat about what happened, get a new prescription and make sure I get the normal capsule form that I know are ok. I really don't like this drug so I am going to ask him to give me a lower slow release drug and get the hell off it. I never wanted it in the first place but at the time I started it my pain was so severe and I was having some trouble with codiene as used it for a while. Gp persuaded me after I refused for ages.

TheNameTaker Thu 25-Apr-13 07:34:23

leverette meant to say not taking anti depressants, or St. John's wort. I take berrocca, but not remembered to take it for a few days! And that's normally fine with it/nothing to suggest I can't take that.

TheNameTaker Thu 25-Apr-13 07:37:38

Also meant to say leverette that serotonin syndrome is the name of the symptoms you talk about if taking St. John's wort or anti depressants!

Footle Thu 25-Apr-13 07:38:00

If you post again with Tramadol in the subject line, you may get replies from more people who've struggled with it. I noticed threads about it on MN when I had a bad reaction to taking it for a few days after surgery. Nasty stuff.

NotALondoner Thu 25-Apr-13 08:49:42

I think it is because you cut it in half, and cut through the slow release 'layers' as it were.

Leverette Thu 25-Apr-13 09:11:45

Glad to hear you're ok this morning. Yes, serotonin syndrome is what I was getting at, and you're absolutely right about the likelihood of the effects of cutting the tablet.

stomp Thu 25-Apr-13 09:13:14

Yes that is what I meant, slow release have layers which the acid in the gut dissolve over time 'releasing' a dose over a period of time, if the coating is damaged- by cutting the tablet- the acid in your stomach will dissolve the 'dose' in one go. Sounds like you did overdose. It is a common mistake, so common i'm surprised the leaflets with these type of tablets doesn't give a warning.

Poledra Thu 25-Apr-13 09:20:13

DO NOT cut slow release tablets in half! Basically what you've done is allow the whole dose to be released at once, leading to side-effects of an overdose. The tablets are formulated to be broken down in the gut, and breaking, chewing or crushing them destroys the slow-release mechaism.

Glad you're feeling better now.

Poledra Thu 25-Apr-13 09:22:22

Sorry, didn't read the whole thread - i see you'd worked it out yourself.

stomp these sort of tablets do have warnings in the instruction leaflet not to chew, break or crush - however, people don't always read them especially when it's a medicine they've been on for some time and are comfortable with.

CajaDeLaMemoria Thu 25-Apr-13 09:23:43

Is the packet not covered in warnings about not cutting Tramadol up? It certainly should be. It's all over my boxes, and in capital letters in the leaflet.

You overdosed due to destroying the layers. It's horrid, but it sounds like you are over the worst of it.

Your doctor might tell you to withdraw for a day now, to get it out of your system, or they may put you on something weaker. Make sure you tell them that there are no warnings on cutting them though, because that is really, really dangerous.

minmooch Thu 25-Apr-13 09:28:13

Agree with other posters - cutting the tablet will have corrupted the slow release layers.

The last time I took some tramadol I had a horrible reaction to it (taken while and not previously reacted). I felt wierd, dizzy, thought I was going to fall off the sofa, had to crawl up the stairs because I was frightened to stand, was sick about 5 times and had to call my mother over to look after my disabled sick child. Horrid, horrid stuff and I will never take it again.

Hope you are feeling better.

TheNameTaker Thu 25-Apr-13 09:30:40

poledra your exactly right about not reading the leaflet. I read the one for capsules cover to cover multiple times, googled side effects etc, proper thorough. But, as you said, been on for a long time, thought I knew it all, and didnt consider that the tablets would be different. Wel, they are not different, but of course I have never cut a capsule in half! I didn't think for a second about the slow release aspect of it.

I have a doc appt this morning. Is there a chance he is going to say I can't take tramadol anymore? I know I want to wean off it, but aware that I can't just stop it either (tried that already!). I am going to ask for a lowest dose of it too.

Seeing it was quite a low overdose, is there a possibility it could have damaged kidneys etc? I only have one but its nice and healthy, would like it to stay that way!

A huge lesson learnt. I might ask MN to put the word tramadol in the title so it can be flagged to others who use it.

TheNameTaker Thu 25-Apr-13 09:35:22

There is no warning on the box itself about cutting it. But also no instruction leaflet as it's been out in a generic box. Sometimes when I get meds there are no instructions at this particular pharmacy for example with diclofenac, no warnings about taking with food etc, but I wonder if its because they are repeat prescriptions so presume I already have that info? I don't think it's a gp thing, I think it's something I need to take with the pharmacy if there is nothing on the box/inside when I get the next lot.

But regardless of it being on the box or not, I do need to take responsibility for it as I should have checked online if nothing on the box before cutting it. I didn't think about it being slow release.

CajaDeLaMemoria Thu 25-Apr-13 09:36:03

It's possible. Tramadol is strong, and not taking it properly is dangerous. Typically one incident won't mean you get taken off a drug, but it's at the doctors discretion. The other concern is that if you are sensitive to Tramadol, it's best not to be taking it at all.

You are on such a low dose, the chances of damage are really, really low. I have bad kidneys, they are literally falling apart, and I take a lot more than you! It was a very small overdose, but it feels extreme because your body wasn't ready for it.

TheNameTaker Thu 25-Apr-13 09:41:24

Can you get slow release on a lower dose than 100mg? I would much prefer a lower dose than that, taken twice a day then I can stop the evening one if I don't need it. It won't be a bad thing to stop it completely, just not good at cold turkey! I can always use cocodemol, or just get the hell on with the pain!

TheNameTaker Thu 25-Apr-13 09:44:19

It odd though that the tablets don't seem to work for pain as well as the capsules. They are fine never had any problems on them, the slowness of the release is good as the side effects have always been minimal, the slowness of release and slowness of wearing off means no in tenseness, which is why I take it instead of the normal ones. Bt the tablets have much stronger immediate side effects, evn without this incident they seem to release quicker and leave my body quicker so I have been getting more of a seesaw effect.

CajaDeLaMemoria Thu 25-Apr-13 09:52:44

I won't take the tablets because they are rubbish. Capsules all the way. Get your doctor to specify that you need slow release capsules.

You can get 50mg slow release, but I don't think they are as common. I had them in hospital after kidney surgery, but was put back on a huge dose after, so I don't know if the pharmacy could have got them.

Could you take one 100mg at lunchtime otherwise? You might find that's enough to get you through til lunch the next day.

Poledra Thu 25-Apr-13 09:57:14

Had a quick look on the BNF - there are 3 branded types of tramadol slow release capsules with a 50 mg dose available in the UK. I would suggest asking your doctor about prescribing you capsules as you get on better with them - different strokes for different folks!

TheNameTaker Thu 25-Apr-13 11:24:14

Just had gp review. I have had all my vitals checked, heart, blood pressure, lungs, kidneys via wee, all fine.

Now been given 50mg modified release tramadol, he has not stated capsules, but I will ask the pharmacist if he can give me capsules, if not I will go different pharmacist, as I think it was purely that they had those particular meds in, that pharmacist usually gives me capsules and my prescription did not change.

He didn't make me feel daft, just reviewed the meds I was taking. So, phew! I won't take one until this evening though, just to give it a full 24hrs from last night.

I feel quite shakey and a bit of a headache but that's all.

CajaDeLaMemoria Thu 25-Apr-13 11:43:06

I'm glad it went well smile

Shaking and headaches are normal, unfortunately. I find that napping helps sometimes, as do eye drops for the headaches. You might find a hot bath helps, too.

I'm trying to think of the other things that helped. I'll poet back if I think of any more smile

digerd Thu 25-Apr-13 11:54:12

I cannot see that a tablet can be effective as a capsule which usually contains different tiny pills that release at different times.

gingeroots Thu 25-Apr-13 11:57:26

I was in chemist yesterday and overheard long conversation between dispensing pharmacist and a mother collecting prescription for baby .

She was querying the different type of tablets she'd been given for baby because she'd had them once before and they didn't dissolve properly .

Think the jist of it was that pharmacist can ( and no doubt will if cheaper ) dispense generic alternative .

Only way to prevent is to get GP to name brand of drug on prescription .

TheNameTaker Thu 25-Apr-13 12:46:03

ginger I will see what they will give me before I put the prescription, and hope they give me the capsules this time as they have always done so for the entire time I have been on them, apart from that one time. If not, I will ask why they have changed and then go to supermarket one which I know does capsules as been there a couple of times over the last year/just under. If I get problems I will speak to the GP and ask what he says. The tablets are called Zydol. I can't remember what the slow release capsules are called but recognise them when I see them.

diger that's what I think too, I remember throwing up the little tiny beads once when I had a stomach bug. they turned flourescent green! It makes so much sense that the small beads release slowly, each one.

caja thank you for the useful tips. I have been drinking camomile and avoiding coffee to reduce the shakes (or, not increase them!) I have a course this afternoon which I can't miss so no sleep for me, although I desperately want one! and got to take DS to park beforehand as I promised him! It will pass, and I can manage it now I know I am fine in myself.

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