Dr prescribed my 14 yo tramadol for headaches - this normal?

[BayesianBlues]

We live abroad so wondering if this would happen in the UK.
14 yo daughter has been suffering from headaches for a month or so. Not totally debilitating like migraines but not nice and quite frequent. She usually would take paracetamol which takes the edge off enough that she can function. Sometimes ibuprofen. Probably every other day on average she's been getting through maybe 4 paracetamols and a couple of ibuprofen if needed.

So the doctor said that this amount of paracetamol is not good for the liver and the ibuprofen isn't good for the stomach and that DD should take tramadol for her headaches. She's prescribed us 10 50mg tabs to take home.

I was a bit shocked that she jumped straight to tramadol. And I wouldn't have thought 4 paracetamol and a couple of ibuprofen every other day is that terrible?

I'm not a dr but it's a VERY different medical culture here (very very quick to prescribe meds and had to push back against the over use of antibiotics) so I'm wondering if this would be considered normal in the UK if anyone has any experience?

I would change doctors. Tramadol can cause seizures, it's addictive, it causes gastro problems that can require emergency life saving but also life changing surgery...

Any doctor who is so casual with opioids and argues they are safer than non-addictive painkillers is not a doctor I would trust with mine or my child's health.

Are you in the US?

@ftw163532

I would change doctors. Tramadol can cause seizures, it's addictive, it causes gastro problems that can require emergency life saving but also life changing surgery...

Any doctor who is so casual with opioids and argues they are safer than non-addictive painkillers is not a doctor I would trust with mine or my child's health.

Are you in the US?

The dr is a paediatrician which based on the responses here makes it all a bit stranger.

No, we're in Asia.

Yeah that’s odd.

I take Tramadol long term for lupus joint pain. Usually people actually take it WITH paracetamol, not instead of it. A bit like Cocodamol (which is Codeine and paracetamol together). Tramadol on its own has more of an anti anxiety effect but when you put it together with paracetamol it has strong painkilling properties. It’s really weird the doctor 1) doesn’t seem to know this and 2) would rather substitute a weaker painkiller like paracetamol for something like Tramadol!

Tramadol is absolutely fantastic and the only thing that works for my pain but it seems extreme for a 14 year old to be taking it for headaches.

www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/medication-overuse-headache/

Do not let her take the tramadol!

@Cyclingforcake out of interest what kind of doctor are you? Just intrigued you would recommend starting codeine for regular headaches, especially in a child, due to the issue of medication overuse headache, it’s not really something that’s done. Just curious.

@BayesianBlues no we would not usually prescribe this in the uk. She needs a proper evaluation of her headaches, either they are simple ‘tension’ headaches in which case medication isn’t the best answer, or if migraines for example there are alternative/ better medication options.

DOI: I’m a gp.

No way would I let anyone regularly take an opioid, let alone a child.

Ok, thanks everyone for validating my gut feeling. I dont like going against medical advice - I always figure doctors go to med school for a reason and I only graduated from the university of Google. But in this country, I've found myself really questioning doctors and what they advise. They hand out antibiotics like they're candies. I had a breast needle biopsy here and they wanted me to take antibiotics after. The antibiotics remained unopened after I found out that it is not done in the UK.

@HermioneWeasley

No way would I let anyone regularly take an opioid, let alone a child.

If you are an adult in chronic life long pain you don’t really have any choice if you want some quality of life……!

Good luck op.

Tramadol makes me feel completely spaced out, i had a few prescribed after an operation and the surgeon said to take paracetamol religiously for a week or 10days and to only take a tramadol if I was still in too much pain to function. He warned me it would likely make me feel very weird. It really did. I would get a 2nd opinion OP.

Have you tried getting rid of all LED lights and screens for a few days to see if the headaches go away? A lot of people get headaches from LED light.

Any advice, even medical advice, is only advisory. It's an opinion, a recommendation or guidance, not a faultless directive, and it is delivered by a human being who has biases and imperfections and can make mistakes.

Which is also why second opinions are a commonplace concept, because sometimes the first opinion is not the right advice.

Blindly obeying doctors is as dangerous as blindly ignoring them. You have to apply your own judgment and questioning too. Don't beat yourself up for being responsible.

It definitely wouldn't be recommended here. Most pain relief is very limited here with headaches as can cause rebound headaches or migraines, if you see a neurologist in the UK you often have to stop taking any pain relief for 6 weeks (aside from migraine specific medications)

My daughter used to have constant debilitating migraines but was never prescribed tramadol for them. Naproxen was the strongest she was allowed but the GP preferred the route of prevention and/or stopping a migraune early on. She ended up taking a daily preventer which worked enough, ie having a migraine once a month instead of 3 or 4 a week. Try asking for something not as strong maybe although it is hard to question a doctors thought process.

i was on tramadol for a few years, its highly addictive and like killing a spider with a sledgehammer. I'm aghast!!!

scrunchies anaesthetics and acute pain. But sorry I didn’t make myself clear. I wouldn’t recommend a weak opioid at all in these circumstances. It just would be unusual for us to jump to sole use of tramadol in the U.K. without going up the pain ladder. And if there’s no contraindication to use of paracetamol and ibuprofen and it’s working I wouldn’t recommend anything else.

I lived abroad when DD was small. She caught whooping cough as a very small baby and it caused ongoing chest problems throughout her first year. She was referred to the children's hospital and seen my the senior consultant there who prescribed all manner of inhalers and strong steroids on top of some serious anti biotics. It all just seemed so much for a baby of 7 months old. On googling, one of the meds was, in the uk only really given to babies who had been on on ventilators and had respiratory damage. The side effects could be bad. Others were not licensed for use in dc in the UK. I couldn't bring myself to give her any of it outside of the anti biotics . On returning to the UK a couple of months later I took her straight to the Dr who immediately referred her to the hospital paed due to the medication provided. Respiratory paediatrician was in no doubt I'd done the right thing not giving dd these medications. He was aghast with some of it. Funnily enough the hospitals in the same country will rarely give pain relief for natural child birth - no gas and air or epidural option. After my c section after one shot of pethadine I was offered only paracetamol.
I'd say trust your own instinct here. Tramadol is very strong, has side effects and is very unlikely/ would never be prescribed here in the UK for a child's headaches

Blimey. Definitely not normal.

Lilifer
Is Tramadol the one with codeine in it?

Not being funny but why didn't you question the doctor about this at the time??
Come, on, how many people would be assertive enough to question a doctor in the heat of the moment when you don't know if you're correct or not? Especially in front of the child?

But it's not being 'assertive'. It's having a sensible conversation for the benefit of your child. I had a doctor's appointment with my teen. The doctor offered strong medicine, I asked if there was a gentler option to try first. Doctor was understanding and gave us a "gentler" medicine option with the opportunity to progress to the stronger medicine when we wanted. It's nit difficult and not being assertive. But gone are the days when the doctor is assumed as being an Oracle and the patient has no opinion in there own health.

And OP, tramadol is an opioid and strongly addictive. I was offered it myself and refused to take it. I think it is shockingly bad doctoring to be offering a 14-year old opioids.

But gone are the days when the doctor is assumed as being an Oracle and the patient has no opinion in there own health.

In the UK maybe. In other parts of the world this is very much still the dynamic

I had tramadol for a broken ankle once and am prescribed it now for a tear in my shoulder which has been agony. I only take it at night if I am woken up with the pain, which I do frequently. I have spoken countless times with doctors about this and will probably end up with a shoulder repair operation.

No way would I take tramadol just for headaches, though I knows these can be pretty debilitating.

I was prescribed Tramadol for a broken leg and it gave me heart palpitations. It seems a bit extreme to me for a headache.

If she has migraines that are that problematic and frequent she shd see a neurologist and have specific treatment for migraine. Tramadol is odd for a child and would not be prescribed over paracetamol or ibuprofen for pain.

I think leaping straight to something as strong as Tramadol for a fourteen year old isn’t great. They’re a strong medication and can become addictive.
Your dr can give medication ( can’t remember the name, sorry) to protect your daughter’s stomach.
You might find soluble paracetamol with a small amount of caffeine works better than regular paracetamol. ( look at Solpadeine ) If they work better might mean fewer taken.
Could you ask your dr about a headache preventative? ( these might be only suitable for migraines but worth questioning a dr)
Make sure everything is checked —- blood pressure, eyes, scans. You might as well rule out everything now as drs tend to let headaches go on and on.

@Cyclingforcake are you a Dr in the UK? I really don’t know anyone who would describe themselves as being ‘in anaesthetics and acute pain’. One would normally say they were an anaesthetist, and you can’t specialise in ‘acute pain’ in the uk….

Your posts just don’t read like you really are a Dr unless you’re a nurse practitioner?

But to be frank it really is no skin off my nose/ I dont really care so crack on