Help with tough case.

[SommeRiver]

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Wonder if anyone else has seen it with SSRIs and tramadol?

I'm sure it's out there and a real phenomenon, but I haven't seen it.

I should say the overwhelming majority of my pts are like 70 yo and 50mg BID works pretty good and they can still take a dump on tramadol.

 

[bedrock]

Start at 5 if naive. Qweek.
start at 10 for all others qweek.
Double if not getting results.

Doesn’t butrans come in a box of 4? Don’t you need to wait a month before you can increase the dose.

 

[lobelsteve]

Doesn’t butrans come in a box of 4? Don’t you need to wait a month before you can increase the dose.

Yes 4 pack. Titrate after 1.