I'm tired, but I'll give you a brief recount of my experience with patients.....it falls within the "mild-moderate" opiate receptive pain situations. I can't comment on the pain use in the depressed patient because, truly, all of the patients I dispense medications to who have depression secondary to pain have gone beyond what tramadol can relieve (I am within 30 miles of two pain treatment centers - one which is in a medical school...so they tend to be aggressive with pain control). That is not to say it does not have a place here - I just don't see it. The most common prescribers in my area are oral surgeons.....
I will say, with very few exceptions, most every patient I've dispensed it to experiences an "odd" feeling & bizarre dreams. When they volunteer to explain these "odd" feelings - they relate to feeling they are observing themselves from outside themselves - is there a word to describe that clinical situation? For some - its disconcerting to the extent they won't take the drug again.
Actually - this is a common complaint with gabapentin also, however, it resolves rapidly. I've not found that to be the case with tramadol & I've not really taken the time to research the postulations as to what mediates it.
I'll be interested to hear other opinions & perhaps when there is more time & I'm not so tired, I'll do some research.......
