Last time I mentioned drugs like paracetamol and anti-inflammatories. This month I want to mention other drugs like Tramadol and Amitriptyline.
Tramadol is a strong prescribed painkiller, which helps pain by affecting how the pain message gets to the brain. In fact that’s how these drugs work.
If you imagine your nerves are like the wiring in your house.
To make the light work, you need to flip a switch – well odd as it may seem, your nervous system can be treated in much the same way: pain runs along the nerves like electric current, and medication works by flipping the switch so not all the pain signals get through.
Sometimes it stops the pain message altogether, and sometimes it stops half the message, so you still get some pain, but not as bad as without the tablets.
Everyone is different in how much dose they need or how effective the tablet is for them.
These medicines all have to go through the liver and your bowels – now are you someone who only needs to sniff a cork to feel tipsy, or are you someone that can drink several pints or glasses of wine and not feel the effect?
That’s because of how effective your liver is.
In some patients they may only get 20 per cent of the dose they take because the liver or the bowel does not absorb it all.
In some patients they may get 80 per cent of the drug and so it’s not only powerful, but they get lots of side effects like nausea and dizziness or feeling spaced out.
Drugs like Amitriptyline can have multiple uses, 40 years ago Amitriptyline was used as an anti-depressant, but it’s side effect is that it makes you sleepy.
However, in more recent years, pain specialists have found that in a smaller dose taken at night time, it can be a good painkiller and help you sleep better.
So if your doctor prescribes this drug, it’s not because they think you are depressed or it is in your head, it is because they think you have nerve pain and this helps nerve pain in particular.
Next time, I will talk about creams and patches.