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Louise Brady
Louise Brady, Registered Nurse
Category: Mental Health
Satisfied Customers: 48
Experience:  Registered Mental Health Nurse
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if elderly patients Tramadol is stopped and replaced with codeine

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if elderly patients Tramadol is stopped and replaced with codeine will they suffer withdrall such as anxiety and panic attacks .what action should i take to help
Hello, I am a qualified Mental Health Nurse and would be happy to help with your question.

Although Codeine and Tramadol work in similar ways (both bind to the opioid receptors in the brain and throughout the nervous system), Tramadol also inhibits the reuptake of norepinephrine and causes the release of serotonin which is why it can aid with feelings of anxiety.

If the anxiety is arising as a result of pain then the dosage of codeine may not be high enough. If your mother in law is taking codeine phosphate then the dose may need to be adjusted. If however she is taking Cocodamol (a mix of paracetamol and codeine) then this comes in 3 strengths as a general rule (30/500, 15/500 or 8/500). Normally following surgery an individual would be prescribed 30/500 strength.

As with any opioid medication large quantities can induce respiratory depression so caution should always be exercised.

If the anxiety is becoming completely over whelming then your mother in law may wish to discuss with her doctor the possibility of taking a low dose of Diazepam (for example 2mg). Diazepam should only ever be prescribed in the short term but is particularly effective at combating anxiety.

In the long term it may be worth checking to see what pain clinics are available in your mother in laws locality. These types of clinics specialise in assisting individuals in coping with pain using cognitive techniques as opposed to medication.

Please rate my answer positively, I will be happy to assist further is necessary.

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