Can long term tramadol permanently deplete my serotonin?

Question

I am 4 and a half weeks out of a 3 year Tramadol habit. I went cold turkey which was a bad idea. I was feeling pretty depressed for a while but that is slowly lifting but I still feel less positive than normal. Is there anything I can do to speed up the PAWS from tramadol? Do diets that are supposed to increase serotonin levels really make any difference? Could a long time use of tramadol permanently deplete my serotonin levels to a point where I would need to us an SSRI just to get back to baseline?

Dr. Stuart Shipko · Accepted Answer

Most people are surprised to learn that depression is not caused by a 'chemical imbalance' related to serotonin or any other neurotransmitter. Actually, the chemical imbalance concept was originally a marketing strategy. Chemical imbalances aside, depression that people experience when stopping opiates can sometimes be severe and may be associated with suicidality. You describe a significant depression that has already improved. Sometimes with severe withdrawal depression an antidepressant is needed. If your depression has improved significantly the antidepressant is not needed. I typically avoid prescribing any medications when people withdraw from medications because over time the prescribed medication may well become a problem. When patients have mild to moderate depression I often recommend a supplement, SAM-e at a 400 mg daily dosage along with b-complex. This facilitates synthesis of neurotransmitters and has a proven track record in helping depression.

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