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Treatment for CHRONIC MIGRAINE with DEPRESSION already on ZOLOFT.

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This is my second consultation after yestarday, (I have Major Depression that i'm treating with Zoloft), and i have also chronic migraines, I took Codeine, I misused it and got addicted to it for 1.5 years. Then i stopped it, but the withdrawals were horrific, so I was put on Subutex (1-2)mg per day, I’ve taken it only for three months.
Now, I’m 31 days of Subutex and i'm still experiencing (withdrawals) severe insomnia, feeling general discomfort and fatigue, lack of energy and motivation, I've tried all medications know to men (All benzo, Klonopin, Ambien, Clonidine, herbal remedies, Multivitamine, B-complex, and even pot), without much relief. Then today after a migraine attack, i took 200mg of Tramadol (that i reserve in extreme emergency as it's addictivce), but all of a sudden, it's magic, i was relieved from it all. But then i read a horrifying information on the internet stating that: (Taking Tramadol during Subutex withdrawal will rest you at square one in terms of withdrawal) . I have two questions
1. is it true that taking Tramadol rests my withdrawal at square one ?
2. I have chronic migraine, my doctor refuses to give me Triptans he says they're dangerous, so what's the frequency/dosage of Tramadol that i can take without risking addiction ?
I'm in pure agony please help !!

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
 26 Doctors Online

Thank you for your query at
I understand your conern.
I have also reviewed the images that you shared.
Yes fever is definitely a sign of inflammation, which occurs due to a bacterial/ viral infection.
Regarding the red swollen area, are they painful? Is here any kind of itching associated in those areas? Are they increasing in number?
Also about vomiting, how many episodes of vomiting did she have? Any change in stool consistency?
Kindly reply and I will get back to you,

Patient replied :

No changes in stool no itching but they are painful and vomiting was just one day but keeps running a fever on and off for a week now. She has been putting a cold compress and says they feel better after doing so. They haven't really spread and no oozing has occurred in the raised areas.

Yes she does need antibiotic in that case. Since the fever has been there for a week.
She will also need Tylenol to bring her fever down as and when required.
Since these bumps are not increasing in number, they seem to be allergic in origin and will settle down on it's own.
For the time being, please consult your local physician and insist on getting the antibiotic done. Even without antibiotic she will recover, but it take a longer time.

Patient replied :

Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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