On a similar subject.. I've been taking tramadol for back pain for 2 years and been getting on well with it. Was taking 100mg a day but recently been feeling like I've built a tolerance to what I used to get off 100mg, so have increased to 200mg. Thing is it still doesn't give me the effect for longer than 3-4 hours, and have been taking the first 50mg in the morning. It seems like taking tramadol with gabapentin sustains the effect. Would this be recommended? Alternatively, with else can I combine with tramadol to help sustain the effect for longer?