Like most of you I found out by accident after having dental surgery that tramadol really helped my depression and anxiety. I've struggled with both for 38 years and have tried most every antidepressant available. A couple of them worked for a few year with awful side effects. But I was willing to put up with the side effects to get any kind of relief. My husband, daughter and I did a great deal of research on tramadol and decided it was worth it to ask my doctor if I could give it a try. She didn't want to saying it could be addictive. My husband told her, so are antidepressants. After a very long talk with her and telling her that tramadol got better reviews for depression than any of the antidepressants she agreed to let me try it. That was 2 weeks ago. I felt so much better after just one pill. My depression was worse than it had ever been. I was suicidal. It's never been that bad before. I've read many of your comments and see that some of you do well on one pill per day, others do well on two pills per day. But, do any of you feel like you need to take three or 4 pills per day? My Dr prescribed one every 12 hours, 2 per day. I went against my Dr and take 3 per day, 1 every 8 hours. I feel like it helps so much more than 2 per day. I know she's going to flip out when my husband and I tell her. After feeling so incredibly depressed for so long I just wanted to stop feeling suicidal, and I have. I don't understand why she kept wanting to increase Effexor when I told her it was making me feel worse. I did what she wanted and I did increase it. But, when she wanted me to increase it a 3rd time my husband and I told her no, things are not getting better. They're getting much worse. Then she wanted to add Seroquel to the Effexor. Again, we told her no, we weren't willing to do that. I took 75 mg of Effexor many years ago and did well on it. I put up with the side effects because it did help. I'm so stressed out by what my Dr is going to do and say that I can't even enjoy feeling better. These are my questions. I've already asked one so I'm sorry for repeating myself. Do some of you need more than 2 50 mgs pills per day? And do you think doctors are willing to throw any antidepressant at us, sometimes 2 or more at a time, because they're not in the opioid family like tramadol?