"i have a badly herniated l5-s1 disc. while vicodin is a very effective and safe medicine, there is just too much stigma and psychological dependence. i&#039;ve been looking for a medication that&#039;s as good and found it. i really think ultracet/tramadol delivers as good of analgesia as vicodin but without the stigma and abuse potential.  i started on ultram er 200 and had some side effects, namely bad headaches, drowsiness, and &quot;crashing&quot; in the evening.  my doctor switched me to the ultracet 37.5/325 and it&#039;s great.  the acetaminophen eliminates the headaches and the drowsiness and crashing are eliminated because i can take my 3rd or 4th dose around 6pm and it carries me to bedtime. i also take gabapentin 300mg at bedtime."