Tramadol Dependence: A Case Series from India

Tramadol is an atypical, centrally acting, synthetic analgesic, acting through opioid and non-opioid systems. We present a series of seven cases, all men, who sought treatment at our centre for tramadol-dependence. The majority were using other opioids at some point in their lives. Their tramadol use had begun with a prescription of tramadol for opioid detoxification, for headache and body pains, and as an alternative to injectable opioids. The doses of tramadol used varied from 50 to 1500 mg per day. All subjects reported an experience of euphoria with tramadol use. Four patients were put on naltrexone, but had poor compliance. This case series underscores the need for caution, while using tramadol in substance-dependent patients.

[1]  P. Dayer,et al.  The Pharmacology of Tramadol , 2012, Drugs.

[2]  G. Bigelow,et al.  Discriminative Stimulus Effects of Tramadol in Humans , 2011, Journal of Pharmacology and Experimental Therapeutics.

[3]  S. Bhatia,et al.  Tramadol dependence in a patient with no previous substance history. , 2010, The Primary Care Companion to the Journal Clinical Psychiatry.

[4]  J. Ahlner,et al.  Tramadol dependence: a survey of spontaneously reported cases in Sweden , 2009, Pharmacoepidemiology and drug safety.

[5]  J. Stoehr,et al.  The risk of tramadol abuse and dependence: findings in two patients. , 2009, JAAPA : official journal of the American Academy of Physician Assistants.

[6]  M. Casacchia,et al.  Severe Tramadol Addiction in a 61 Year-Old Woman without a History of Substance Abuse , 2008, International journal of immunopathology and pharmacology.

[7]  C. Thurstone,et al.  Tramadol dependence: treatment with buprenorphine/naloxone. , 2007, The American journal on addictions.

[8]  A. Muñoz,et al.  The Diversion of Ultram®, Ultracet®, and Generic Tramadol HCl , 2006, Journal of addictive diseases.

[9]  G. Woody,et al.  A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. , 2006, Journal of pain and symptom management.

[10]  Z. Martinovic,et al.  Seizures Associated with Intoxication and Abuse of Tramadol , 2006, Clinical toxicology.

[11]  S. Schnoll,et al.  Tramadol abuse and dependence among physicians. , 2005, JAMA.

[12]  H. Ehrenreich,et al.  Dependence on tramadol , 1993, The clinical investigator.

[13]  A. Muñoz,et al.  An independent assessment of MEDWatch reporting for abuse/dependence and withdrawal from Ultram (tramadol hydrochloride). , 2003, Drug and alcohol dependence.

[14]  A. Muñoz,et al.  Physical dependence on Ultram (tramadol hydrochloride): both opioid-like and atypical withdrawal symptoms occur. , 2003, Drug and alcohol dependence.

[15]  Christopher Barsotti,et al.  Withdrawal syndrome from tramadol hydrochloride. , 2003, The American journal of emergency medicine.

[16]  W. Yates,et al.  Tramadol dependence with no history of substance abuse. , 2001, The American journal of psychiatry.

[17]  R. Narendran,et al.  Methadone detoxification of tramadol dependence. , 2000, Journal of substance abuse treatment.

[18]  E. Freye,et al.  Acute abstinence syndrome following abrupt cessation of long‐term use of tramadol (Ultram®): a case study , 2000, European journal of pain.

[19]  J A Inciardi,et al.  A postmarketing surveillance program to monitor Ultram (tramadol hydrochloride) abuse in the United States. , 1999, Drug and alcohol dependence.

[20]  K. Preston,et al.  Abuse potential and pharmacological comparison of tramadol and morphine. , 1991, Drug and alcohol dependence.