Tramadol Withdrawal

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Authored by Matthew Idle

Edited by Hugh Soames

Reviewed by Michael Por

  1. Title: Tramadol Withdrawal
  2. Author: Matthew Idle
  3. Editor: Hugh Soames
  4. Reviewed: Michael Por
  5. Tramadol Withdrawal: At Worlds Best Rehab, we strive to provide the most up-to-date and accurate information on the web so our readers can make informed decisions about their healthcare. Our subject matter experts specialize in addiction treatment and behavioral healthcare. We follow strict guidelines when fact-checking information and only use credible sources when citing statistics and medical information. Look for the badge on our articles for the most up-to-date and accurate information. If you feel that any of our content is inaccurate or out-of-date, please let us know via our Contact Page
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Tramadol Withdrawal

Tramadol is often described as a safe pain medication that not only enables individuals to quell their long-term pain, but isn’t as addictive as other drugs. Although it is marketed as safer to take, Tramadol still contains an opioid.

Tramadol is classed as a narcotic just like codeine and oxycodone. A number of countries, especially the United States, are experiencing opioid epidemics due to the high volume of prescriptions that doctors hand out for drugs such as tramadol. These drugs are also bought on the street.

In 2014, it was revealed that doctors in the U.S. wrote 44 million prescriptions of tramadol to patients. Tramadol’s addictiveness and effects have made it a controlled substance in the U.S.1

What is Tramadol?

Tramadol is approved to treat pain in adults. The pain is classed as severe pain and often, is considered long-term.2 The dosage is determined on a patient by patient basis. Doctors will prescribe the lowest effective dosages to patients for the shortest amount of time. Addiction often occurs when patients become tolerant to the pain medication and up their own dosage.3 In addition, patients who can use a lower potency pain medication may be prescribed tramadol as they oversell their need for help.

How does Tramadol work?

The pain medication works by suppressing pain and blocking it from the central nervous system.4 After the pain is suppressed, individuals feel a sensation of calmness and relaxation. Individuals can often become tolerant of Tramadol’s effects. Tolerance leads to individuals taking higher doses of Tramadol or ingesting it more frequently. The more a person takes of Tramadol, the more likely it is that the brain’s chemical messengers can alter the structure and pathways of the brain. This can become permanent over long exposure to Tramadol.

Withdrawal symptoms of Tramadol

Compared to other opioids such as oxycodone and hydrocodone, tramadol works differently. Oxycodone and hydrocodone create a high in individuals. Tramadol blocks neurotransmitters such as serotonin and norepinephrine. These neurotransmitters cannot be reabsorbed into the body.5

Individuals may go through two phases of Tramadol withdrawal. Individuals may experience some or all of these symptoms in the first phases, early opioid withdrawal:


  • Runny nose
  • Sweats
  • Yawning
  • Muscle and/or body aches
  • Difficulty sleeping and/or insomnia
  • Increased anxiety
  • Restlessness and agitation
  • Increased heart rate
  • Hypertension
  • Rapid breathing


The second phase of Tramadol withdrawal is known as late opioid withdrawal. Symptoms include:


  • Chills
  • Stomach pain and/or cramps
  • Diarrhea
  • Vomiting
  • Loss of appetite
  • Pupil dilation
  • Difficulty concentrating
  • Agitation
  • Drug cravings
  • Depression
  • Depersonalization


Getting help for Tramadol withdrawal

Withdrawal from Tramadol has been described as similar to the flu. Individuals experience physical symptoms that peak within a few days. After the physical withdrawal symptoms leave, individuals must deal with the psychological issues created by drug addiction.

Individual may undergo medical detox to get off of Tramadol. Individuals who are dependent on Tramadol should gradually stop taking the drug. Like other opioids, suddenly stopping the use of the drug could have adverse effects.

Three forms of medical detox are recommended to end the addiction to Tramadol. These include methadone, buprenorphine, and naltrexone, and allow individuals to recover their lives.

References: Tramadol Withdrawal

  1. Hashmey RH, Roberts NJ., Jr Fever and fever of Radbruch L, Grond S, Lehmann KA. A risk-benefit assessment of tramadol in the management of pain. Drug Saf. 1996;15(1):8–29. [PubMed] []
  2. Sweetman SC, Blake PH, McGlashan JM, Neathercoat GC, Parsons A. Martindale: The Complete Drug Reference. 35th ed. United Kingdom: Pharmaceutical Press; 2006. pp. 114–5. []
  3. Vickers MD, O’Flaherty D, Szekely SM, Read M, Yoshizumi J. Tramadol: pain relief by an opioid without depression of respiration. Anaesthesia. 1992;47(4):291–6. []
  4. Senay EC, Adams EH, Geller A, Inciardi JA, Munoz A, Schnoll SH, et al. Physical dependence on Ultram (tramadol hydrochloride): both opioid-like and atypical withdrawal symptoms occur. Drug Alcohol Depend. 2003;69(3):233–41. [PubMed] []
  5. Labate A, Newton MR, Vernon GM, Berkovic SF. Tramadol and new-onset seizures. Med J Aust. 2005;182:42–44. [PubMed] []
  6. Boyd IW. Tramadol and seizures. Med J Aust. 2005;182:595–596. [PubMed] []
  7. Boyer EW, Shannon M. The serotonin syndrome. NEJM. 2005;352:1112–1120. [PubMed] []
  8. Lange-Asschenfeldt C, Weigmann H, Hiemke C, Mann K. Serotonin syndrome as a result of fluoxetine in a patient with tramadol abuse: plasma level-correlated symptomatology? J Clin Psychopharmacol. 2002;22:440–441. [PubMed] []
  9. Lantz MS, Buchalter EN, Giambanco V. Serotonin syndrome following the admnistration of tramadol with paroxetine. Int J Geriatr Psychiatry. 1998;13:343–345. [PubMed] []
  10. Karunatilake H, Buckley NA. Serotonin syndrome induced by fluvoxamine and oxycodone. Ann Pharmacother. 2006;40:155–157. [PubMed] []
  11. Kitson R, Carr B. Tramadol and severe serotonin syndrome. Anaesthesia. 2005;60:934–935. [PubMed] []
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