Although detoxing from opioids is not usually life-threatening, people who are tapering off tramadol may experience certain medical complications. Because tramadol interacts with the central nervous system, the body can quickly become dependent on this medication. One of the main concerns with acute tramadol withdrawal is dehydration. Tramadol detox causes people to experience flu-like symptoms, including vomiting and diarrhea. Once a person detoxes from tramadol, their body loses its tolerance to the drug.
If the person ends up using the drug again and attempts to take the previous amount they were used to, they could experience an overdose. Opioid overdoses kill more than Americans every day. If you or someone you love is ready to stop taking tramadol, discuss your plan with your prescribing doctor. Your healthcare provider may suggest a tapering schedule, where you slowly lower your dose in order to avoid severe withdrawal symptoms.
In other cases, it may be best to consider an addiction treatment program. Research shows that simply detoxing from a drug is not enough to achieve long-term recovery. Many people benefit from detoxing in a formal addiction treatment program, where they can access long-term support. While no one type of treatment is right for everyone, rehab programs lasting at least 90 days are associated with more positive recovery outcomes.
In , more than 28, people died as a result of synthetic opioids like tramadol. Many people who want to stop taking these drugs are unsure how to successfully detox from the substances for good. After complete heroin and opiate cessation about 2 years ago, he was taking mg of tramadol per day until a week ago when he suddenly stopped taking tramadol and was referred to this center with the above mentioned symptoms.
In his history there was no evidence of opioid abuse in past 2 years. He had no family history of any specific mental or physical illness. In psychological examination, he was well alert and had time, place and person orientation. His concentration and attention was reduced. He was anxious and had normal affection. Restlessness was revealed in his psychomotor examination. He had persecutory delusion, delusional mood, and first stage of trema, 13 and had Lilliputian hallucinations.
Based on DSM-IV, tramadol withdrawal syndrome was considered at the admission and psychosis following drug cessation was the differential diagnosis. After 3 days all physical and mental symptoms including hallucinations and delusions completely subsided.
Therefore tramadol cessation diagnosis was confirmed and psychosis following drug withdrawal syndrome was ruled out. However, in some cases tramadol withdrawal symptoms are similar to serotonin reuptake blockers withdrawal symptoms rather than opioid blockers and this may be related to tramadol mechanism of action as a serotonin and epinephrine reuptake blocker.
Tramadol withdrawal symptoms and signs include typical and atypical types. Symptoms normally seen in tramadol withdrawal according to their prevalence are as follows: gastrointestinal pain, anxiety, bone pain, depression, diarrhea, insomnia, epiphora, nausea, agitation, rhinorrhea, excessive perspiration. Atypical symptoms include severe anxiety, panic attacks, unusual CNS symptoms such as confusion, delusion, derealization, depersonalization, paranoid thoughts 2.
It should be mentioned that typical symptoms are usually seen during the withdrawal period and just in one out of eight cases, atypical symptoms appear. According to a case report, administration of a therapeutic dose of tramadol to control cancer pain caused auditory hallucinations in a year-old man.
Yates et al 10 presented a year-old female who was first used tramadol to control her pain due to carpal tunnel syndrome and became dependent to a daily mg dose for three years while she took no other drugs or opioids.
During tramadol withdrawal, she developed severe symptoms including vertigo, diarrhea, headaches and insomnia. Recently, high rate of tramadol abuse has been noticed 12 and even though in most cases, it is associated with opioid dependency, there are some cases of only tramadol dependency. There are evidences that only a few patients with tramadol dependency are susceptible to atypical withdrawal symptoms; Senay et al 12 reported no relation between age, sex, drug intake duration and history of accompanying drug dependency and it was not predictable, but many patients who experienced atypical symptoms were taking more than mg tramadol per day.
Senay et al, 12 in their recommendations, ask physicians and other health authorities to pay attention to tramadol withdrawal atypical symptoms such as hallucinations and delusions and do not justify them with drug withdrawal psychosis or delirium. In our reported patient, tramadol withdrawal psychosis was ruled out because the symptoms subsided in a few days without any antipsychotic prescriptions and the definite diagnosis was atypical symptoms of tramadol withdrawal.
Your withdrawal experience will also depend on the factors that led you to become dependent on tramadol in the first place, such as your level of pain and history of substance abuse. An opioid use disorder addiction presents additional complications. An important study published in established, for the first time, that it is possible for humans to become physically dependent on tramadol. This is true even when taking it as directed by a doctor. When someone is physically dependent on a drug, it means they will experience withdrawal symptoms when they stop or reduce their dose.
Tramadol works like an opioid, which means that many of its withdrawal symptoms resemble those of other opioid withdrawal syndromes. Because of this, you may experience additional withdrawal symptoms, including those more commonly associated with antidepressant withdrawal. When withdrawing from tramadol, you may experience any of the following symptoms:. It is impossible to predict exactly when your symptoms will start, how long they will last, or how severe they will be.
Things that can influence your withdrawal experience include the duration of your drug use, how much you use, and how often you use. Other factors that can influence your withdrawal include:. In a typical healthy adult, tramadol withdrawal begins one to two days after the last dose, peaks after day three, and subsides within one to two weeks. A tramadol taper is the simplest and most reliable way of preventing withdrawal before it begins.
Tapering tramadol means that you take gradually smaller doses over the course of two or three weeks. Studies have shown that psychosocial approaches in conjunction with pharmacological interventions may improve outcomes as well. When done right, a taper should provide a smooth transition off of tramadol. Several case studies have found that benzodiazepines, like clonazepam or lorazepam, can help reduce tramadol withdrawal symptoms.
This is particularly true in cases where anxiety, agitation, or restlessness is present. Other drugs that have been used to treat tramadol withdrawal include the hypertension medications clonidine and moxonidine. These drugs have a history of success being used off-label in the treatment of opioid withdrawal. Some people are at greater risk of a complicated withdrawal.
While some people are solely dependent on tramadol, many people take it in combination with other substances. The majority of these people combine tramadol with another painkiller or sedative. When people use several therapeutic or illicit drugs at the same time, they can develop multiple physical dependencies. If you have been combining or alternating your tramadol dose with another painkiller, like hydrocodone, your opioid dependence may be more severe. If you have become physically dependent on anti-anxiety medications benzodiazepines you are at risk of dangerous withdrawal complications, including seizures and delirium.
Tramadol is also associated with seizure activity. Seizures can occur in people both with and without a history of seizures. People with a history of seizures or traumatic brain injury may be at increased risk during tramadol withdrawal. Tramadol has been shown to lower the seizure threshold, making seizures more likely to occur.
People over the age of 65 are also at increased risk of withdrawal complications. Older adults metabolize tramadol slower than younger people. In older adults, withdrawal may start later than normal and be more severe. While it is not common, some people do appear to be more sensitive to tramadol withdrawal than others. Even using tramadol as prescribed can lead to dependence and withdrawal. Withdrawal is the result of the body becoming chemically addicted, or altered, from taking Tramadol on a continuous basis—even after only a few weeks.
This happens because users develop a tolerance to Tramadol, meaning they must take more frequent and larger doses to feel the same effects, ie. In response, the brain adapts to the constant presence of the drug and adjusts chemically. Tramadol withdrawal symptoms generally last between days.
Because of the influx of Tramadol, the brain attempts to self regulate by speeding up and slowing down some of its processes. While most people detoxing from Tramadol describe the symptoms as flu-like, there is the potential for serious withdrawal effects, such as severe anxiety, panic attacks and hallucinations.
Tramadol withdrawal relieves pain differently than most opioids, such as hydrocodone , as it relieves pain by two mechanisms: stimulating opioids receptors in the brain, and inhibiting the reuptake of two neurotransmitters, serotonin and norepinephrine. Therefore, there are two forms of withdrawal that may be experienced: traditional opioid withdrawal and atypical opioid withdrawal syndrome.
This is unique as it does not occur in other opioids. This also means that those going through Tramadol withdrawal may experience two unique sets of symptoms. These atypical symptoms are generally not life-threatening; however, they do put the individual at high risk of making bad decisions or putting themselves in dangerous situations.
Therefore, it is highly recommended to detox in an inpatient, medically-supervised detox center. Learn More. Tramadol withdrawal symptoms vary from individual to individual. It is best to taper off the drug over time in order to minimize negative withdrawal symptoms. Make a Call Withdrawal symptoms usually begin within hours of discontinuing or dramatically reducing use of Tramadol. Symptoms can linger for several weeks. Certain factors can influence the duration and severity of withdrawal symptoms, such as the length of time spent using Tramadol, how often they took the drug and the dose.
However, most withdrawal periods last about two weeks. Tramadol detox can vary from mild, moderate, to severe depending on the severity of usage, along with any administered drugs or medications.
It can potentially be very uncomfortable and should be done under the supervision of a doctor supervision. Because tapering the dosage is a common practice to aid in the withdrawal process, a doctor may schedule a stepped down dosing protocol and monitor the withdrawal symptoms over a period of weeks.
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