ABSTRACT
Gradually discontinue tramadol pharmacotherapy. The abrupt discontinuation of tramadol pharmacotherapy, particularly high-dosage or long-term pharmacotherapy, may result in an acute withdrawal reaction. Tramadol is addicting and habituating. It has a high abuse potential. Prescribe tramadol pharmacotherapy cautiously to patients who have histories of problematic patterns of alcohol or other abusable psychotropic use. Tramadol pharmacotherapy reportedly is associated with a risk of seizures. This risk is increased with dosages exceeding the recommended maximal dosage. Tramadol pharmacotherapy also has been associated with an increased risk for seizures among patients who concurrently are receiving MAOIs, opiate analgesics, SSRIs, TCAs, or other pharmacotherapy that may decrease the seizure threshold. Concurrent alcohol use may increase the CNS depressant action of tramadol. Advise patients to avoid, or limit, their use of alcohol while receiving tramadol pharmacotherapy. Signs and symptoms of tramadol overdosage include respiratory depression and seizures.
