Tramadol Induced Seizure: Report of 106 Patients


P Petramfar 1 , A Borhani Haghighi 2 , *

1 Department of Neurology, Shiraz University of Medical Sciences, Fars, Iran

2 Associate Professor of Department of Neurology, Nemazee Hospital, Comparative Medicine Research center, Shiraz University of Medical Sciences, [email protected], Fars, Iran

How to Cite: Petramfar P, Borhani Haghighi A. Tramadol Induced Seizure: Report of 106 Patients, Iran Red Crescent Med J. Online ahead of Print ; 12(1):49-51.


Iranian Red Crescent Medical Journal: 12 (1); 49-51
Article Type: Research Article
Received: May 16, 2009
Accepted: July 5, 2009




Background: Seizure is one of the possible adverse effects of tramadol hydrochloride, a synthetic, centrally-acting analgesic, prescribed for the treatment of moderate to severe pain. In this study, we describe 106 patients with tramadol induced seizures.


Methods: The patients, who were referred to Nemazee Hospital, Shiraz, Iran, from March 2006 to March 2008, were examined in this cross-sectional study. All of the patients had experienced seizure(s) after ingesting tramadol. Each patient was interviewed for demographic data, history of epilepsy, family history of epilepsy, duration of tramadol use, total dose and the last dose of ingested tramadol. Neurological examinations, routine laboratory tests, electroencephalography, and brain computed tomography were performed for each patient.


Results: One hundred and six patients were studied (102 males and 4 females, mean age: 26.7±6.9 years). Among them, 92 (86.8%) had new-onset provoked seizure(s) induced by tramadol and in 14 patients (13.2%), tramadol ingestion was considered as a precipitating factor in the setting of previously-known epilepsy. Tramadol was prescribed by the physicians for alleviation of pain in 20 patients (18.9%) and abused in the remainder (86 patients, 81.1%). The dose of ingested tramadol before the seizure(s) was 50 to 1500 mg.


Conclusion: Tramadol may provoke seizures in patients with epilepsy and also in previously healthy people even within the recommended dose ranges. Because most of the cases had occurred in young abusers, strategies to prevent tramadol addiction should be sought.



Tramadol Seizure Abuse Iran

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