What is Tramadol? Is it a Safer Option than Opioids?

What is Tramadol? Is it a Safer Option than Opioids?

What is Tramadol? Is it a Safe Alternative to Opioids?


What is Tramadol?

Tramadol is a powerful analgesic drug that acts on opioid receptors and inhibits the reuptake of certain neurotransmitters. It has pain-relieving and antidepressant effects similar to venlafaxine.

Tramadol has been found to have antidepressant effects when used in combination with other antidepressants. However, caution is necessary when prescribing tramadol to patients taking Mono-Amine Oxidase inhibitors, as it can cause serotonin syndrome. Tramadol may also cause hypomania in patients with a history of anxiety.

History of Tramadol

Tramadol was first manufactured in Germany in 1962 and was approved by the United States Food and Drug Administration (FDA) in 1995. It was initially considered a safe drug, but further research revealed short-term and long-term side effects, as well as the potential for abuse.

Why Should I use Tramadol?

Tramadol is an effective short-term treatment for moderate to severe pain. It can be a good alternative for those who want to avoid other opioids and do not want to become addicted. However, it should not be used for chronic pain or for a long period of time due to the risk of dependency.

Is it a safe alternative to opioids?

Tramadol has its own risks and can be addictive. It can cause unpredictable metabolism rates and has atypical reactions compared to other opioids. Withdrawal symptoms can occur when stopping tramadol, including cravings and negative thoughts. It is important to be cautious when using tramadol and to follow medical advice.


There are medications available to manage the withdrawal symptoms of tramadol, such as benzodiazepines, buprenorphine, naloxone, methadone, clonidine, and moxonidine.

Side effects

Some uncommon side effects of tramadol include hypoglycemia, weakness, fainting or lightheadedness, anxiety, heart palpitations, excessive hunger, and shakiness. Tramadol toxicity, seizures, ultra-rapid metabolism, and breathing problems can also occur.

Withdrawal Symptoms

Tramadol withdrawal symptoms can be similar to the flu and include anxiety, restlessness, agitation, racing heart rate, hypertension, fast breathing, runny nose, sweating, tearing up, muscle and body aches, and trouble sleeping. Delayed withdrawal symptoms may include loss of appetite, pupil dilation, difficulties concentrating, irritability, drug cravings, chills and goosebumps, stomach pain and cramping, and vomiting.

Choice of Alternative opioids

Paracetamol and ibuprofen are not considered effective alternatives for moderate to severe pain. Other opioids like oxycodone and hydrocodone have limited impact. Buprenorphine and morphine are potential alternatives to tramadol.


Tramadol prescription should be adapted to the patient’s pharmacogenetic profile. Phenotyping/genotyping should be considered for chronic pain management. Morphine can be a first-line therapy for tramadol with unknown status. Tramadol should be used with caution in children and certain situations. It is important to start at low doses and adjust based on tolerance and efficacy.

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