Monday July 28th 2014

Tramadol withdrawal symptoms

You can become physically dependent on Tramadol.  Even after taking Tramadol for a few days!  And if you stop taking Tramadol suddenly, or lower the dose too quickly, you can experience symptoms of withdrawal.

Most cases of Tramadol withdrawal present withdrawal symptoms that doctors expect. But some Tramadol withdrawal symptoms are atypical of opioid withdrawal syndrome. We review the differences here.

Tramadol and low risk of abuse

Opioids have been used for many years to treat pain and either come from the opium poppy or are chemically related to drugs made from opium. Tramadol is a formula that is much weaker than other opiates. In fact, Tramadol has about 10% the potency of morphine and is generally not taken recreationally. Although Tramadol euphoric effects are possible, they can be almost imperceptible in most people. So, with such a low risk for abuse, Tramadol is frequently prescribed.

When does Tramadol withdrawal occur?

Many cases of Tramadol prescription are written for short-term use or short term medical conditions such as postoperative pain relief. In another case, Tramadol used for opiate withdrawal can benefit opium or heroin users wanting to quit. Additionally, Tramadol may also be prescribed for the long term management of chronic pain. And it is these users who generally go through withdrawal.

Withdrawal symptoms occur when you lower doses of Tramadol, or stop taking Tramadol abruptly. Slowly tapering off Tramadol by slowly lowering doses may help relieve these symptoms. But what kind of symptoms can you expect? And who is generally at risk of experiencing atypical symptoms?

Tramadol withdrawal symptoms

In most cases, Tramadol withdrawal symptoms manifest as classical opioid withdrawal symptoms. Withdrawal symptoms are more commonly associated with chronic Tramadol use, but may also be experienced if you’ve been on Tramadol for less than a few weeks, even as little as 3-4 days. Furthermore, the majority of Tramadol withdrawal cases occur at or below the maximum recommended daily level of 400 mg per day. Opioid abstinence or withdrawal syndrome is characterized by some or all of the following:

  • abdominal cramps
  • anorexia
  • anxiety
  • backache
  • chills
  • diarrhea
  • dilation of the pupils
  • increased blood pressure
  • increased heart rate
  • increased respiratory rate
  • insomnia
  • irritability
  • joint pain
  • muscle aches
  • nausea
  • perspiration
  • production of tears
  • restlessness
  • runny nose
  • vomiting
  • weakness
  • yawning

Atypical Tramadol withdrawal symptoms

The primary distinction between typical and atypical withdrawal from Tramadol is that atypical withdrawal has a strong component of other central nervous system disturbances not usually observed in typical opioid withdrawal. These symptoms occurred in about 1 of 8 cases of people who stop taking medicine which contains Tramadol (Ultram) and seem to be connected to dosage. In other words, atypical symptoms are more likely when you take more than the 400 mg per day recommended level. Furthermore, these types of withdrawal symptoms do not normally occur in other cases of opioid withdrawal, and seem unique to the drug Tramadol. Some documented cases of atypical withdrawal symptoms not normally observed in opiate withdrawal include:

  • confusion
  • extreme anxiety
  • hallucinations
  • numbness in one or more extremities
  • panic attacks
  • paranoia
  • tingling in one or more extremities
  • unusual sensory experiences

Tramadol withdrawal symptoms questions

Do you have questions about Tramadol withdrawal symptoms? Or maybe an experience to share with us? Please write to us and fill in the comment box below. We are happy to answer questions or respond personally to your stories.

Reference sources: FDA warning for Ultram
Physical dependence on Ultram (tramadol hydrochloride): both opioid-like and atypical withdrawal symptoms occur
Clinical pharmacology of Tramadol Clin Pharmacokinet. 2004;43(13):879-923

 

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28 Responses to “Tramadol withdrawal symptoms
marie
3:35 am October 18th, 2012

You mention withdrawal may be helped with over the counter or home remedies….could you please explain or advise which otc or remedies you are referring to.

9:25 am October 18th, 2012

Hi Marie. Thanks for your question. Ibuprofen, aspirin, and/or acetaminophen can be helpful during withdrawal. But be sure that you don’t overdose on these NSAIDs when detoxing from tramadol, because each does have a daily intake limit.

Roni
7:20 am October 20th, 2012

When stepping down off of tramadol gradually after long term use for chronic pain, is it normal to have an extremely elevated heart rate for 8+ hours?

7:56 am October 22nd, 2012

Hi Roni. Yes, increased heart rate is an expected symptom experienced during tramadol (or any opioid) withdrawal. Check in with your prescribing doctor to report the symptoms and to schedule a follow up appointment if the fast heart beat has become bothersome or worrisome, or just to help you ease your mind.

michael Thomas
1:58 am December 13th, 2012

Stopping addiction to tramodol can be a very difficult challenge that will make you feel the worst you ever have. I know. I have tried quitting many times, sometimes cold turkey, sometime gradual. I relapsed everytime, except the latest. I was taking 20 50mg pills a day, morning day and night. Had to to function and feel good. I knew I had to stop and finally geared up. Have the following in place:
1. time alone and time off from work. I suggest 10 days. 2. drink lots of energy drinks and lots of water. LOTS. 3. Exercise as much as possible, even walking. 4. Smoke pot, espcially at night. this will help greatly and for me it took away the restless leg issue, a biggie! 5. Lots of vitimins and good healthy food. 6. Avoid diet soda and all carbonation. 7. Watch movies and relax. Be in a space where you dont have to be around people. Best wishes!!

doug
3:24 am January 4th, 2013

regarding from your article here: and is generally not taken recreationally. Although Tramadol euphoric effects are possible, they can be almost imperceptible in most people. So, with such a low risk for abuse, Tramadol is frequently prescribed.

Not sure what this is based on. I’ve read much on the web about people abusing this and taking it recreationally because they like the buzz and no pain effects. I did a simple web search and ran across numerous boards where people were discussing their love for the drug and that they can get it without a prescription from out of the US.
And considering the harsh withdrawals that so many have, it seems that a lot of professionals aren’t listening to patients as much as the drug salesman – another simple web search will reveal that, try looking on medhelp.org for many, many bad stories of people saying vicodin, etc. is easier to quit. My doc was telling me it would be minor to use. At 150mg a day, it began to claw at me like a monster to take it more and more, sooner and sooner after barely 4 weeks. I could no longer keep a regimen of use and had to stop using it, and then the withdrawals were bad.

2:40 pm January 4th, 2013

Hi Doug. Point well made and taken. We’ve sourced references from mainly government websites, which are institutions notoriously slow to make declarations about the addictive potential for ANY drug. And among the medical community, tramadol is generally viewed as one of the less dependence creating opioids, as compared with oxycodone, hydrocodone or morphine. We tend to agree with you – doctors and patients beware!

Connie Snyder
9:29 pm June 8th, 2013

I was taking 1 and a half 50mg tramadol for one year before and following back surgery, I stopped for 3 days and had sleeplessness for two nights, and weakness in all my limbs. Today I took a Half a pill to try to conteract the symptoms. What should I do now??

5:17 am June 11th, 2013

Hi Connie. Contact your prescribing doctor and ask for a tapering plan. Any time that you cut opioids by 50% or more, you can trigger withdrawal symptoms. So you need a plan for reducing doses over time to minimize the severity of the symptoms.

ben
11:41 am June 14th, 2013

hello and thanks for your help
i have taken tramadol for 7 years 100=200mg per day.
have tapered down to 25 to 50 mg over a period of months
without much problem. now have been without for 4 weeks.
cannot sleep which i expected…but now my heart rate keeps
jumping to 148 beats a minute….will stay there for 5 days and
then go back to 80 bpm for 5 days…wierd??? should i expect this? so far i have had 2 weeks of normal heart beat and 2 weeks of rapid….i dont wont to go to a heart specialist unless
this is not related to tramadol withdrawal.

ben
12:04 pm June 14th, 2013

not sure what you mean by moderation

Susan
1:57 pm July 7th, 2013

Was taking tramadol ER and just quit cold turkey thinking about my craving for more and what was going to happen when I reached the maximum allowed dose? The withdrawal was horrible and went on for days. About a year later I tried just the 50 mg tablets that I wanted to take once in awhile when my pain was at its worst. Warning: this is very hard to judge when you have chronic pain. I wasn’t taking more than the prescribed dose; never more than 100mg twice a day. But my prescription ran out and I did go into withdrawals again, although not as bad as it was from the ER version. This time no stomach cramps nor vomiting. Yesterday was probably the worst, lots of body ache and headaches. Personally I find Alka Seltzer cold plus helps a lot. I think the aspirin in alka seltzer delivers faster, just my opinion. It usually wears off faster than four hours, so it’s okay to take acetimeophen (Tylenol) when that happens. Sadly, tramadol is what works best on my pain..

Heather
12:58 am July 27th, 2013

Hi I have been taking Tramadol for a little over a year now due to injuries in my neck and shoulder. I take the 50mg ones usually 1 to 1 an 1/2 to two a day, no more than that, but need it everyday at least 1 depending on my pain level. Will I go through withdrawal also after my pain is finally relieved ?

9:51 am July 29th, 2013

Hello Heather. Daily dosing of tramadol can lead to physical dependence. Have you ever missed a dose? What happens when you do?

Alison
10:44 am August 11th, 2013

Hi i was taking tramadol for about a year 200mg a day and for the last 3 months 2 x 30mg morphine slow release tablets. Due to being unwell I stopped all my medication last week and I’m now on day 6 of withdrawal for both drugs.

Is it better to continue taking the Imodium and phenergan or let my body flush it out? And how long can I expect it to continue as this is like hell.

And should I be trying to eat and if so what?
Thanks

Chris
11:32 am August 13th, 2013

I have been on tramadol 3 yrs 300mg a day. At first it was very good but recently it has made me a introvert. In alabama most chronic pain is done by pain management clinics.Which i can’t afford. How should i approach my physician without coming of as a junkie and him refusing me further treatment?

9:51 am August 14th, 2013

Hi Chris. The best thing to do is to be honest. If tramadol is required for pain relief and you’re noticing behavioral symptoms which may be linked to its euphoric effect, a doctor will not judge you for this. At least a GOOD doctor won’t. Instead, there may be an alternative medication for you out there.

Donna Puleo
3:38 pm September 21st, 2013

So what IS recommended for chronic AND acute pain secondary to a cervical fusion c3-c7 with a incomplete spinal cord injury? I have terrible muscle spasms from my neck and scm to my traps and shoulders bilaterally. I also have painful neuropathy on my right side down my shoulder and down to T-1 and T-2. I am on flexeril, which does nothing except make me sleepy, and Cymbalta. I do need analgesia and DO NOT want narcotics.

Thank you.

Heather
2:36 pm September 24th, 2013

I haven’t missed a dose and I am taking 2 a day everyday 50mg. I did notice that one day I took three and the next day in the morning before I took any I had some anxiety, unsure if it was from that though because I have anxiety sometimes also just not all the time.

Rodney
6:33 pm September 26th, 2013

I have been taking Tramadol 100 mg at bedtime for over five years. I have stopped Tramadol for as long as a week with no noticeble side effects. I went off the drug twice when times did not allow the cost of the prescription. The only thing I noticed is the pain was back that I was taking the med for. Not every one has withdrawal symptoms from normal usage. I am proof of that. Please, if you are reading this, want to quit taking bthe drug, have been taking as prescribed under a Dr’s care, and want to quit. Taper off slowly but don’t sit anticipating the worst. It may be you will have no withdrawal symptoms at all. Sometimes the power of suggestion is the strongest drug we face.

Ian Williams
8:33 pm March 7th, 2014

I tried many times to quit Tramadol and it was a complete nightmare. I stumped on the Tramadol Withdrawal Action Plan and for me at least it worked. It’s written by someone who’s been there and done it and talks a lot of sense. You could do worse than give it a try.

Lori
10:21 am March 17th, 2014

I have only been taking tramadol twice a:day 50mg but every time in try to stop them I get terrible depression. I take them for pain due to my neck. I can handle the pain it is the terrible depression. Is this normal? I feel like I am going crazy.

2:11 pm March 17th, 2014

Hello Lori. Tramadol can affect mood. I’d suggest that you record the symptoms of depression, linking them to dates, severity, and doses of tramadol…and consult with your prescribing doctor. It it possible that short term us of antidepressants during tramadol withdrawal can help ease this symptom (under medical supervision).

jade
3:38 pm April 6th, 2014

I’ve been taking tramadol off and on for a few years. I’ve decided to quit cold turkey. Now I’m going through serious typical and atypical withdrawal symptoms… I have school, work, and other things to worry about right now. What will help me?

Leah
10:15 pm June 1st, 2014

Hi, I have been taking tramadol 50mg every 4-6 hours for 8 years now with the exception of two years in that time period when I was pregnant then nursing. I take it for Lupus SLE and secondary fibromyalgia. I stopped taking it two weeks ago because I have had consecutive flare ups and felt like this was just putting a band aid on a broken bone because maybe my body has become immune to this drug. My withdrawals have been horrific for me with anxiety, depression, panic attacks, chronic neck and shoulder pain, and nausea. My family doctor put me on Xanax, Prozac and zofran, but again it only helps a little. I already go once a week to a massage therapist, and every two weeks to a chiropractor. I cannot just be in a sedative state due my job and a toddler who is very active, so I would be so grateful to any suggestions anyone has for a more holistic approach. Thank you so much, I’m so glad I found a MSG board with people who have actually experienced this.

arthur
1:09 am July 10th, 2014

I took tramadol for 2 yrs about 300mg a day or more and I just stopped..it’s killing me! What do I do?

Ivana @ Addiction Blog
8:25 am July 10th, 2014

Hello arthur. I’m glad you are begging your journey and have decided to quit. Tramadol has a harsh withdrawal, as you’ve experienced. You can call your doctor or general physician for help and monitoring during this period in time. Just to be sure and safe, doctors assistance is recommended, they can provide adequate medical assistance if needed, advise and asses your medical state, perhaps even prescribe some medications to help with the withdrawal symptoms.

Lisa
10:00 am July 17th, 2014

Hi, I was on between 200 -400mg a day for a back injury and post operation. I’ve slowly reduced and I have been clean for nearly 2 weeks. I experienced some withdrawals whilst reducing but since I’ve completely stopped I’ve had some issues and just wanted to know if it’s connected to the stopping of Tramadol. I had 3 days of continuous vomiting and diarrhoea, which I thout had stopped but I still keep vomiting every now and again. My sleep is very disturbed with very vivid dreams. I have no appetite and most of the time I feel nauseous and get stomach pains when I do eat. Im also sneezing…alot! Is this any connection and if so, how long do you think it will last?

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