Thursday October 23rd 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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36 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?

Diane
12:21 am July 29th, 2014

I have been taking tramadol for five weeks due to a motorcycle accident. I have tried to stop taking it but feel sick to my stomach and very weak and shaky. I’m not sure if it is withdrawal or not. Could someone please tell me how long I can expect to feel this way? How long does withdrawal last?

mac
3:06 am August 3rd, 2014

about 5 years ago my doctor put me on oxycodone for pain & as long as i took it the pain was managed. then i could no longer afford to go to this doctor and he refused to write any more refills. i went through withdrawals for 3 weeks, the worst thing i’d ever experienced. after i was over the withdrawals i was still in pain from arthritis, back, & deformed feet. when i was again able to go to a doctor to get on something to manage my pain i was adament that i did not want oxycodone. she put me on tramadol 50mg up to 300mg/day, saying this was a better and non-addictive drug. most days i was able to take 100mg when i woke up and 100mg before going to bed. if my pain was bad during the day i would take the other 100mg. well, to make a long story a bit shorter, i took my last 100mg friday aug. 1st and friday night after sleeping perhaps an hour, i was awake tossing & turning, legs pumping, arms flailing. by 3:00am i could take no more and got up, IN PAIN. i tried to lay down sat afternoon as i was exhausted but sleep would not come to me. it’s now 11:00pm sat night. i laid down at 8 but was back up at 10 without falling asleep. i realized as i was getting up that i was feeling the same way i had when i withdrew from the oxycodone. but this is the better non-addictive drug, right? bull pucky(pardon the hillbilly). all day i have been in pain. what can i take? hopefully my trams will be in the mailbox monday at noon. but that means no relief sunday or monday till i get home from work. a 58 year old man should not have to go through this. thank you for listening to my rants, god bless

Trece
5:31 am September 1st, 2014

Hi everyone–I have a temporary aid for tramadol w/d symptoms–immodium ad. The ingredient loperamide relieves symptoms, but you need to take about 5 to 10 times the required dose for relief. I hope this helps some of you; it has helped me in the past greatly!

Missey
12:17 am September 10th, 2014

I’ve been on Tramadol for 6 months due to a back injury. Usually I took 2 50 mg pills 2x/day. I only took it “as needed” but at least one dose each day unless I was having a procedure done. It didn’t take away the pain, but made it more tolerable. Since it also tends to make me unable to concentrate (and, therefore, to work or drive or anything that would allow me to return to ‘normal’ life), my doctor suggested that I try switching to another medication that doesn’t give the spacey feeling to see if it does anything for me. By the end of the first day without tramadol, I had pain all over, feeling hot/cold, low-grade fevers, occasional sneezing fits, & insomnia. I gave in & took it the next morning. I waited a few days & I’m trying again, but having the same problems. If these are withdrawal symptoms, how long can I expect this to last? I’m hopeful that I can wait this out, but it will help if I know how long this is likely to continue.

Lonna
4:15 pm September 24th, 2014

There is not enough area here to write all I can. I was put on this medication a little over 20 years ago. My doctor said he was putting me on a new drug that managed pain and was addiction safe. Little did they know then. He wrote me an open script and after taking it I found it does give euphoria feeling, and got rid of my depression while taking it. Regardless I have been taking this since that day minus the 2 years I was in treatment and prison for it. The withdrawal is intense, just like heroin withdrawal. You kick, cry, scream, vomit, your body hurts, basically you want to die. After my doctor would not prescribe it any longer I went through the withdrawal for the first time in my life. I would have blown my brains out it was so bad. I forged scripts to keep from going through it and drug seeking. That is what got my put away. When I went to treatment for the first time, they had to call the makers of it and find out how to get me off of it without killing me. You CAN NOT GO OFF IT COLD TURKEY YOU CAN HAVE MASSIVE SEIZURES. They told them to ween me off of it a little at a time. Buy this time I was taking around 40 to 50 tablets a day and that is not a lie. I was deep into it. I don’t know what kept me from over dosing? I have been through treatment four times. I was put on this medication because of a a back condition that can not be fixed. I live in horrible pain everyday. I have had five major back surgeries, two debriments from gangrene, staph, and infection of the bone. The university of Iowa wanted to write a paper up on me since I was the first and only case they had ever dealt with or heard of. Since then there are a lot. They say it is synthetic heroin and you better believe it. You will find out why they call it kicking the habit. I would not wish this on anyone. Not just the pain from withdrawal, it ruined my life. I had never been in trouble in my life with cops. It taught me to steal, lie, cheat, and con everyone around me to get it. I took myself away from my two girls for years because I was selfish and only thought of me. I was very lucky that they forgave me and we had a long long time to trust again. I would write more but you wouldn’t believe what I did to get them. I cut my arm open with a piece of glass had 19 stiches teeth pulled, etc to get it. And that is just the tip of the iceberg. I had to write this after seeing a book that was written by a guy that was on it for three years and thinks he is a authority on it. LOL No way!! I am though and didn’t want to be. But you don’t wake up one morning when you are little and say I want to be an addict when I grow up. If anyone needs help and or someone to talk to get ahold of me anytime. Take care.

Lonna
4:27 pm September 24th, 2014

The only thing that will help withdrawal is to be weened off this medication over time. As I said going cold turkey on your own can kill you. There is a very very good chance you will have a seizure and that is a fact. Read the small print on your medication. It has also been known to cause heart attacks and strokes. Yes physicians don’t take this serious and will treat you like crap when you tell them you are addicted to it, but just remind them that a doctor put you on it, and if you have a seizure you will sue if you live through it. Nothing else works go to the nearest rehab and tell them your story, I did and they got me off them one day at a time, and that was a lot of pills to ween off of. Thank you.

Chris
3:27 am September 29th, 2014

I have been taking 300 mg. of tramadol for about 10 years. I am currently weaning off. I have reduced my daily dosage by 50 mg per for two weeks at a time. I am now down to 150 mg. per day. The problem is that when it starts to wear off it feels like every nerve ending in my body is throbbing. I take an advil about 2 or 3 times a day. It seems to help. Is this throbbing normal to withdrawals? Is there anything I can do to stop it? How long will this horrible feeling last?

Ivana @ Addiction Blog
11:45 am September 29th, 2014

Hello Chris. Throbbing is very annoying, I understand. You can try laying on the floor and elevating your legs on a chair. Use a hot pad, or put your blankets into the dryer and cover yourself while they are warm, or use an ellectric blanket. Epsom salt baths can be of great help, or hot baths in general. Another advise I have is to take magnesium. I hope this helps. Stay strong!

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