Does Tramadol cause seizures?

Yes. Long term use of Tramadol can cause seizures in a general population. And some drugs that reduce the metabolic clearance of Tramadol can trigger a seizure. But some people seem to be more at risk of seizures when on Tramadol. Learn more here.

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In general populations, seizures have been reported in patients receiving Tramadol within the recommended dosage range. Although this number is low (fewer than 1% of users in a recent study made a seizure claim after their first Tramadol prescription), this number can increase 2-6 fold. So, what factors increase your risk of seizures when taking Tramadol? We explore and explain here.

What happens during a seizure?

Seizures happen when your brain cells send out abnormal signals. Seizures are caused by overexcited nerve cells in the brain that fire abnormally. The most common form of seizures triggered by Tramadol are tonic-clonic seizures (grand mal), which bring on loss of consciousness, shaking or jerking of the body, and loss of bladder control. Visual or auditory aura or an unusual feeling may be present before the seizure starts. These types of seizures can last from 5 – 20 minutes. Seizures are not considered to be epilepsy if they occur only once or are correctable.

Risk factors for seizures and Tramadol

Tramadol is a remarkable drug, but like all drugs, effective use means weighing the benefits of use against the risks. Although seizures may occur if Tramadol is the ONLY drug that you are taking, some risk factors increase the likelihood that you can experience a seizure or convulsion. The main risk factors are: age, length of use and dosage, concurrent drug use, and medical history.

1. Age – Adverse reactions such as seizures appear to be more common in the elderly than in younger people.

2. Drug or chemical interactions – The coadministration of other drugs, particularly antidepressants, can trigger seizures while you are taking Tramadol. In particular, serotonergic agents (including SSRIs, SNRIs, and triptans) or drugs that significantly reduce the metabolic clearance of Tramadol can cause seizures.  Tramadol and acetaminophen drug combinations like Ultram are not likely to trigger seizures.  But the most notable drugsthat have interacted with Tramadol include:

  • Carbamazepine
  • CYP2D6 inhibitors (Ex. quinidine, fluoxetine, paroxetine and amitriptyline)
  • CYP3A4 inhibitors (Ex. ketoconazole and erythromycin)
  • Linezolid
  • Lithium
  • MAOIs Monoamine oxidase inhibitors
  • Naloxone (used to treat tramadol overdose)
  • Neuroleptics
  • Other opioids
  • SNRIs Serotonin norepinephrine reuptake inhibitors
  • SSRIs Selective serotonin reuptake inhibitor
  • St. John’s Wort
  • TCAs Tricyclic antidepressants and other tricyclic compounds (Ex. cyclobenzaprine, promethazine)
  • Triptans
  • Other drugs that reduce seizure threshold

3. Long term use or abuse of Tramadol – Firstly, the risk that you may experience a seizure when on Tramadol seems to be linked to long term use. This adverse reactions may develop during Tramadol therapy, but seems to experts much more likely to emerge during cases of misuse or overdose. In a recent study, seizures were more common in younger abusers with a longer duration of exposure to Tramadol and with the combined use of Tramadol with alcohol. Which brings us to our second point.

4. Medical history or the presence of other medical conditions – Risk of convulsions by seizures may also increase in people already diagnosed with epilepsy, those who have a history of seizures, or for people with a recognized risk for seizure (such as head trauma, metabolic disorders, alcohol and drug withdrawal, CNS infections). In a recent study of more than 9,000 participants, risk of Tramadol related seizures was highest among those with a history of alcohol abuse, stroke, or head injury.

What to do during a seizure

The neurotoxicity of Tramadol commonly manifests as generalized tonic-clonic seizures occurring most frequently within 24 hour after taking Tramadol. But unfortunately, there is not much that you can do once a seizure has begun. The main focus is on prevention of FURTHER injury, and recording details to take to your doctor.

If you experience a seizure, it is most important that you are in a safe environment. So, people around you should make sure that you cannot injure yourself by clearing furniture or obstacles. If others witness the seizure, it is important that they observe and record the actual seizure event as it progresses. The more you can provide information on how the seizure started, location and duration of motor activity, as well as your subjective sensory experience will help doctors diagnosis the type of seizure.

Finally, you should always see a doctor if you think that you have experienced a seizure. This is because between 30 – 70% of people who have one seizure will have a second seizure within 1 year. There are a number of drugs that can help treat seizures, including anti convulsants (anti-seizure drugs) and sedatives, and you will want to re-evaluate your Tramadol therapy, as well.

Lowering your risk of seizures on Tramadol

If you are taking Tramadol in the single-dose and 24-hour dose limit, keeping the time interval between doses you are taking Tramadol as prescribed. Exceeding these recommendations can result in seizures. And if you have a general medical history free of seizure-provoking events and are not taking interactive drugs you are less likely to experience a Tramadol-induced seizure. Although you cannot be sure that you WILL NOT be seizure-prone, your risk is minimized.

Questions about Tramadol use?

We hope that we’ve thoroughly addressed your questions about Tramadol and seizures. If we haven’t provided enough information, please tell us! Send us an email or comment below. We try to answer all questions personally, and may even write a new article to help you! Your questions, comments, experience and feedback is welcomed.

Reference sources: Daily Med drug info on Tramadol
Tramadol: Seizures, Serotonin Syndrome, and Coadministered Antidepressants
Seizures associated with intoxication and abuse of Tramadol
Tramadol and seizures: a surveillance study in a managed care population

National guidelines for neurological nurses in the care of the patient with seizures. 2nd edition.
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. I’ve taken a lot of medications and other drugs. Most dangerously mixed benzos with opiates. I’ve never had a bad reaction from any drug legal or illegal. My father has a tramadol prescription and my tooth was killin me so he gave me four 50 mgs I took too that night and then two more the next day around 1pm. At about 2 or 2:15 I had a grand mal seizure. That’s the only drug I’ve ever had a bad reaction from and it was a big one!

  2. Helbeen all.. Me and my girlfriend of 4yrs now have been addicted to painkiller, opioids for a really long time now at least 10yrs now.. She has had multiple seizures after taken tramadol recently and within the past yr. She has been taking trams for about 15yrs and has never had any issues with them. She was in a accident where she was hit by a speeding car blowing a red light it was horrible it was like something you would only see in the movies but anyways she hit her head was messed up badly and since she has had the seizers they have been really bad. I have not had any but sometimes I just don’t feel right I studder when I speak and just kinda get quite. So hear is the problem is as I briefly mentioned we both have struggled for some time with opioid pain killers and I dabbled in heroin a little bit and we both knew we were in trouble so we have got into a methadone maintenance rehab and both have been doing GREAT and for awhile she was completely happy with the methadone it was amazing for her pain and just everything but now we been on the methadone for about a yr and a half or so now and have BUILT a tolerance and its not helping her the way it was so been taking the tramadol with it and you are not supposed to mix the 2 and I am scared to death this is gonna hurt her worse idk what to do or what route we can take any suggestions PLEASE

  3. Hello all, I’ve been addicted to painkillers since my dad died st age 15, first codeine and now codeine and tramadol 150mg.. I had a seizure last week due to taking over 30 150mg tablets in the space of 48 hours. During the seizure I smashed my head and blood was everywhere, I smashed it on my fireplace and had to be glued and stitched back together. I literally can’t beg enough please don’t misuse tramadol

  4. I took an overdose of tramadol and had a seizure.My doctor prescribed carbamazepine for me but i dont knw if i can stil take tramadol while on the drugs bc he asked me to take the carbamazepine for 3yrs that i wont experience seizure anymore.

  5. I’m starting to get concerned with the way I feel occasionally when taking this medication. I feel panic that is hard to describe. I take two doses of tultram daily and two doses of nerco. First thing in the morning I take 150mg, four hours later I take 125 mg with this dose i get the weird feeling. Around 5pm I take 15mg nerco and around nine I take another 15 mg of nerco. I suffer from chronic painand I’ve been on this Same dose for over a year . I am concerned because I am taking the three at a time in the morning and 2 1/2 in the afternoon. So total in a day I am taking 275mg within a 4 to 5 hour span. Is this putting me in danger? I think you greatly for your time.

  6. If I had one seizure from taking 850 mgs, can i decrease to 400 mg is one day and elimaite the risk of seizure. Basically, am I more susecptible to have another seizure no matter the dosage, since I have already had one.

  7. OK. well I was just presbed horizant and have weened myself from 150 3 x day of lyrica to 1 x 5o. no small feat there might i add. anyway…..dont want to end up back where I started lyrica is from the pits of hell when you run out…your skin goes crazy…you gain uber weight…altthough it helps w pain…not worth it. so anyone know if im making a mistake by taking this new one?

  8. Hello, I recently was Rxed 50mg of Tramadol to take one for pain. The most I have taken was 1 tablet in a 24 hr period because of fear of seizure. I am also taking 800mg of Gabapentin 3x a day. Some days I don’t take any Tramadol. My daughter was once taking this med and had a seizure and lost her license.
    My questions are 1st will the gabapentin help prevent a seizure? And 2nd Will I be able to safely have any alcohol at all while I am on vacation?

    1. Hi Kimberly. In theory, yes. Gabapetin may have some role in preventing tramadol seizures. But, you should be careful since long term use of this medication can increase CNS depression and stopping it may cause more seizures. I wouldn’t recommend mixing any amount of alcohol while regularly taking medications.

  9. Hi Douglas. I’m so sorry to hear about your knee. Thank you so much for your work and sacrifice in Afghanistan. Are you being treated via the VA?

    If you’ve experienced seizures from tramadol withdrawal in the past, I’d suggest that you make sure to detox under inpatient medical supervision. And keep in mind that prescriptions for withdrawal are best managed under the supervision of an MD with experience in this field. We are not medical professionals here, but can help with research. I cannot find any direct guideline for withdrawal from tramadol, so it will be best to consult an MD or pharmacist for more information.

  10. If i have had seizures in the past on tramadol, will taking an anti epileptic help? I was precribed 3 mg’s of klonopin a night bc my seizures came when two things happened: I went more than 2 days without sleep, and I took ultram which i contnue to do because no doctor cares that i got my knee shot up in Afghanistan and will not treat me with anything stronger. So can you control the risk factor for seizures at all with an anti convulsive, like klonopin, taken in a large dose, nightly? Thank you in advance for answering. This question is obviously very important to me

  11. Hi Guys Just a little problem I have been on 200g tramdol for two year and over the past 6mths I have been getting seizures during sleeping that my wife tells me as I dont know that I am doing it.
    Also I have experince a qiuck jerk just as I am going to sleep ?
    can you help
    Kind Regards
    ps I have explianed to my doctor who just says nothing?

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