title: Seizures associated with intoxication and abuse of tramadol.
abstract: OBJECTIVE
  To assess the frequency of seizures and patient characteristics associated with tramadol intoxication and abuse in young addicts.
  
  
  METHODS
  Patients with history of tramadol abuse and intoxication were prospectively studied during a 3-year period. The characterstics of patients with seizures and those without seizures were compared.
  
  
  RESULTS
  Fifty-seven patients (mean age 22.3 years [range 16-43 years], 47 males) were included. Tonic/clonic seizures occurred in 31 (54.4%) patients, (26 males and 5 females): single in 14 (45%), multiple in 17 (55%) patients after a tramadol dose ranging from 250-2500 mg. Seizures occurred within 24 h after tramadol intoxication in 26 (84%) patients, and later in 5 (16%) patients. Compared to addicts without seizures, the abusers with seizures were younger (p < 0.05). Both epileptiform and nonepileptiform electroencephalographic patterns were more common in patients with seizures than in patients without seizures, but the differences did not reach statistical significance.
  
  
  CONCLUSIONS
  The neurotoxicity of tramadol commonly manifests as generalized tonic-clonic seizures occurring most frequently within 24 h after tramadol intake. Seizures were more common in younger abusers with a longer duration of exposure to tramadol and with the combined use of tramadol with alcohol.
authors.affiliation: Institute on Addictions, Belgrade, Serbia and Montenegro.
authors.forename: Vesna
authors.initials: V
authors.lastname: Jovanović-Cupić
authors.forename: Zarko
authors.initials: Z
authors.lastname: Martinović
authors.forename: Nada
authors.initials: N
authors.lastname: Nesić
mesh_terms: D000293:Adolescent; D000328:Adult; D004357:Drug Synergism; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D009294:Narcotics / Q000506:poisoning*; D011446:Prospective Studies; D012640:Seizures / Q000139:chemically induced* / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications*; D014147:Tramadol / Q000506:poisoning*
chemical_list: D009294:Narcotics; D014147:Tramadol