title: Unrecognised long-lasting tramadol-induced delirium in two elderly patients. A case report.
abstract: We present the cases of two elderly patients with intermittent long-term tramadol intake against chronic back pain. Over a period of more than two years they experienced fluctuating confusional states and cognitive deficits, reversible only after discontinuation of tramadol. According to the DSM IV-criteria, an unrecognised recurrent tramadol-induced delirium can be diagnosed in both cases. Although tramadol may represent a well established safe therapy for chronic non-malignant pain in the elderly, these cases demonstrate that it should be applied with caution even in healthy subjects.
authors.forename: G
authors.initials: G
authors.lastname: Künig
authors.forename: S
authors.initials: S
authors.lastname: Dätwyler
authors.forename: A
authors.initials: A
authors.lastname: Eschen
authors.forename: U
authors.initials: U
authors.lastname: Schreiter Gasser
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001416:Back Pain / Q000188:drug therapy; D002908:Chronic Disease; D003693:Delirium / Q000139:chemically induced*; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives; D000078785:Mirtazapine; D011788:Quality of Life; D013997:Time Factors; D014147:Tramadol / Q000009:adverse effects*
chemical_list: D000317:Adrenergic alpha-Antagonists; D000701:Analgesics, Opioid; D008803:Mianserin; D014147:Tramadol; D000078785:Mirtazapine