title: Seizures after use and abuse of tramadol.
abstract: Seizures have been reported with tramadol monotherapy in animal and human studies, both at recommended and high doses. After tramadol abuse or overdose, neurotoxicity is speculated to be related to the reuptake inhibition of serotonin and norepinephrine, rather than its opioid effects. THE AIM OF THIS STUDY is to show three unusual cases of seizures provoked by tramadol.
  
  
  METHODS
  A 56 year-old female was hospitalized with intensive lumbosacral pain. Because the standard therapy with non steroid anti-inflammatory drugs and diazepam did not show enough pain release, Tramadol ampoules were applied. Fifteen minutes later generalized tonic clonic seizure was noticed. A 24 year-old female was admitted to the Toxicology Clinic, one hour after ingestion of 1000 mg Tramadol (20 pills of 50 mg) in a suicide attempt. Five hours later generalized tonic clonic seizure was noticed. A 27 year-old male was hospitalized for detoxification procedure with buprenorphine. The patient was a more than four years heroin abuser, and in the last two years he mixed the heroin with high doses of tramadol. 16 hours later, after application of the first 2 mg of Buprenorphine, generalized tonic clonic seizure was noticed.
  
  
  CONCLUSIONS
  Tramadol prescription, use and abuse are connected with the risk of developing seizures. The neurotoxicity of tramadol commonly manifests as seizures.
authors.affiliation: University Toxicology Clinic, Skopje, R. Macedonia.
authors.forename: N
authors.initials: N
authors.lastname: Bekjarovski
authors.forename: D
authors.initials: D
authors.lastname: Chaparoska
authors.forename: S
authors.initials: S
authors.lastname: Radulovikj-Bekjarovska
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000506:poisoning; D005260:Female; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000139:chemically induced*; D013406:Suicide, Attempted; D014147:Tramadol / Q000009:adverse effects* / Q000506:poisoning
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol