Psychosis following Tramadol Withdrawal.
BACKGROUND
Tramadol is a centrally acting opioid analgesic used to treat moderate to sever pain. It has more advantage and less opioid adverse effects than conventional opioid analgesia.


METHODS
This article reports a patient with tramadol dependency that had psychosis after tramadol withdrawal.


CONCLUSIONS
By the increase of tramadol usage for relief of chronic pain, tramadol abuse and dependency is increased. Some of tramadol withdrawal symptoms are not related to opioid, for example when the effectiveness is not only on opioid receptors, but on catecholamine and serotonin receptors. So, together with typical symptoms of withdrawal, atypical symptomes had been reported. Psychosis is one of tramadol atypical withdrawal symptoms which subsided a few days after suppression of withdrawal symptoms. In such cases, the diagnosis is substance withdrawal instead of psychotic disorder due to substance withdrawal and treatment is based on this diagnosis.
Assistant Professor of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Ghodratolah
G
Rajabizadeh
Resident of Psychiatry, School of Medicine and Kerman Neurosciences Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Ali
A
Kheradmand
Resident of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Mansoureh
M
Nasirian
Atypical withdrawal; Psychosis; Tramadol