title: Tramadol treatment of combat-related posttraumatic stress disorder.
abstract: BACKGROUND
  Improved psychopharmacologic treatment of posttraumatic stress disorder (PTSD) is needed. Accruing evidence implicates pain-conducting signals in PTSD pathophysiology.
  
  
  METHODS
  Four combat-related PTSD patients from the wars in Iraq and Afghanistan were treated with open-label tramadol hydrochloride (HCL), an atypical analgesic with opioid and non-opioid mechanisms of antinociception. Tramadol also inhibits neuronal reuptake of norepinephrine and serotonin.
  
  
  RESULTS
  The clinical outcomes show evidence of a positive effect of twice-daily immediate-release tramadol HCL in men with combat-related PTSD. Total daily doses were 200 to 300 mg/d, with individual doses ranging from 100 to 200 mg.
  
  
  CONCLUSIONS
  Given its unique mechanism of action, relatively low abuse potential, and ability to double as an analgesic for minor to moderate pain, tramadol is a promising candidate for clinical use in PTSD.
authors.affiliation: Veterans Affairs Medical Center, Cincinnati Department of Psychiatry and Behavioral Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA. E-mail: thomas.geracioti@uc.edu.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Geracioti
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D014147:Tramadol / Q000627:therapeutic use*; D016896:Treatment Outcome; D014857:Warfare
chemical_list: D000701:Analgesics, Opioid; D000068760:Serotonin and Noradrenaline Reuptake Inhibitors; D014147:Tramadol