Tramadol has a variety of side effects, and although some are mild, others are potentially fatal. Consider these risks and side effects before beginning tramadol use.

Article at a Glance:

  • Tramadol is an opioid painkiller and controlled substance that carries the risk of addiction.
  • Although tramadol is generally well-tolerated, side effects like nausea and vomiting are common.
  • Tramadol has been linked to serious side effects like seizures, serotonin syndrome and overdose.
  • Help is available if you or someone you love is struggling with tramadol addiction.

An Overview

Tramadol is an opioid painkiller used to relieve moderate-to-severe pain. Doctors typically prescribe the drug for short- or long-term management of acute or chronic pain. Marketed under the brand names ConZip, Qdolo and Ultram, tramadol is classified by the Drug Enforcement Administration (DEA) as a Schedule IV controlled substance.

As a narcotic, tramadol impacts your brain’s reward centers, which may prompt you to desire more of the drug. Even if you use tramadol as prescribed by your doctor, the drug can cause problems that include a range of side effects and even addiction. Whether you are concerned about your own tramadol use or the use of someone you love, it’s important to learn and watch for the signs of abuse and addiction.

Tramadol Side Effects

Prescription tramadol can help with pain relief, but as with any drug, side effects are possible. Though some side effects may be mild, others are quite dangerous.

Long-term tramadol side effects can include physical dependency that develops with or without addiction. As you continue taking tramadol, however, your risk of addiction to the drug increases. Even if you don’t develop an addiction, long-term use of tramadol will likely cause withdrawal symptoms when you stop using it, especially if you take a high dose of the drug. The following provides an overview of minor and major tramadol side effects.

Minor Tramadol Side Effects

Gastrointestinal symptoms are by far the most common types of side effects from tramadol. Other short-term, minor side effects usually require no medical attention, as they disappear on their own after the body adjusts to the medication. However, if any of these side effects continue or you simply have concerns about them, consult your health care provider.

The most common side effects include:

  • Constipation
  • Nausea
  • Dizziness/vertigo
  • Headache
  • Sleepiness
  • Vomiting
  • Central nervous system stimulation
  • Indigestion
  • Weakness
  • Itching
  • Dry mouth
  • Diarrhea
  • Sweating

Tramadol and Nausea and Vomiting

Like other opioids, tramadol can cause gastrointestinal side effects like nausea and vomiting. Although experts are not exactly sure why this occurs, they believe that factors may include:

  • A direct effect on the chemoreceptor trigger zone in the brain, which is responsible for creating a sensation of nausea
  • An effect on the vestibular system, which comprises the inner ear and parts of the brain that control balance and eye movements
  • An effect on the gastrointestinal tract, causing constipation that may worsen nausea

Major Tramadol Side Effects

Tramadol is generally well-tolerated with few serious side effects. However, serious side effects can still occur. If you suspect that you or someone you know is experiencing a serious tramadol side effect, seek emergency medical attention.

Severe side effects include:

  • Seizure
  • Serotonin syndrome
  • Respiratory depression (slowed breathing)

Tramadol and Seizures

Tramadol is known to cause seizures in people who abuse the drug and even people who use it as prescribed. However, experts are not sure what tramadol does to the brain that increases seizure risks.

A seizure occurs when the brain’s electrical system becomes overstimulated, causing brain cells to send abnormal signals. The severity of a seizure greatly depends on how much of the brain has been affected, ranging from a short-term state of confusion to uncontrollable muscle movements and convulsions.

Although the risk of seizures with tramadol is small, certain people may be at a higher risk for experiencing them based on their age, medical history, frequency of use and what other drugs they are taking at the same time.

Tramadol and Serotonin Syndrome Risk

Serotonin is a major neurotransmitter in the brain. Certain drugs, including tramadol, can increase the amount of serotonin available to the brain. However, increasing serotonin too much can be dangerous and lead to a condition called serotonin syndrome. Although serotonin syndrome can develop if you take any drug that increases serotonin, a person generally needs to take more than one serotonin-increasing drug for this condition to develop. Many such drugs exist, including most antidepressants, monoamine oxidase inhibitors (MAOIs), amphetamines, cocaine, St. John’s wort and tryptophan.

Symptoms of serotonin syndrome can include:

  • Muscle spasms
  • Sweating
  • Agitation
  • Tremor
  • Rigid muscles
  • Fever

Serotonin syndrome is a medical emergency and can be fatal. For this reason, it is important to seek emergency medical attention if you suspect this condition.

Tramadol and Respiratory Depression

Respiratory depression, or slowed breathing, is a serious and potentially deadly side effect of all opioids, including tramadol. When a person takes too much tramadol and overdoses, it can cause their breathing to slow down so much that they stop breathing entirely. The opioid reversal agent naloxone can temporarily reverse respiratory depression and should be administered if a person’s breathing appears to slow. After administering naloxone, seek emergency medical attention to make sure the person recovers and does not lapse back into respiratory depression.

Signs of Tramadol Abuse

Tramadol abuse is often among the earliest stages of addiction. If you cannot stop taking the medication — despite negative life consequences and efforts to quit — then you’re seeing the most telling sign that abuse has grown into a bigger problem. Taking a self-assessment quiz about your tramadol use may help give you insight into whether you are at risk for abuse and addiction. Further, you and your loved ones may notice behavioral, psychological and physical signs that commonly develop when someone begins to struggle with a substance like tramadol.

Behavioral Signs of Tramadol Abuse

Often, substance abuse is accompanied by some changes in behavior. Even if you do not notice behavioral symptoms, loved ones may notice symptoms like:

  • Nonmedical use of tramadol
  • Visiting multiple doctors to get more tramadol prescriptions
  • “Drug-seeking” behaviors, such as emergency doctor visits and lying about loss of prescriptions
  • Continued use of tramadol despite negative consequences

Psychological Signs of Tramadol Abuse

When you struggle with tramadol, you may notice that your own thought processes increasingly revolve around the drug. This can translate into a variety of psychological signs of tramadol abuse, including:

  • The belief that tramadol is necessary to get through the day
  • Craving tramadol
  • Lack of control over tramadol use

Physical Signs of Tramadol Abuse

Substance abuse is very stressful on your body. You may notice a variety of physical symptoms when you are between tramadol doses. These withdrawal symptoms can be unpleasant and may drive you to consume more of the drug.

Withdrawal symptoms include:

  • Anxiety
  • Sweating
  • Trouble sleeping
  • Rigors
  • Pain
  • Nausea
  • Tremors
  • Diarrhea
  • Upper respiratory symptoms
  • Goosebumps
  • Hallucinations

Tramadol Overdose

Taking too much tramadol can be deadly. This is especially true if you are using other central nervous system depressants, such as alcohol or other opioids, at the same time. For this reason, it’s important to be familiar with the symptoms of tramadol overdose and what to do if you observe them. Symptoms of tramadol overdose are similar to those of other opioids and include:

  • Unconsciousness or coma
  • Slowed or stopped breathing
  • Muscle flaccidity
  • Cold and clammy skin

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

Staging an Intervention for Tramadol Abuse

It is often difficult for a person with addiction to recognize their problem and seek help on their own. As a result, if someone you love has an addiction, you may need to help them become aware of their problem and seek treatment.

Consider holding a tramadol addiction intervention. This event should be carefully planned to meet the following three goals:

  1. Give specific examples to your loved one of how their addiction has hurt you.
  2. Offer treatment options that you have already researched and vetted.
  3. State what you will do if your loved one does not agree to get treatment.

Because interventions can be difficult and emotional, you may want to consult an intervention specialist or another addiction professional to help with the planning and executing processes. They may recommend you begin by writing an intervention letter to your loved one. Whether you opt to intervene alone or with outside help, remember that your primary objective is to bring your loved one back to health.

Find the Help You or Your Loved One Needs

Tramadol addiction can be frightening and overwhelming. Fortunately, help is available at The Recovery Village. Our tramadol experts have extensive experience in treating tramadol addiction and helping people begin the path to a drug-free life. Contact us today to learn more about treatment plans and programs that can work well for your needs.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

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Simon, Leslie V.; Keenaghan, Michael. “Serotonin Syndrome.” StatPearls, November 20, 2020. Accessed December 20, 2020.

Drug Enforcement Administration. “Tramadol.” March 2020. Accessed December 20, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.