Article at a Glance:

  • When a person is physically dependent on tramadol, abruptly stopping its use often leads to withdrawal symptoms and complications.
  • In general, tramadol withdrawal symptoms occur within a few hours after the drug’s effects wear off.
  • The withdrawal effects of tramadol are unique amongst opioids and can include hallucination and mood changes.
  • To safely detox from tramadol, it is best to remain under close medical supervision until the body expels the substance.

Tramadol is an opioid prescribed by physicians as a painkiller for treating moderate to moderately severe pain. Tramadol may cause both psychological and physical dependence. Attempting to stop consuming tramadol abruptly is often tied to severe withdrawal symptoms and complications. The psychological and physical pain associated with withdrawal symptoms during opioid detox often leads to setbacks in recovery.

What Is Tramadol Withdrawal?

Traditional opioids like oxycodone and hydrocodone increase sensations of pleasure and can produce a high when taken in larger doses than what was originally prescribed. Tramadol works a little differently, activating opioid receptors in the brain while also increasing the amounts of neurotransmitters like serotonin and norepinephrine. For that reason, tramadol withdrawal may take two different forms: traditional opioid withdrawal syndrome or atypical opioid withdrawal syndrome.

In general, tramadol withdrawal symptoms occur within a few hours after the drug’s effects wear off. That’s why, if you forget to take your dose one day, you may start to feel these symptoms only a few hours after your last dose. The length of time until withdrawal stops can vary from weeks to months later, depending on the individual.

Tramadol Withdrawal Symptoms

Tramadol is habit-forming, and as a result, dependence can occur over time. The severity and length of tramadol addiction can directly impact the withdrawal’s presence, intensity and duration.

Opioid withdrawal generally has two main phases: early and late withdrawal. Early withdrawal starts when the substance leaves the bloodstream, and late withdrawal occurs a little later. Signs of opioid withdrawal vary according to the stage:

Early Opioid Withdrawal
  • Sweating
  • Muscle and body aches
  • Trouble sleeping or insomnia
  • Anxiety
  • Restlessness
  • Agitation
  • Racing heart rate
  • Hypertension
  • Fast breathing
  • Yawning
Late Opioid Withdrawal
  • Chills and goosebumps
  • Stomach pain and cramping
  • Diarrhea
  • Vomiting
  • Loss of appetite
  • Pupil dilation
  • Difficulties concentrating or thinking clearly
  • Drug cravings
  • Depression

Atypical Withdrawal Symptoms with Tramadol

Tramadol is unlike other opioid painkillers like oxycodone in that it relieves pain by way of two different mechanisms: 1) by stimulating opioid receptors and 2) by inhibiting serotonin and norepinephrine reuptake. Because it is atypical in this way, some users will experience a whole set of symptoms not normally seen in opioid withdrawal. This atypical withdrawal syndrome includes a range of psychological symptoms marked by:

  • Auditory hallucinations
  • Intense paranoia
  • High anxiety and panic
  • Depersonalization

These tramadol withdrawal symptoms might not be dangerous by themselves, but they can lead to dangerous situations. People who experience visual or auditory hallucinations, paranoia and delusions can make poor choices, putting themselves and others around them at risk.

Physical Complications from Tramadol Withdrawal

Post-acute withdrawal syndrome (PAWS) is a rare complication that can occur if a person has taken substances like tramadol for a long time in large doses.

PAWS involves long-term tramadol withdrawal side effects. They are typically psychological but can manifest physically. The individual could feel weak or tired for weeks after detoxing from the substance. They could also experience intense cravings, anxiety, depression, insomnia or increased pain sensitivity. Working with a doctor to taper the tramadol dose can help prevent PAWS.

PAWS symptoms include:

  • Cravings
  • Mood swings
  • Depression
  • Cognitive problems (memory loss)
  • Sleep problems
  • Agitation
  • Anxiety
  • Sensitivity to stress
  • Sensitivity to pain

Because tramadol also influences serotonin in the brain, abruptly discontinuing taking the substance can, in some instances, produce psychosis. Tramadol-induced psychosis typically ends after a few days.

Tramadol Withdrawal Timeline & Severity Factors

Tramadol detox symptoms typically show up within a day of stopping the medication. If you are experiencing withdrawal, you may wonder: how long do tramadol withdrawal symptoms last?

The duration of tramadol detox of tramadol detox is unique to each person but can range from three days to several weeks. A client’s personal timeline depends on their dosage, tolerance, physiology and how long they’ve been struggling with tramadol use disorder.

Tramadol Taper

Physicians may choose to taper tramadol itself to ease the person off physical dependence. This means the withdrawal experience from tramadol may be milder, but the timeline will be longer, often taking weeks or months to overcome the body’s dependence.

How Is Tramadol Withdrawal Diagnosed?

A clinician would take a careful history of tramadol use and compare this to symptoms experienced. If the patient has taken tramadol for long periods or in high doses, they are more likely to be in withdrawal.

Usage coupled with opioid withdrawal symptoms like sweating, dilated pupils, nausea, vomiting, and a racing heart rate is a good indicator of withdrawal.

How Is Tramadol Withdrawal Treated?

If a person decides to stop taking tramadol after establishing a physical dependence, they are likely to experience withdrawal symptoms from tramadol. This occurs because the brain has grown accustomed to the substance and has adapted many of its processes to accommodate the presence of tramadol.

When there is a sudden absence of the substance of the drug, the brain has such difficulty adjusting that it triggers tramadol withdrawal symptoms. The primary goal of detoxification is to minimize the harm caused by the substance. Detoxification is accomplished through:

  • Evaluation — In this stage, medical, psychological and social factors are evaluated to determine the best course of action.
  • Stabilization — The individual receives medical supervision and psychological support to achieve a substance-free state.
  • Encouraging further treatment — Because tramadol detox is not a complete treatment for substance misuse, further treatment is recommended for sustained recovery.

Detox at Home or Under Medical Supervision

To safely detox from tramadol, it is best to remain under close medical supervision until the body expels the substance. Choosing to detox at home can expose an individual to many withdrawal-based dangers and severe detox side effects, including:

  • Hallucinations
  • Psychosis
  • Depression
  • Anxiety
  • Sleeplessness
  • Extreme sweating
  • Vertigo
  • Serotonin discontinuation syndrome

Instead of detoxing at home, a client should consider these options:

  • Inpatient Treatment: With 24-hour supervision, doctors and nurses can closely monitor tramadol detox symptoms and help make clients as comfortable as possible during their stay. Patients then address the reasons they started using tramadol in the first place through therapy and other treatment modalities. This method may produce higher success rates than at-home or outpatient programs.
  • Intensive Outpatient Treatment: While maintaining other life obligations like family, work and school, outpatient detox allows clients to attend treatment sessions for multiple hours during the day or evening.

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

U.S. National Library of Medicine. “Opiate and Opioid Withdrawal.” MedlinePlus, August 5, 2021. Accessed August 29, 2021.

Sidana, Ajeet. “Tramadol withdrawal psychosis.” Indian Journal of Psychiatry, 2019. Accessed August 29, 2021.

World Health Organization. “Withdrawal Management.” 2009. Accessed August 29, 2021.

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.