Opioid harms Seizures Serotonin syndrome Tramadol.Ĭopyright © 2018 Elsevier Inc. Our objective is to summarize the literature on the pharmacology, epidemiology, risk factors, clinical presentations, and evidence-based management of tramadol-related seizures and serotonin syndrome. Cyproheptadine should be administered in moderate to severe cases of serotonin syndrome. Serotonin syndrome and seizures can be effectively treated by administering benzodiazepines, providing supportive care, and discontinuing tramadol and other contributing agents.

Various risk factors such as medical comorbidities, use or abuse of supratherapeutic doses of tramadol, and concomitant administration of proconvulsant serotonergic cytochrome P-450 inhibitors will help clinicians identify individuals at an elevated risk for serotonin toxicity and seizures. The prevalence of tramadol-induced serotonin syndrome and seizures is modest in the general population, but if left untreated, the morbidity and mortality can be high therefore, prompt recognition and management is essential. Two such adverse events are serotonin syndrome and seizures. However, tramadol's serotonin and norepinephrine reuptake inhibitory effects result in a unique adverse effect profile. When used together, the combination provides better pain relief than either medicine used alone. Tramadol is commonly prescribed for pain control because it presents a lower risk for addiction and respiratory depression compared to other opioids. Tramadol and acetaminophen combination is used to relieve acute pain severe enough to require an opioid treatment and when other pain medicines did not work well enough or cannot be tolerated.

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