stressed out woman pulling her hair

Doctors love tramadol (Ultram, Ultracet) because it is perceived as safer than narcotics like hydrocodone (Lortab, Norco, Vicodin, etc.) or oxycodone (Oxycontin, Percocet, etc). Many prescribers are unaware of the withdrawal reaction that can occur when people try to stop tramadol suddenly.

There is a sanitized term for this extremely disorienting condition: “discontinuation syndrome.” It does not begin to describe what some people go through when trying to stop tramadol. At last count there are over 300 comments about this problem with this article. SomeĀ are truly hair raising. To read them all, click on the box at the bottom of this page labeled “Older Comments.” But first, the question that started this thread:

Q. I have been taking Ultracet (tramadol) for several years for back pain. I was taking 100 mg three times a day as prescribed. The pain is better and I tried stopping the tramadol and had a terrible reaction.

I went to my internist who advised that I stop taking the tramadol over a period of time. I am now taking 50 mg three times a day but cannot get any lower than that without experiencing nerve twitches in my legs and intense jitteriness that interferes with my sleep.

Have you heard of similar problems and do you know of any way to alleviate the withdrawal symptoms without getting hooked on another medication?

A. Tramadol (Ultram, Ultracet, Rybix ODT, Ryzolt) is a strong pain reliever that was originally thought to have opioid-like activity without the same potential to cause addiction as morphine or similar narcotics. To quote the “experts,” tramadol was thought to have a “low potential for abuse.” In other words, it wasn’t supposed to cause physical dependence or produce a “withdrawal syndrome.”

It turns out the drug is a lot more complicated than many experts first believed. In addition to its analgesic action via opioid receptors in the brain, tramadol exerts a profound effect on other neurochemistry. That means that brain chemicals like serotonin and norepinephrine are profoundly impacted by tramadol. Sudden discontinuation can bring on a host of symptoms including:

Tramadol Withdrawal:

  • Anxiety, mood swings, irritability
  • Brain zaps (shock-like sensations), tingling
  • Sweating, chills, goose bumps, shivering
  • Tremors
  • Headaches
  • Insomnia, sleeping difficulties, nightmares
  • Flu-like symptoms
  • Nausea, diarrhea, loss of appetite
  • Depression
  • Hallucinations, unusual thoughts
  • Aggresiveness

Some of these symptoms may persist longer than many health professionals realize and there is no one-size-fits-all tapering program. People vary greatly in the way their bodies adapt and recover. It may take several months to gradually wean yourself from tramadol. You should not attempt this on your own. A health professional who understands the complexity of the drug may be essential.

Many of the withdrawal symptoms associated with tramadol are reminiscent of those linked to sudden discontinuation of antidepressants like sertraline (Zoloft), paroxetine (Paxil) or venlafaxine (Effexor). Symptoms can include dizziness that will not quit, brain “zaps” or “shivers” that are a bit like electrical shock-like sensations, sweating, insomnia, headaches and difficulty concentrating. Read stories from readers who tried to get off antidepressants like duloxetine (Cymbalta) at this link.

The FDA has not provided physicians with clear guidelines on how to phase off such drugs. We frequently see recommendations like “gradual withdrawal,” but no one bothers to provide clear instructions about what that really means. We’re really sorry that we don’t have any great insight on this process either. Readers have shared their own solutions at this link.

Although many people can relieve their acute or chronic pain with tramadol, here are some symptoms to be aware of while taking this medication.

Tramadol Side Effects:

  • Nausea, vomiting, indigestion, diarrhea
  • Constipation
  • Headache
  • Drowsiness, dizziness, fatigue
  • Restless legs
  • itching
  • Dry mouth
  • Sweating, flushing
  • Loss of appetite
  • Difficulty sleeping, insomnia
  • Skin rash
  • Serotonin syndrome

Please note serotonin syndrome above. This can be a life-threatening situation and can be precipitated if tramadol is combined with other medications such as “triptans” prescribed for migraine headaches or antidepressants that affect serotonin. ALWAYS check with a pharmacist about the drug interactions before combining tramadol with any other medication. To learn more about serotonin syndrome, click here and here!

Share your own tramadol story below and please vote on this article at the top of the page.

Join Over 90,000 Subscribers at The People's Pharmacy

Each week we send two free email newsletters with breaking health news, prescription drug information, home remedies and a preview of our award-winning radio show. Join our mailing list and get the information you need to make confident choices about your health.

  1. Bill

    Have been on Tramadol for 3 years, for back and neck pain. My script says 1 tablet every 12 hours AS NEEDED. That’s the key word. I take it every day to prevent any pain and exceed the prescribed dose, so that makes me an addict. Never dreamt I’d become so addicted to a drug, and I’m ashamed. I’ve been off it for 2 days, and have been using gabapentin. It seems to be helping (Praying it will). These pain killers are a nightmare. I’ve gone off it before and the withdrawal is scary. Going to talk to the doc about weaning off both. I’ll just have to live with the back/neck pain…somehow. theyve told me surgery is not an option.

  2. Paula

    This information is valuable. Please know that after the pain of withdrawal it gets better. If you can make it a few days (safely, of course) you’ve got it!

  3. Lynne
    New Zealand

    Hi All
    I only found this site yesterday morning after thinking that I may be going through Tramadol withdrawal!!
    I have been taking Tramadol for 2 and half years after getting very sick with acute pancreatitis and hospitalised. First, I have been a chronic pain sufferer for just over 30 years because of treatment for back injury that went horribly wrong then urgent spinal surgery was required, which also went wrong!. More on this if anyone is interested.

    But to cut a long story short I have always been terrified of medications and distrustful of doctors because so many lied to me over the years. I was on liquid morphine for 10 years: would not take the slow-release because I wanted to be in control and only took what I needed when I needed it. After being admitted to hospital for the acute pancreatitis they decided to add Tramadol to my mix of meds and, being too ill to protest, I took them. I did not realise that this medication was making me feel sick and have hunger-like pains a couple hours after taking it as I had not eaten for 2 weeks. But I was able to withdraw easily from the morphine 2 years ago since I had already reduced the doses previously and never ever, in all these years, have I suffered any type of withdrawal symptoms until now.

    I am at day four of cold turkey withdrawal from Tramadol, not realising that you can even get withdrawals until reading this site yesterday.

    I rang my doctor immediately and went in yesterday afternoon. He confirmed that indeed it was withdrawal symptoms and tried to get me to go back onto them and reduce slowly. I did not want to do this and stated so. My pain levels were higher again plus mobility was less. The doctor gave me Panadeine to see if that helped pain levels and, so far, today I feel better than I have for last four days. I managed to get about 4 hours sleep early this morning after 2 sleepless, disturbing nights. I plugged my MP3 player into one ear on low, taking my mind off things and hoping to relax me more. It worked.

    I am so scared that if I get off the Tramadol now, I will loose what I have gained the last 2 years mobility-wise and go backwards again. My distrust in doctors has returned. I was stupid for not checking the side effects of Tramadol when released from hospital and blame myself most of the time but still feel I should have been told what may happen with this medication, plus the problems of stopping it. I reduced the doses down to 2x 50mg instead of 3 a year ago because I found it was causing sleeplessness and horrible nightmares. I told my doctor, nothing was said about reducing it more or anything about stopping it.

    I feel for all of you going through withdrawal from this terrible drug and its symptoms, and if I had not been so sick I would have refused it, as I had done since it came on the market. Hang in there. The withdrawals get better each day. At least each day is better for me, and I know everyone is different. I am functioning better this morning than I have for 4 days and am not as tearful.

    The doctor actually told me yesterday that not many people can tolerate Tramadol, so I ask WHY is it the drug of choice given by hospitals and doctors. Is it for money for the pharmacy producers???

What Do You Think?

We invite you to share your thoughts with others, but remember that our comment section is a public forum. Please do not use your full first and last name if you want to keep details of your medical history anonymous. A first name and last initial or a pseudonym is acceptable. Advice from other commenters on this website is not a substitute for medical attention. Do not stop any medicine without checking with the prescriber. Stopping medication suddenly could result in serious harm. We expect comments to be civil in tone and language. By commenting, you agree to abide by our commenting policy and website terms & conditions. Comments that do not follow these policies will not be posted.