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. Some 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.

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  1. Melanie

    I’ve been on 50mg of Tramadol 3x daily for almost 2 years due to lingering symptoms of Thoracic Outlet Syndrome after the initial surgery to removal the cervical rib to correct it. When I called about my refill two days ago, having completely run out of the medication, my doctor’s office informed me that they couldn’t give me more and I would have to see a pain management specialist (most of whom are booked for months due to the recent legalization of medical marijuana in my state).

    I’ve basically been forced to go cold when this could have been avoided by my doctor telling me with the last refill that I would be done, so I should wean myself over that month to decrease the withdrawal effects. The fatigue is terrible and my arms feel like they weigh a ton but they burn and itch and ache and I can’t hold still or it gets unbearable. As the day goes on, I can feel it getting worse and I’m getting the shakes as well. I feel like a junkie and I am so angry at my doctor for not warning me when I was initially prescribed this for pain and for not giving me a heads up about the prescription not being renewed. That is just careless.

    • Melanie

      *remove, not removal.
      I’d like to add that I experienced no negative side effects while taking Tramadol and it did take the edge off the nerve pain and muscle spasms. However, I don’t think that relief was worth the withdrawal and I’m only 2 days in.

  2. Alf
    Salford England

    Been taking Tramadol for six months because of a shattered wrist, decided I didn’t really need them any more (no problems with the wrist) due to the lack of ongoing pain . Stopped 2 days ago (on 200mg per day) sinc then Iv’e had hot flushes shivering had no real sleep for 2 night , feel lousy all day. The last time I saw the doctor ,he called Tramadol “a dirty drug” now I know why . I will have to ask him just exactly these symptons will last.

    • Matt

      Hello Alf,

      I have been addicted to this medication for five years. I have taken up to 20 50 mg pills a day at different times. I was cut off abruptly on June 20th as my supply was intercepted by the postal inspector. There is a good possibility that I may have legal consequences now.

      My last dose was 5 50 mg tramadol on June 20th. It is now day number three without them. I went to my family doctor and he prescribed me some Vistaril which seems to help with the anxiety. I have muscle aches, no energy, and find it difficult to work.

      I am hoping the worst of the acute withdrawals are peaking now, and I’ll have more energy next week. It’s been a shock to my system, but so far the withdrawals are not extreme as I thought they would be. Good luck to you and everyone else withdrawing off this nasty drug.

  3. Gigi

    I have been on 100mg of Tramadol for 18 months to help lower back pain. During this period I had my gallbladder removed which certainly was needed but I knew little about the after effects. Some of the problems included constipation, gas pains, occasional nausea which I also confused with the Tramadol problems. With the Doc’s OK, I decided to decrease slowly the Tramadol and I actually feel better. I am less fatigued, have a better appetite and with the help of enzymises the constipation is not a problem. I want to be off 25mg by the end of the week.

  4. Liz
    Corona, Ca.

    I started to take it for my shoulder, and it gave me false energy. So I desired to stop, I started today to take one pill, going to workout for one hour of Zumba. My doctor said three a day, .50mg . Loss of sleep, appetite, sweating. I’m 66, don’t want this pill, I have forgotten to take it and came home sick. So tomorrow 1/2 tablet for three days, then I’ll break it again to take it 1/3 for three days, and go through the sweats, sleepless, tiredness, and whatever. But I’m done with tramdol. Going back to naps.
    or my shoulder, tramdol is bad very bad. I’ve been on it for two years. But three than two, and I’d forget, now one…….let you know how it goes. Thank you and good luck, I’ll pray for all of you. For me, it gave me false energy. DONE

  5. Angela
    North Carolina

    I had been prescribed Tramadol for arthritic pain and was taking 400mg for about two years before had my hip replaced. My discharge instructions were to discontinue my use of this medication. About 3-4 days after discontinuing I started noticing stomach issues (diarrhea), night sweats, mood swings and lethargy. I investigated myself to see if these issues could be due to the discontinuation of Tramadol. Low and behold I found multiple articles about withdrawal. When I notified my orthopedist about what I was experiencing his response was “It could be from the surgery and/or the medication. Taper yourself off of it over the next couple of weeks.” Why wasn’t this taken into consideration when I discharged? Why wasn’t it monitored by them? No clear instructions on HOW to taper off. Physicians who prescribe this medication should be more careful about instruction and monitoring their patients when they decide to stop use of it. It has. Even two weeks now and I’m still having the sweating, some stomach discomfort, episodes of depression and lethargy. I hope that this will end soon as I have to return to work in another two weeks.

  6. JoAnn

    Thank you. A thousand times, thank you. I had been on 100-200mg of Tramadol for just over a year. I would take it as needed so I would skip a day or two if the pain was bearable. I am a recovering alcoholic with bipolar disorder so I try to be careful not to get too attached to any kind of opioid-type pain killer. This is why my doctor prescribed tramadol in the first place. Said it was ‘safer’.

    Last month my psychiatric doctor put me on Wellbutrin but it seemed to make the symptoms worse. I stopped taking the Tramadol because I figured it would mask my symptoms and only make things worse. NO DOCTOR ever mentioned not to stop Tramadol cold turkey. My script was for 50mg 4 times daily but I usually only took one or two except when I hurt my back badly last year. I use it now for pain related to my ever-worsening Psoriatic Arthritis but since I was using a much lower dose I didn’t think too much of just stopping completely. Then all hell broke loose, and I do mean hell.

    I have been in an almost constant state of psychosis with auditory hallucinations, invasive thoughts, delusional thoughts, irrational behavior etc. I refer to it as my descent into madness. Because I am bipolar everyone assumed that this was just a really bad manic episode and maybe the Wellbutrin played a role. But I have been bipolar since I was 15, and I am 60 now. I had never experienced anything this extreme before. I never had hallucinations of any kind. Honestly, I was not going to tolerate this much longer. I am like a distant observer to my own life without the ability to stop anything.

    Then I read this article, and now I have hope. There is no guarantee that Tramadol withdrawal is the source of my psychotic symptoms but, lo and behold, I took a Tramadol a few hours ago, and I am able to think clearly enough to write this. I’ll contact my doctor about how to proceed, but honestly, I don’t have a lot of confidence in a doctor who puts me on this stuff without any warning or instruction regarding potential problems. Yes, I should have checked online myself but being out of your mind tends to inhibit sensible thinking.

    So thank you soooo much everyone. I am not exaggerating when I say that this article and the stories may very well have saved my life.

  7. Mike

    I’ve been taking 300mg of tramadol for almost 14 years. I’ve decided to get off this evil stuff and from what I’ve read on this forum, I expect withdrawals will be brutal. I started taking it after lower back surgery. Within a year I discovered Tramadol was an effective anti-depressant. When I told my Dr I wanted to take it for its anti-depressive benefit, he didn’t even know that it could be used for that purpose. Now I’m at a point where I can’t take any more than 200mg per day and only one in the middle of the night for the leg and arm twitching. I appreciate all of your comments and advice. We’re all going to pay the price it seems. I’ll try to update my progress, if I can. Thank you all!

  8. Marcos

    Hey guys!

    I was on tramadol for three months contiusly lunatic crazy amounts more than 2000mg a day and to be honest they helped me a lot and kept me happy and energized the whole day, helped me a lot with my stressful job and everything was normal sleeping well eating well and always motivated until a week ago the magic stopped and I used feel sick when taking them I used to dose 5 x 100mg pills at a time 4 or 5 times a day.

    Anyways I reached to a point where I know I’m only harming my self and I should stop taking them and its been 4 days tramadol free. The first two withdrawal days were mild awful but what helped me more was all in my mind stayed positive as much as I could and I know its only matter of few days and I will get my normal life back.

    My only problem now is fatigue and I pray to God to get over that in few days.

  9. dg

    I had been taking 50 mg once a day of Tramadol for 4 years for chronic back pain. It started to be less helpful so I increased to 75 mg. (cut a 50 mg in half) 2 years ago.

    If I forget to take the Tramadol, I feel weak and listless with extreme fatigue. Now, after taking the 75 mg for the past 3 years, it no longer gives me the same relief.

    Interestingly, after about 3 hours of taking it, I would feel better emotionally – less depressive thoughts and a surge of energy. For this reason, I would hate to stop it b/c I am so depressed and lethargic most of the day.

  10. Glfngrl

    Have taken Tramadol, 50mg once a day in mid-afternoon for about 4 years, for restless legs. It does a great job and has allowed me to remain at a low daily dose (0.5 mg) of Requip at bedtime. However, for several months now, often experience severe fatigue an hour or so before time to take the Tramadol. Within 30 min. of taking it, the fatigue starts to dissipate. About 10 days ago, I began a tapering off schedule, beginning with 3/4 of the tablet, but adding a half dose of Requip (0.25mg) along with the reduced Tramadol dosage. Noticed fatigue level earlier in day, and somewhat exacerbated. Yesterday, reduced T. dosage again, to 0.25 mg, and kept same Requip regimen. A couple of hours before regular time for the meds today, extreme episode of fatigue – arms and legs heavy & weak, breathless feeling. Took meds, fine within a few minutes. Am having more severe RLS problems since I started tapering, but hoping that will gradually lessen once I get Tramdol free. My GP assured me that 50 mg of Tramadol/day would never cause any problems, but the slowly increasing, daily fatigue is not acceptable … having become leery of it from all the worrisome examples of withdrawal.

  11. David
    Boston MA

    Took Tramadol (100 to 300 mgs/day) for fibromyalgia pain/associated depression for seven, consecutive years. Worked like a charm; pain suppression with no soporific side effect and several nootropic effects (increased alertness, focus, fatigue suppression, and appetite suppression). Tramadol was a godsend (for me).

    I would still be taking it, but, due to rescheduling by FDA/DEA, prescriptions must now be renewed monthly (written Rx and mandatory office visit/ evaluation). The insurance company was unhappy that they now had to pay for 12 office visits/ yr. Dr./ insurance company decided to wean me off “opiate” due to increased regulatory scrutiny, “off label” Rx, and associated costs. I was forced to wean/ withdraw from Tramadol and have been “Tramadol-free” for 3 months.

    My withdrawal symptoms were relatively mild compared to some of the comments reviewed, but they have been protracted. Since I was gradually weaned, I did not experience the “zaps”, but have experienced the loss of the nootropic effects and, most profoundly, the targeted pain suppression effect. I have also experienced chronic coughing, intermittent sneezing, and emotional disinhibition (e.g. rapid onset anger when frustrated, impatience, crying, etc.). This is not “normal” behavior for me. These symptoms have persisted for a disturbing long time (12 weeks and counting).

    I am now forced to live with chronic pain/ depression because of regulatory forces beyond my control. Dr. has attempted alternatives with no success to date. The “alternatives” (Lyrica, Effexor, Cymbalta) have not been effective and also have associated withdrawal attributes; but as long as they are not scheduled as “narcotics”, he is not reticent to prescribe them. I am dismayed that the regulatory pendulum is preventing me from receiving the one medication that I have found entirely effective.

    • Stephen
      Sebring, Florida

      Tramadol Withdrawal: Day 8

      Anxiety, mood swings, irritability. ✔️
      Brain zaps (shock-like sensations), tingling
      Sweating, chills, goose bumps, shivering✔️
      Insomnia, sleeping difficulties, ✔️✔️nightmares✔️✔️
      Flu-like symptoms✔️✔️
      Nausea, diarrhea, loss of appetite
      Hallucinations, unusual thoughts✔️✔️✔️
      Other than the flu like symptoms, irritability, sweating, rash like symptoms, sleeplessness, restlessness, and weird mini dreams I’m good

    • Shirley
      New Zealand

      I sympathise with you David as I have found Tramadol along with ibuprofen and panadol are a godsend for the back pain /fibromayalgia I have for about 2 years. Nothing else has worked for me and I have few side effects. But if I go 12 hours without pain relief I can end up in a ball of pain and unable to function. I can suggest warmth of a heated towel, wheat sack, hotwater bottle, bath or spa to get through some bad times and work on a mixture of less potent pain relief. Strangely, an antihistamine, along with anti-inflammatory medication and panadol has worked at times – all the best with efforts to relieve pain. My sister swears by marijuana if it is legal where you are. Cheers

      • Terry Graedon

        For US readers, “panadol” is acetaminophen.

      • Lee

        I am from a state that has legal marijuana. I tried that for my back pain. I found it to be much stronger than in the 70’s and the more you use the more and more you need to buy. I got off that merry go round. It is very expensive. I hate the effects Tramadol has on my body. I am getting off it and plan to use vapo rubs and hot showers and heating pads for my back and shoulders. I cannot handle this fatigue, sweating, loss of appetite and lack of motivation anymore. It is going to be rough but I have no choice. I used Percocet which helped greatly and much better than Tramadol. I was not an abuser but I have to be punished because ridiculous regulations! I used 1-2 a day and only if needed. Punish the good ones. It just is not fair! I think they can submit to blood tests if there is a suspicion.

    • Robert E. H. III

      You said you had to quit using your Tramadol due to the medications move into Schedule IV of The Controlled Substance Act Of 1970. A Schedule IV medicine does not need a new written prescription each month as I am on Tramadol. Schedule IV allows a 6 month supply (written 30 day prescription + 5 refills). Only 2 doctor visits per year for me. I do not have to see my doctor every month as you have stated. Schedule IV allows 6, 30 day supplies per written prescription, however you only have six months to use the 5 refills before the prescription expires. But monthly visits are not necessary nor required by any law. This is a choice your doctor has made in spite of the regulations for whatever reason I cannot say as I do not know. My advice to you if you need the Tramadol and it helps you, then see a different Physician because you only need to see a Dr. twice a year for Tramadol HCl (C-IV). My doctor gives me my new bottle every 6 months with 5 refills, no problems.

  12. Aaron

    I was taking tramadol 50mg for a week stopped taking them cause I have had opioid addictions in the past and it was giving me similar experiences like nodding out and vomiting I stopped taking them and felt like I worked out for 50days straight and also was heavily angry and depressed to the point I actually lost my job because I was agrees I’ve to a fellow employee. Horrible withdrawl I’d rather deal with pain then ever have to take those nasty things again.

  13. Jan Macnab

    I have taken Tramadol for weeks 2x50mg at a time – 2/3 times per days before my back surgery and now three weeks after surgery have tried to reduce it and I have been out of my mind through lack of sleep – depression – and most of the other withdrawal symptoms listed. No GP or consultant warned me this would happen when I tried to stop them a,though consultant did say gradually decrease them. I think I tried to reduce them too quickly but the quicker I get off this awful drug the better as I cannot sleep with restless legs and lack of sleep is making me so depressed.

    • John

      Thank you I am in identical situation as you as sleeping and feeling sick is bad, how long did you take to normalise.

  14. Tony
    Lavergne Tn

    I am so glad I came on here and read everybodys thoughts on this Tremadol addiction, I was on Percoset 10s for 2 months, then my dr lowered it to 7.5 for a month then 5.35 for 2 months, I just started taking Ibuprofon 800 just yesterday morning….I couldn’t sleep last night for more than 10 minutes at a time and found myself sitting up and couldn’t sit still to save my life. I at first thought it was the ice cream and brownies I had ate a few hours before I went to bed. I then proceded to the couch to watch TV at 1am and fell asleep for a bit and woke up to what I felt was a body slam and it freaked me out…I final fell back asleep again and BAM another body slam, I sat awake until I finally got back to bed in my bed and all night till day break no sleep and a feeling of being tired but couldn’t sit still, constantly uncontrollable movement of my legs and arms….I’m up now and it is after 10am and feeling like I need to stay busy and I have feelings like I am worthless and no concentration…I wish I had someone to be with me just to keep me occupied….I hope this don’t take long to get through my system

    • Glfngrl

      Hope your Restless Legs are much better by now….if not, see if your Dr. would prescribe the lowest doseage of Requip available to help.

      • John

        I am on the third day and feel exactly as you did, have you recovered and any recommendations

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