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.

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  1. Makayla

    I’m only 16 and was prescribed tramadol. I took 50mg 3-4 times a day for my pain. I have an enlarged liver, a folded pancreas, unaligned main arteries and intestinal malformation. The tramadol eased the pain but recently I ran out and a mix up with the local pharmacy has made it so I have had to go 2 days with out it.

    The withdrawals have been absolute hell. I’m furious with my doctor for prescribing such a young person this demon drug. What I find helps is if you have access to Netflix, before you fall asleep look up “Moving Art.” They have different kinds such as waterfalls, forests, oceans ect. The videos are only 25 minutes long and help with difficulty to sleep.

    Also laying down in a hot shower I found helped me tremendously. Lay on your back and transition what parts of your body feel too hot or too cold by switching what’s under the water and what’s not. This was the only way I came close to feeling somewhat normal through out the hell of these withdrawals. Good luck to everyone experiencing this. It’s awful but we’ll eventually all get through this

  2. Caroline
    queensland australia

    I First would like to thank all the people who shared their stories to help others like me. I have been wondering what was wrong with me….. I was in so much pain getting off this terrible drug and didn’t know it was the Tramadol at first. I have been soooo tired pain in my legs and hips so restless when trying to sleep. I then was crying every day and thinking suicidal thoughts…? I knew this is not me and did some research and found your comments thank goodness!! I’m on day 4 without them now and will persist despite the bad side effects and will never touch Tramadol again!!!

    • blest100
      United States

      I admire your determination and strength. Thanks for sharing, it motivates me to keep persisting through this

  3. John
    Waretown, NJ

    My wife has been on Tramadol for years for RA, at one time with Cymbalta. New Dr. started biologic drug. In the process of changing drugs, the insurance companies delayed treatment. Relied heavily on Tramadol for the pain management. No one told her of the problems with constipation. Ended up in the ER with impacted bowel. ER Dr. said to stop taking Tramadol due to the fact that it caused the constipation to occur. No one ever told her of the probability of bowel issues. Been off Tramadol since last Friday. Finally had to take one tonight. Hope she gets some rest. Been plagued by restless legs, chills and other stomach issues. There has to be a better way.

  4. Kristin

    I’ve been taking Tramodal 50mg 3XD for over a year. I’ve tried not taking them and I get so sick! I also have chest tightness and shortness of breath. I feel like something is choking me. I also get restless leg and body at night when I try to relax and sleep. This is hell!

  5. Pat

    I was taking 50 mg Tramadol after a hip replacement. I only took one or two doses a day. By the end of the first week I had sleep disturbances and weird dreams. I suspected it was from the Tramadol, so I stopped taking it. Fortunately, the sleep problems and nightmares stopped.

  6. Debra
    Calgary, Alberta. Canada

    I’ve been on Tremadol for over 2 years. Taking 200mg slow release. I decided I really felt no pain and went off them 5 days ago. I started zapping so bad, every tine I blinked or walked. It is horrible. I thought I had the flu. Nausea, vomiting , diarrhea , headache. I’ve Been crying feel absolutely horrible. Went to my dr and I am being weaned. 50ml 3x a day for 3 days. Then 2x a day for 3 days then I a day for 3 days. Also taking clonazepam to help with anxiety and sleep. Hope this works. I am only on day 3 and still zapping and feel so sick. Little did I know that this medication that was not supposedly not addicting would made my body totally addicted.

  7. Margie

    I’m 56 year old female. Was taking two tramadol 2 sometimes 3 times a day for about 5 years for back pain and knee pain. I started a diet plan using “Contrave”. The dose started 1 x daily worked up to 2 pills 2x daily. I read about it interfering with opioid and possibly tramadol ~boy howdy did it. Literally stripped the effectiveness. I had sever withdrawls. Diziness, nausea, sweating and I could barely walk I was so light headed. I ended up going to the Emergency Room because I thought it was stroke or heart related. My vitals and EKG came back normal. They sent me home with anti nausea meds. I will never take that medicine again!

  8. tina

    I was on 300 mg of Tramadol a day for for 2 years and I didn’t want to take it know more so they took me off it, and the hell began. Withdrawals were hell. So I was put back on them and weaned off. I had to cut down one pill every 2 to three weeks and I still got sick. It took me over 4 months to get off them. It’s been over a year I’ve been off Tramadol, but let me tell you the nightmares are still with me they didn’t stop. The doctor’s really need to let the people know what you are in for before giving it to us. Hope every one gets better soon. hang in there.

    • blest100
      United States

      Your strength is amazing

  9. Jen

    I have been taking about 20x 50mg Tramadol for three years now. I’m a 33 year old woman and I keep my addiction secret. I was prescribed after spinal surgery, and it really helps with the pain. But it’s ruining my life. I try to quit all the time, but the sickness is unbelievable. I think I will die I’m so sick. I sweat to the point that my clothes are wet. I shiver. I’m cold then hot then cold. Diarrhea. Confusion. Brain zaps. The worst is I hide away. Ive lost so much weight. During withdrawal I don’t even have the energy to wash. So I’m a mess. Help.

    • Jane
      Manchester UK

      Hello Jen in UK

      My heart goes out to you. I have been where you are. All you have explained has happened to me. I have weaknesses and daily battles. If you need to talk I would like to help. Not sure how we contact one another privately, do you?. Do not give yourself any challenges yet.

  10. Tammy

    I’ve been on the maximum dose of tramadol along with morphine and naproxen since I was 17;don’t think I’ll ever be able to stop because the withdrawal would kill me

  11. Jay

    Omg, I can’t believe this! I have been taking TRAMADOL for two yrs since two knee ops, I tried to come off and thought I was gonna die, ten days of chills, goose bumps, fatigue, crying, sickness, limbs so heavy I couldn’t move, Lost a stone in weight!
    I went back on them!
    3 a day 50mg
    I have asked the doctor to get me off them! But nothing, they just keep giving me them!
    I feel like am walking through sludge everyday, I am trying to work and I am so fatigued all I want to do is sleep, if I miss a pill I am in trouble! I start to feel weak, shiver! Skin hurts! I thought I was going mad, or seriously I’ll, I have upped my night pill to two, and now in the morning I can function! But I know what’s happening! My body wants two a time! By lunchtime I am completely beside myself with tiredness! I could cry as I won’t up the dose! So I struggle and hurt!
    I wish I never ever took these things! My life is in pieces!
    I have wondered if to take a week off work and go to bed and try to get off them!
    I need help!! Someone!!
    I won’t my life back!!!

  12. Chelsea
    St. Louis MO

    Hello, I am 25 and have Lupus and Arthritis and have been on a Naproxen and Tramodol regimen for three years now; among other meds. I take 1000mg daily of Naproxen (1 500mg tab 2x daily) and 300-450mg of tramodol a day depending on how bad the pain is (2 50mg tab 3x daily) a total of 190 tramodol pills a month, and if I miss my tramodol dose by even an hour or two the withdrawal symptoms start; severe hot and cold sweats, agitation, goosebumps, fidgeting, and restlessness. My doctor said that tramodol is virtually non habit forming and minimal side effects but they are wrong! I do have high levels of pain and the regimen helps tremendously but the tramodol is highly addictive and my body can no longer even function without it. I’m terrified for when the day comes to begin weening myself off the medication. When I got into a car accident not that long ago, someone hit me, I went to the ER and he prescribed me OxyContin and Valum and said I couldn’t take the tramodol with it. I began taking the new pain meds and immediately went into withdrawal from the tramodol, even while being on another pain medication, the withdrawal symptoms got severe. So I couldn’t take the new pain meds and had to suffer through the pain but for me the withdrawal symptoms were worse than dealing with the pain. I wish I never would have been put on the tramodol. Anyone that is going to be prescribed this medication PLEASE USE CAUTION AND BE WEARY OF THE EFFECTS.

    • Debra

      I have missed 4 days this week as I am being weaned off. I am such a crying mess that I can’t deal with people. Have been on the couch. Can’t do anything as I instantly feel dizzy and nauseous. This is definitely hell. Hang in there!

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