stressed out woman pulling her hair

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 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). 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.

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!

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  1. Joni

    It’s good to know I’m not the only one experiencing this!
    Was put on Tramadol 3yrs ago for pain relief due to Fibromyalgia & severe menstruation pain. I started off on 50mg 3 times a day & it did seem to work but not for long so they upped my dose to 100mg twice a day plus 50mg 3 times a day. Again it worked but not for long so they took me off the 50mg & increased my 100mg & told me to take as much as needed including taking 2 400mg ibuprofen with every Tramadol capsule.
    Fast forward & I tell them it has stopped working they insist I come in to see them to discuss an even higher dosage. I refuse so they then refuse to renew the Tramadol prescription unless I come in to see them.

    Instead I took this opportunity to take myself off of them thinking I wouldn’t have any symptoms. Like hell I don’t! Didn’t even realise it could be withdrawal symptoms until last night after suffering for the last two weeks with what I thought were flu symptoms combined with a fibromyalgia flare up. How wrong could I be! I’ve had a migraine for the better part of a week I’ve had no energy & no urge to do anything the entire time.
    They never told me this shit would happen.

    I have an autistic son who needs me & a hubby who works long hours to provide for us.
    I can’t go back now knowing what it does to people but I’m suffering.
    I’m so glad I found this site.

  2. karen

    Started this weekend,hate it but it’s time. Suffer from back pain but started med due severe menstrual cramps. I’ve done this before,it’s not fun but it’s doable. Diphenhydramine helps a bit,for a no prescription choice. I’ve treated my symptoms as I would a cold. As adults I truly believe we should conduct ourselves as such and not look to place blame on others. All medications have side effects and should be approached with caution. Every thing,just about, has the potential for dependency; caffeine,sugar,nicotine,alcohol,the list goes on; and are perfectly legal. Approach a problem,seek solutions,choose what suits you and be patient and determined. No one needs government in their lives. Good luck all.

  3. Sheryl

    I am so glad that I found this website! I have been taking Tramadol since about 2002. I ruptured a disc in my neck lifting weights and ended up having to have it repaired surgically. I was prescribed Tramadol 50 mg as needed up to 400 mg per day. I started out taking 50 mg 3 times per day and it worked great. The doctor that originally prescribed it said it was a very mild pain reliever with no side effects. Fast forward a few years and I started having severe knee pain. I was diagnosed with severe osteoarthritis and had my first knee surgery in 2005 at the age of 45. Between 2005 and 2015 I have had both knees replaced and one hip. I have arthritic pain in my other hip, both shoulders and my lower back. I have taken the Tramadol along with Diclofenac all these years and the combination has worked well to relieve my pain and allow me to live a normal, productive life. I am up to 350 mg of Tramadol per day now. I have asked both my orthopedic and internal medicine doctors numerous times if I need to come off the Tramadol and they both told me it was fine to take it as long as my blood work is good (checked every 6 months). The reason I looked up withdrawal symptoms on the Internet is because like many of you I have always been able to get my Tramadol prescription filled a little early. I called my doctor last week and asked for a refill because my prescription will run out before my next 6-month appointment (in 2 weeks). Well, I got a call back from his nurse saying it was too soon and that I must be taking too many pills if I am almost out. I was furious! First of all I am not completely out and secondly I thought this stuff was safe to take long term! I have never taken more than prescribed. So it got me to thinking that maybe I should try to stop taking it. I took only 50mg on Thursday and Friday and today I am feeling like crap(day 3). I ended up taking 100 mg today just to be able to function! The thing I notice the most is the feeling of doom and gloom. I also have the hot/cold feeling that is miserable. My feet are freezing but my upper body is sweating profusely. I do also have some tingling in my lower legs but I’m used to that after 2 knee replacements (the last one was just 4 months ago). I am so angry at my doctor!! I moved up my appointment to next Wednesday and he is going to get a piece of my mind. I am also going to tell him to read the posts on this website and maybe he will think twice before prescribing this highly addictive drug in the future! No doubt I will have to have his help to get off this stuff. I work full time and can’t afford to miss work while trying to detox! I feel stupid for not being more proactive about my health. But when several different doctors tell you over and over that a drug is safe you believe them. The more I think about it the Tramadol may be causing problems such as my lack of energy and being irritable. I blamed most of that on menopause and have been getting hormone replacements trying to deal with those issues. Hopefully getting off the Tramadol will improve my health overall! Again, I am so glad that I found this website because it has given me plenty of information to throw at my doctor next week. Good luck to all of you that are going through this nightmare!

  4. Anastasia


    I am not easily addicted to anything, quit smoking easily, quit antidepressants easily, etc. but I’ve only taken Tramadol two days, and today I’m off it and I couldn’t get out of bed!
    My fluffy black kitten who I love so much now irritates me more than anything, everything irritates me. I’m so ready to punch something.

    However, everytime I get any hyped up emotion my whole brain hurts. When I calm down my headaches stop for the moment but it still feels really weird and uncomfortable; all I want to do is down a couple more pills.
    I’ve hidden them from myself and I’ve taken a Lisinopril to help with high blood pressure which seems to be helping me calm a bit. Tramadol feels good for 8-12 hrs and then messes you up twice as long.

    Vicodin never left me a wreck like this.

  5. Bob
    United States

    Been on tramadol for separated hip (gotta love drunk drivers) for 4 years (100mg, 3x daily). Had a procedure that lessoned the pain, so began taking “as needed” per perscription, usually 2 in the am, then anywhere from none to 2 or 3 depending on activity. First thought I had the flu, then experienced 5 of the symptoms described above. Went back to full dosage, all went away. Due to kindey issues I can’t take anything that metabolizes in the kidney, including opiods, tylonol, asprin, ibuprofin etc. Now faced with a lifetime addiction at full dose that I don’t need for pain, or a lifetime of pain without painkillers (other than alcohol, with it’s own dangers.)

  6. Tina

    Hi just would like to tell you about a bad experience I have had, I have been on tramadol for nearly 12 years due to a bad accident I had at work, I on my own accord to decide to come off the tramadol. I was on 400mg 8 four times a day I started by stopping 1 (50mg) for 2 weeks then down to 7 a day for 2 weeks, just at the end off that 2 weeks I had a doctors appointment for another medical reason, my doctor just asked me how I was getting on with weaning of said “it was going well” he then said “I want you to come off them completely, I want you to take 5ml of morphing when you would be due to take the tramadol”

    I was really weary but thought doctor knows best, well that was on Tuesday by the Friday I started feeling really ill felt so nausea it wouldn’t go I felt like I was on a fair ride, I felt so down I could not sleep, I never felt so ill in all my life, by the Sunday evening my husband said perhaps it could be withdrawal symptoms I said no it probably the flu as thinking no way would a doctor tell you to do what he told me to do when it’s a dangerous way of doing it when you put your trust in your doctor, well a hour later I when and took just one tramadol with in 20 minutes it all went I felt like dancing on the table, so on the Monday morning I phoned the surgery and asked to talk to a doctor and to make the story short I spoke to another doctor, he replied you never go cold turkey on that sort of medication, he told me to start taking them as normal and do it the way
    you was doing it, I’m sure that the other doctor will be having a talk too, so the reason I am writing this is to let other people know never do it the way the doctor told me.

  7. sasha

    Dose off very slowly I had to do that off of xanex it took me three months to dose off xanex they actually put me on klonopin because its longer acting to fill the gaps take the total mg u are taking and take an 8th or even a 16th of the pill away by cutting it. If its cuttable. Do that for a week then try to cut down one more 8th or 16 th of a pill every week do this til u have stopped if the pill is every six hours continue taking every so hours but make sure u just cut the dose down a very small fraction. Watch for fast heartbeat and know that this works any other way I would have hallucinations and almost have a heart attack until a doctor helped me she told me to cut it in Half but that didn’t work so I did much smaller … I’m drug free except for the fact that I hurt my hip with sciatica and went to the doctor and asked for a non addictive rx and he gave me tramadol. I noticed it was addicting right away so here I am getting off I week two very slow because I had withdrawls that quickly. I cut an eighth off for three or four days now I will be cutting back a 1/4 of a pill and hopefull be off this thing in a couple weeks … Never again. How could a doctor prescribe me addicting pills when I told him not to? To a mother of a two year old. High five to him. I asked him if he knows for sure as I looked him in the eye that its not physically addicing and he said no.

  8. Gregg

    I had a life threatening disease. Not expecting to live over one year. After surgeries My organs started to fail. Regardless, 6.5 years heavy morphine use, then switched to Tramadol.

    12 years later I am ready to stop all drugs. Not sure if I can now or not. 300mg Tramadol daily 4 years.

    So far this is my experience.

    300mg. to 50mg for a week or so. Very sick!
    0 mg. for 17 days. Not much better. I am getting some sleep now, but not much.
    I never got depressed? Just felt extremely bad all the time.

    At this point I have given up on a daily feel better view. Realistically, I am thinking (hoping) 3-6 months will be a more accurate time line.

    17 days out, one day I will sleep some. The next day all withdrawal symptoms return in full force.

    I hate to paint such a gloomy picture, but the reality is (for me) it is going to take months.

    Even at 50 mg. / day you are still going to be going threw some rough times.

    If the withdrawal systems do not go away in one month. I am going to go to my doctor and see if I can get some relief. Also, I am going to talk to a lawyer about this.

    IMO it is threatening my life. No sleep is very bad for the immune system. It is throwing all my hard work on staying alive down the drain. And I am not in good shape. If I die, I want them held responsible.

    My story so far, regards.

    • Wyatt
      United States

      Ive been taking Tramadol for 3 and on. This last time almost killed me. I go days without sleeping. I stopped 2 full weeks ago and still only sleep every other night. And only with a sleeping pill. Has this ever caused permanent damage? Anyone know? I don’t even get sleepy anymore.

    • Azman

      I just posted and found that I have similar tapping method and maybe by 2 days time to detox. Anyway GREGG it’s gd to hear that u have gone past the critical stages and thumb up bro. I don’t know yet of how tram reaction on me.

  9. Leslie
    Jacksonville florida

    Thank you all so much for your posts.
    I am trying to stop the Tramadol.
    I can’t stop crying and sweating… I am in and out of the bathtub- but can’t regulate my temperature.
    I can’t sleep well and am anxious and agitated.
    I am 50 year old women who had to have a hip replacement.
    I am 2 or 3 days in, trying to stop taking this drug!
    I have been taking 50mg every 8 hours totaling 1-3 a day for about 5 months.
    The pills begin to stop working as well and I was having side effects.
    I decided to stop taking them.
    I am hanging in there but scared.

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