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. Nicola

    i found tramadol over the counter in Mexico and thought it to be awesome ….
    Until , I realized I required them dependent like. Now I am plane old sick of being medicated and stopped with minor discomfort . Scale 1-10
    I will say 5 for withdrawal .

  2. Niia

    Hi everyone! It has now been a full day since I’ve stopped taking the tremadol. I ended at 50 mg once a day and then I completely stopped. The only symptom I’m having so far is constant sneezing and being unable to sleep. I was taking tremadol for only 4 months! After reading every posts I kinda hate that I even started taking it! I’ll keep everyone updated as the days past! Hopefully my withdrawal symptoms are manageable because whether they are or not I will NOT BE TAKING TREMADOL AGAIN! So let the suffering begin

  3. mary

    I am 9 weeks off of Tramadol. I started taking it 3+ years ago, after getting off of oxycodone and morphine for back/tailbone pain. The doctor assured me it was not a narcotic, but it got moved into that Schedule about a year later. I was taking 50 mg. 4x daily, down from 8x daily 2 months before. The withdrawals were fatigue and constant sneezing, so I went cold turkey after tapering down to 2 for a few days. OMG! I did not sleep for 3 weeks unless I drugged myself with either Lorazapam, Benedryl, or Tizanadine, along with Gabapentin, and only then for an hour the first week, and maybe up to 3 or 4 hours by the third. The brain zaps were unbelievable, like fireworks. I finally stopped the torturous cough (OTC cough syrup with DM really helps) at about 8 weeks off. My doctor prescribed something for restless legs that helped too. Someone called it the Devil Drug, and they were right! Oxy was much easier to withdraw from than Tramadol.

  4. vince c
    United States

    Can anyone answer my question\? I have been taking tramadol for about 2 years but all together before I got clean about 10 years I have recently been experiencing needle like symptoms numbness and tingling on my left side and back area why is this happening? I know I shouldn’t be addicted to them again but please someone give me advice!

  5. Cindy M. Black
    Seattle, WA

    Good Grief! Thank you, Peoples Pharmacy. I take no Rx meds and can’t imagine what horrible circumstances it would take to make me start. Every one of ’em has serious side effects and/or nasty little surprises like in this story. You are doing the public a huge, huge service by warning about stuff like this. It is certainly more than most doctors would (could) do.

  6. Caroline

    I must say it is rathr destirbuing when you read what people are going through the withdrawal of tramadol I have only been taking it for 14 days and I have to stop, the vomiting and loss of appetite it terrible I have lost 12lb in those days can’t eat being sick bringing up just water tha nausea is horrendous and that just 14 days when people have been on this for months and years I have stopped and an suffering from most of the symptoms you get with withdrawal but I will put up with this till the he’ll is over I pity the people who have a longer way to go we have to weigh up what is important yes we want the pain to go away but at what cost it ain’t worth it.

  7. Brian
    Tucson AZ

    So kinda scared of posting this to people who I do not know but after reading some comments I want to share my story so it can help others. I am 33 years of age but all my pain started when I was 29. I was diagnosed with Type 2 diabetes with that a year later came Diabetic neuropathy. I would never wish this pain on anyone. My feet hurt to the point where I can not walk etc eat. I tired evening that was supposed to work but didn’t do anything for me. Than finally went to pain management and I was given oxycodone 15 mg 4 times a day.

    For almost two years now I been on the drug thought it was a life save because all my pain went away while I am taking the drug. But soon after came all the side effects My feet started to swell up while I slept I itch very bad throughout the day and very bad constipation. Soon after that I found out the pain management did not go above my oxycodone 15 mg and my body started to crave more because it got used to it. So I started taking 60 pills a week and if you do the math that’s 120 in two weeks and that was supposed to last me a month. So with that started my withdraws and man this was hell just after one day of not taking my pills I was in a bad spot. So bad I started doctor shopping meaning I went to many places lying just to get Percocet.

    I struck out sometimes and some docs felt bad and helped me out. Did this for 3 months until I came across one doctor who came back with some papers and showed me all my pain pills I was getting. See here in Arizona everything you get gets sent to a database where all doctors can see. Guess others just didn’t do it for some reason. So I had to go to an ER where they have a withdraw program but I just went there for mess to get me to pass the withdraws. I ended up getting back on oxy til all my symptoms started again but worse. So I had my wife get me some tramadol and started taking 50 mg but taking 3- 4 at a time.

    I will say this I do not understand why people say the drug does not work I am telling you from experience it does. All my symptoms while on oxycodone went away and life became great again. I have my pain appointment this Monday and I am telling her that I want 200 mg of tram with 4 times a day. I feel like this is going to help me more than oxy. Oxycodone in the long run is truly hell. What makes it worse is that the doctors know if you take the drug long term what it does but they treat you like a addict and stop helping you it’s a damn shame. To me the real problem are the doctors shit get my pain take the drugs for two years and see what happens. I hope this can help people and hopefully show you that the really strong pain meds are so hard to get off cause of many reasons.

  8. Sharon
    Greensboro NC

    I have been taking tramadol for 20 years. 200 mg. twice a day AM and PM. I’ve discovered that to combine any narcotic like Percocet or ambien creates terrible side effects, mostly night terrors, insomnia, anxiety and confusion. I have a trifecta of back pain. Ankylosing Spondilitis , a cyst at L5 in the spinal cord with a permanent stent and tethered cord syndrome. My pain is not managed by tramadol and the doctor ordered Percocet/tylonal with tramadol and after three months I’m experiencing anxiety producing confusion. I need to find a new pain management plan.

  9. Chris N.
    Sanford nc

    In the past I have struggled with both alcoholism and drug addiction, both I had recovered from completely until now.

    A few months ago I was prescribed tramadol after a rather serious surgery. I specifically asked for a painkiller that did not contain codeine due to my history of abusing that drug.

    After taking 2 50 mg tramadol pills a day for about two months, I am now trying to come off of the drug and holy cow! I will contest that this drug has more extreme withdrawal conditions than any painkiller I have taken in the past. The physical and psychological discomfort I can only compare to alcohol withdrawals. This drug is dirty, and when I do manage to get through this hell. I WILL NOT be taking this drug again. What a nightmare. Heck with tramadol.

    • vince cruz

      How did you get off of them?? I have never been able to detox by myself the only way I have ever got off of them was being incarcerated…. I am so tired of taking these stupid pills it is ruining my family and my life if you have any suggestions please share I am open to everything

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