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 norepinehprine 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. monica
    Denver
    Reply

    I’ve written on this forum before and I wasn’t strong enough then to completely stop taking tramadol. But I am now on day two and this time I know I can do it. I now have a great therapist and have great support behind me. My chronic back pain is always gonna be a problem for me but I can’t live my life revolving around this horrible drug. I am taking meds for anxiety and depression now and I hope I can’t get through this. I feel like absolute hell. And my legs ache, my brain zaps, I’m grouchy, and I can’t stop sneezing! Weird. But oh well I’m gonna do it and you all can too!

    • Rose
      UK
      Reply

      I am now 5 months down the road to coming off of Tramadol.
      Taking 1 x 50mg every other day down from 200mg a day now since Sunday so 6 days.
      I had no sleep, aching legs, and felt like I had cold running through me…
      I am getting there. It has taken a long time but I hope within a week I can kick it :)
      So all I can say it doesn’t matter to me how bad my knee is, I won’t take it again.
      Good luck to all that are on this very hard road.

  2. david
    usa
    Reply

    This med caused me hell on earth. I’ve detoxed from 200 mg daily of oxycodone and I have to say the tramadol withdrawal to me was comparable. You will want to saw your legs off on day 3. It screws with your personality too. Been 10 days and still I’m not right. The insomnia will make you psychotic as well. I wish everyone the best who get off this stuff. I sincerely feel for you.

  3. Lynn
    Calif
    Reply

    I was a 10yr Tramadol user up to 1 month and 2 days ago. I stopped because my prescription ran out and when I called to refill my Dr was on vacation for 2 weeks. I admit the first 2 weeks were awful. Could not sleep had RLS so bad had to put heating pads around my legs. Took so much over the counter stuff just to try to sleep. I tried Ambien and it did nothing. I still sneeze and cough but I feel so much better. Don’t give up try and get off these things. I am so glad my Dr was out of town!

  4. AJ S.
    United States
    Reply

    I was taking 8 50mg a day for over a year and ran out during a time when my provider was on maternity leave. I have severe osteoarthritis, tendonitis and dysplaysia in my hips along with bone spurs. Needless to say I am in constant severe pain. It has been six days now and it was so awful, while better now it is still pretty bad. I will never take another Tramadol again. I experienced dizziness so bad I could not sit up and I had to hold on to the bed.

    I never see the dizziness on the list of withdrawal symptoms but even missing a dose and taking it a couple hours later than usual I would feel so dizzy and nauseous that I would be reminded to take my dose. I was taking three to four 10/350 Norco per day for two years prior to that and never had a reaction like with the Tramadol when a dose was missed or I had to wait for a refill. I have also been reading about it and am just grateful I did not go into seizures. Tramadol is very dangerous. I am glad they reclassified it even though I know some people are really suffering for it and for that I have empathy but it is truly dangerous and the physical addiction needs to be acknowledged. I was given no warning whatsoever as to what would occur should I run out either. I still feel awful but the worst seems to be over. Never again.

  5. Jamie
    US
    Reply

    So it has been a month with no tramadol or pain pills, and I’m finally able feel somewhat back to normal. I can fall asleep and stay asleep for about 3 hours before waking up to leg pain and brain zaps. I still sneeze like crazy I counted 35 sneezes in one day! But I feel so much more happier now, I have my energy back for the most part. I still have the days and moments where my body starts to crave the pills so i go jogging or state cleaning the house even if its 2am, and it really seems to help. I still have the full bottle of tramadol next to my bed just to remind myself that I am a strong woman and can fight/ over come anything. :)

    • Rosemary C.
      Midlands UK
      Reply

      I was on Tramadol for 10 years, and I decided approximately 5 months ago I was coming off of it. I was taking it for severe knee pain. I was beginning to feel worn out and I had no energy, so I looked it up and found that it is one of the side affects of the drug. I was on 200mg a day so went to the doctors and found out that it is now classified as a class 3 drug- which made my mind up.

      As of last night, I am no longer taking Tramadol. But I’m not sleeping well at all, I have a cold feeling running through me, and I don’t know were to put my legs. So this is confirming that I am going down the right path- no more Tramadol for me.
      I do realize that some people do need these and I sympathize with them.

      Hopefully this is the end of the road for me and my relationship with Tramadol :)

  6. Princess
    Inland Empire
    Reply

    I was prescribed tramadol 50 mg twice a day. It seemed to work for a few weeks and helped with the arthritis foot pain. Recently though my mood began to change and I have had issues with pain meds in the past (so I kind of felt strange) low and behold I think it was the tramadol. I stopped on Fri night, so this is the 3rd day off the meds…I feel a little better today but not great. And I have a feeling that if I took a tramadol it would make me feel better. That is why I want to ride this out and hope it gets better with time. I am so grateful for all the comments I have read as it helps me to know I am not alone…..I will post an update in a couple of days…

  7. Gee
    Sacramento
    Reply

    I was prescribed 50mg tramadol every 4 to 6 hours 10+ years ago for spinal stenosis, 10 bulging discs due to degenerative disc decease, plus osteoarthritis & fibromyalgia. Last week I was denied my refill by the pharmacy due to the DEA changing Tramadol to a Schedule IV drug.

    Now 4 days later still dealing with flu like symptoms, running nose, RLS, insomnia, chills & just a general blah feeling. I was waiting for Monday so I could contact my doc for a new Rx. But now after reading all the comments I’m rethinking getting a new script. I was completely out of tramadol before my trip to the pharmacy. Although not by choice, I’m off cold turkey. This forum is helping me understand what withdrawal effects I will be facing in the days or weeks ahead. I’m an active 68 yr old & I’m hoping my doc will find a good substitute that works as well as tramadol did to alleviate my pain. Thanks for helping me “Stop Tramadol”.

  8. Ayashi
    US
    Reply

    I suffer from a nasty and complex TMD situation. My jaw cracks so loud people across the room can hear it, and it hurts like a knife through my ear, jaw and throat. I was first given 10/325 Norcos which allowed me to function at work, until I realized how addictive they were. I of course withdrew nastily from them and was put on Tramadol afterwards while my Maxofacial doctor continues to send me to other TMD offices/docs with me having to spend weeks getting x-rays and files sent back and forth between them. I was told I wouldn’t be addicted or suffer the same withdrawals as I did from the Norcos. .

    Boy was that a mistake. I only had a month of 150mg a day as a ‘test’ and instead of a refill I was instructed to discontinue use as I will require surgery. It’s been a week and I would take the Norco withdrawal over what I’m feeling right now ANY day. Sleeping is not possible, I toss and turn on my sides in the fetal position, I don’t suffer the brain zaps but I noticed a change in my mood. The worst is the chills and sweating, if not the inability to sleep. I can stand in a scorching shower and still be shivering with goosebumps. I pile blankets over myself when I’m not at work and just shut my eyes and feel unbearable layers of fever and coldness whenever my body senses muscle movement. At work I’ve been wearing layers while others have shorts and t-shirts, and they see me shivering.

    To top it off, my TMD doc retracted his statement about surgery and has decided I should see another two specialists, but to “stay off Tramadol.” I told him and my primary physician about the withdrawals and was given an apology, not a solution. So thousands of dollars wasted so far on a diagnosis and treatment that will not come, mixed with the worst drug withdrawal I have ever experienced, working 4 days a week 10 hour shifts. I’m writing this at 4am almost in tears because I haven’t slept in nearly 40 hours and I’m starting to lose my mind. I just want the horrible freezing and shivering to stop so I can sleep. I wish I could take solace in knowing this will get better, but for anyone who suffers from TMD and knows the frustration of trying to get it corrected, better is a VERY relative term.

  9. Harriet
    Seattle
    Reply

    I started on Tramadol 10 years ago after I shattered my wrist. I have been taking 50 mg twice a day ever since to relieve the arthritis I have developed in my wrist, but now I also realize it also makes me feel better mood-wise. I am 57 years old. Before my PCP retired, he prescribed me 6 refills. I just saw the woman physician who took his place, and she informed me that this a “dirty drug” and it would be wise to try and wean myself off of it. I always had it in my mind to stop taking it eventually because I just don’t want to have to remember to take meds in my old age!

    Now I am reading all the withdrawal symptoms and problems people are having and I realize I am addicted too. I was in Mexico years ago and forgot my Tramadol – back then, you could buy it over the counter there. I remember going a couple of days and got very agitated without it… yup. Addicted. So… here I go. I am going to try a wean very gradually, as I have a very supportive doctor. I have a 2 month follow up appointment and I hope to be down to 50% or 25% of the dose by then.

    I am also not ruling out that I might have some depression issues – which might have made this drug appealing to me. Sigh. I know we are not supposed to feel great all the time, and pain is an important tool to tell us something is wrong (chronic pain is not right). I wish you all well and may god help us! Happy to share my path as well.

  10. jamie
    u.s
    Reply

    Its been 24 days now with no tramadol. I quit cold turkey because i ran out and had to wait a 3day weekend for a refill so after 2 days of feeling like poop and trust me you feel like a truck ran you over, I decided at the point to stop taking everything. The first week was the hardest week ever but I did it and so can you. I still have RLS only at night but nothing like I did the first week. I felt so alone during the first 2 weeks I didn’t want to let anyone know what I had done to myself.

    I work in the medical field and didn’t want my boss or coworkers to know either. This website was the best thing for me it was my support group and it really worked. It showed me I was not alone and that it was going to be ok. Like they say “one day at a time” and its so true. I have a full bottle of tramadol and I WILL NOT touch it. Tramadol equals HELL when you get off the them. They work when you take them but the second you don’t have them you feel awful…..

  11. Jamie
    US
    Reply

    I have been on tramadol for 3 years taking 500mg a day as directed by my doctor. 3 weeks ago U decided to quite taking the rx cold turkey because when I would run out I couldn’t sleep and would be in server pain. So I made up my mind to stop taking them all together. The first week was hell I’m not going to lie I felt like I was all alone and didn’t want to tell anymore what I was going though.

    My whole body hurt from head to toe and the worst restless legs I have ever had. The only thing seemed to help was a hot shower. That was the only way I could get some sleep was in the shower on the floor. But it does get better its been 24 days now without tramadol and doing great still had to sleep and my legs hurt very night but everyday gets a little better.

    I will never touch another tramdaol or pain killer if I can help it. I don’t wish this on anyone. Just know you’re know alone and you can get though it. Just stay positive and tell yourself this pain is not worth the pill!

  12. Kerry
    UK
    Reply

    I have been on tramadol for 10 years as I have fibromyalgia and ME. We want to start a family as I am 38. So need to come off all medication. I came off tramadol a week ago and feel so poorly. Restless legs at night which is driving me crazy, but worse still is the coughing, sneezing and terrible stomach pains. Can’t stand up for long. Feel sick. Feel as if it’s never going to stop. Even considering going back on them but I know that won’t let me have a family. Having read some of the others comments looks like am just gonna have to ride this out. But I can’t even stand up long enough to cook a meal. I feel so helpless. Do not want to go anywhere or see anyone I feel so poorly. Reading these posts has helped me stay off them and hope it passes soon.

  13. lori
    United States
    Reply

    My doctor moved without telling me. The nurse says because the doctor was the one who prescribed it, I cannot refill without that doctor’s consent? I would need to make another appt with another one of their doctors to get a prescription. A week from now. Really? Now I’m day two of withdrawals. I feel crappy. Can’t sleep. Don’t wanna eat. These little, annoying electrical buzzes in my head are so annoying!

    Anyone who says tramadol is non habit forming is lying! I want my life back.

  14. Jake B.
    NZ
    Reply

    This article is interesting but it doesn’t say what is considered long term usage or what a tapered does is. I injured my back during a rugby game on June 7th which got worst and after physio ended up going to hospital on 18th July when I was put on 4 x 100mg SR per day. I had discectomy on 3rd Sept and Dr has told me to stop taking all this Tramadol. This is the second day of nothing and I fell terrible, emotional, flu symptoms, shaking, shivers, syliva which doesn’t stop etc.

    What to do restart on 50mg SR 3 times a day and reduce from there?
    Is roughly 6 weeks considered longterm usage and what reducing doses have worked for people?
    Thanks

  15. monica
    Denver
    Reply

    My nightmare started in January 2013. I hurt my back at work and my life has never been the same. I was told tramadol was a good alternative to narcotics. Little did I know that this is not true. I’ve tried to stop cold turkey a few times in the past with no success. My doctor has recently put me on an extended release formula for long term use. Well no thank you I’d rather stop taking this drug all together but my problem is I still have back pain. But now I’m wondering if now I do have back pain due to the meds.

    Not sure what to do. But I do notice a significant change in me such as leg pain, insomnia, I feel like I have the flu, ugh and these stupid brain zaps! I know I just need to get past this hurdle and then it will get better. It definitely helps to read all these posts and I immediately feel better and I know I can do it!

    • Brian
      Ohio
      Reply

      There is light at the end of the tunnel.
      I Have been off Tramadol for 7 days now.
      Had some very bad days physically but that awful feeling ended yesterday on day 6.
      Don’t give up. Give yourself a good week. You owe it to yourself and your loved ones!

  16. mike
    louisville
    Reply

    I was put on tramadol for a long term foot injury in 2006.I took 300 mil per day. Got off because of stomach problems. After 1 week, of no tramadol, still nervous, anxious, mood swings and emotional things, crying over songs and tv shows, ear ringing, loud noises in my head when trying to sleep. Tramadol worked to a degree, but not worth getting hooked up into that cycle again though.

  17. In torment
    Uk
    Reply

    I had been on Tramadol for 8 months due to back surgery, I began to drop the dose last week and 3 days ago I attempted to stop completely. I felt so bad on the second day I had to open a capsule and pour most of the medication out just to allow my body a tiny bit to get through work.

    I have the flu like symptoms and runny nose, I get random shivers, I feel really emotional at a song or somethig on tele, which has never been me before. I almost feel hungover. All of this I can now handle and accept it as something I’m going to have to ride out. I write this led in bed at 2.52am knowing I’m up for work in less than 4 hours. The reason I’m still awake is my legs. I have never experienced such a constant annoying feeling. I can’t lie still, I thrash as my legs ache desperate to get comfortable and to get some sleep. Like another person posted I don’t feel Tramadol massively helped with my pain at all and the effects of stopping were never pointed out. I have told almost begged everyone I know never ever to take the stuff, this aftermath of torment just isn’t worth it. I feel for each and everyone of you, just ride it out

  18. AD
    Reply

    The thing is, Tramadol “works” fine. It does what it is supposed to do while you are on it.
    BUT, and this is an enormously huge BUT, when you STOP taking it, is when you feel AWFUL. And, for most people, they have to stop taking it at some point – then they feel like they are going psychologically bat-shit crazy!!! And, there are the physical symptoms to boot. This is NOT a non-addictive drug.

  19. AD
    Reply

    I am now 5 weeks off Tramadol. Although the horrible withdrawal stuff has passed, I am still in a state of BLAH’s. I have good moments, but nothing makes me “really happy”. I know this stage of the game will pass too. Just takes time for the chemicals in my brain to function on their own, and they will. I still feel mildly depressed alot of the time and some unexplained anxiety sometimes (that I never used to get) and my blood pressure is still higher than it normally has been for the last 20 years.
    I don’t notice a difference in myself day to day, but I can see that when I look week to week, I am getting better. Tramadol is HORRIBLE stuff. It feels fine when you are on it, but stopping in hell incarnate. Just keep reminding yourself it is just the chemicals in your brain that have to get functioning again and the only way to do that is to stop the Tramadol.

  20. Deb
    Reply

    Well, I have been taking tramadol for 21 years with no side affects unless I miss doses. Same as all of you from the restless leg to the flu like symptoms, runny nose.
    But…. I have severe arthritis in my hands and I wouldn’t be able to move them without tramadol. It doesn’t take the pain completely away, but it dulls it enough to keep me moving everyday. I’m 56 and I take 50mg every 6 hours.
    I think if any pill doesn’t agree with you talk to your doctor on the steps to quit taking it, don’t do it on your own. Tramadol has never made me lethargic or buzzed like some of the pain meds out there, I actually think it works pretty good.

  21. LadyBarbie
    Reply

    It’s been over a month since I had to quit Tramadol cold turkey due to moving and running out. I still have some withdrawals just not as bad. My heart still beats hard at night and my flu/cold comes and goes just not as bad. My tummy troubles come and go also. I was on Tramadol since Jan 2008. 240 pills a month. Do I miss them…Not at all. My back pain seems the same with or without them! I stopped taking the muscle relaxers also. Unless I have a bad back day.
    I never did get the leg pain/twitching with the withdrawals. But it was bad enough. I know that it was all worth it! This safe med the doctor put me on! This is the first time since 2008 that I am pain pill free. I thought my back would get so much worse. Not at all. Good luck to you all..will write again in 2 weeks…hopefully all withdrawals will be done by then!

  22. SPOOKY#1
    Reply

    I was told it is not addictive too but my experience has been a little different. I have been taking them for about 10 years and just returned from the pharmacy after being denied a refill due to the DEA chaging Tramadol to a Schedule IV drug. Nice of them to cancel existing scripts for legal users.
    It’s going to be a long 48 waiting for my doctor to write a new prescription and on top of that, at 62, I’m raising my six year old granddaughter as a single parent so I have to suffer with a smile.
    I wrote down some phone numbers for her to call if anything bad happens during the wait so I think I have covered everything. Lots of hot and cold showers to help with chills and sweats. RLS is a given and last time I was off for a few days wound up sitting with my knees pulled against my chest tight just to gain some control over it so I could sleep.

    • Juno
      Usa
      Reply

      This medication is the devil. I feel on top of world when I take it! in the process of cutting back to 25 mg daily. Horrid! It wouldn’t be so if bad if it was just me to take care of, but I have a home and family to take care of. Good luck to all!

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