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). In case you had not noticed, opioids have been getting a lot of bad press for their addictive potential. As a result, many prescribers are turning to tramadol to ease patients’ pain. We fear that most are unaware of the withdrawal reaction that can occur when people try to stop tramadol suddenly.

Tramadol Withdrawal:

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 600 comments about this problem associated 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.

Many antidepressants also affect the reuptake of the neurotransmitters serotonin and norepinephrine. For years clinicians thought there would be no consequences after altering brain chemistry with drugs such as desvenlafaxine (Pristiq), duloxetine (Cymbalta) or venlafaxine (Effexor). Sudden discontinuation of such drugs can bring on a host of symptoms. Here is a link with over 1,300 comments regarding Cymbalta complications:

Duloxetine (Cymbalta) Side Effects & Withdrawal

Remember that tramadol not only affects neurotransmitters. It is a synthetic cousin of codeine and binds to opioid receptors. That means it is weaker than narcotics like hydrocodone or oxycodone. But it works in part to ease pain by binding to opioid receptors in the brain. Many physicians were convinced that it would not cause dependence the way strong opioids might. In other words, no worries about abuse and no DEA (drug enforcement administration) agent looking over your shoulder.

The Double Whammy:

The problem is that patients may be vulnerable to a double whammy. Stopping tramadol suddenly may affect the brain and nervous system via multiple pathways. First, you have the opioid issue. But there could also be the serotonin and norepinephrine pathways. Here is what we have discovered when it comes to that sanitized phrase “discontinuation syndrome”:

Tramadol Withdrawal Symptoms:

  • 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 the symptoms of tramadol withdrawal may persist longer than many health professionals realize. There is no one-size-fits-all program for tapering off tramadol. People vary greatly in the way their bodies adapt and recover. It may take several months to gradually wean off from tramadol. You should not attempt this on your own. A health professional who understands the complexity of the drug may be essential.

Stories from Readers:

Arika in Washington is going through prolonged withdrawal:

“I was on tramadol for about five years. By the end of that time I was only taking 50 mg per day. I’ve been off of it for about a month and I’ve had several nightmarish weeks. One week, the anxiety and panic was hellish.  The next week I had to deal with extreme fatigue and muscle pain.

“I think I’m past the worst but am still being plagued by anxiety, panic, muscle weakness and fatigue (which gets worse after eating and exercise). Then there’s tingling and numbness all over my body.”

“I’m not seeing a light at the end of my journey – just making it through a day feels like a battle.”

Sweety in Bangalore shared this story:

“My mother-in-law has osteoporosis, rheumatoid arthritis and spondylosis. Her rheumatologist started her on tramadol. She took this medicine for nearly a year.

“Then her doctor changed her pain medicine in one day. After stopping the tramadol she experienced withdrawal symptoms: extreme pain, seizures and electric shock-like sensations. She got no sleep because of the symptoms.

“She also received anti anxiety drugs given by her doctor. The tramadol was not tapered.  She is going through bad withdrawal.”

Shae in the Cayman Islands reports:

“I took it [tramadol] for 6 weeks, 4 x per day at 50MG per dose. I stopped cold turkey and I’m on my fourth day of withdrawal symptoms.

” I have blurred vision, severe abdominal cramps and pain breathing. I am disoriented, have body aches, swelling of my feet, electric shocks in my hands and feet, back pain, chills, depression and flu-like symptoms.”

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.

Where is the FDA?

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

Serotonin Syndrome Can Be Life Threatening:

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!

FDA Warns of Serotonin Syndrome

Share your own tramadol story below in the comment section. Have you suffered from tramadol side effects or tramadol withdrawal? Was tramadol the right solution for you? If you found this article helpful please vote on this article by clicking the 5 stars at the top of the page.

Revised: 3-1-17

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  1. Patty

    Because Vicodin was no longer available my doctor prescribed tramadol. I have only taken it for 4 months. I thought it was safe and now know that it is not. I have taken 2 tramadol as needed and not on a regular basis. I am now seeing a chiropractor whose practice is razor edge and promises significant changes in my spinal alignment. I am already better but low back pain can bring me to the edge. I am also in the process of detoxing off gabapentin – suicidal thoughts that are challenging and amazing, unbelievable insomnia. I have taken it for years. I have a detox schedule and will follow it carefully. No more tramadol unless I am screaming with pain. Thank your this article. PS – major sweating problems.

  2. Phyllis

    I have taken 200mg per day tramadol for back and neck problems for years. It causes the high feel good plus pain relief for me. Lots of energy and quick thinking. The down side is no sleep, so I take Lunesta for sleep. I cannot take tramadol after 5p of I plan on sleeping, even with the aid of Lunesta. The combo overtime has given me Resless leg syndrome, severe. I have been one month trying to wean from the Tramadol cutting back 50mg a week. It is torture. The brain zaps come first, then the flu like feeling and fatigue. Low low energy and my sleep med now exasterbate the RLS. I am trying natural vitamins B12 and magnesium to calm the muscle twitches and RLS. Its going to be a long term weaning process and not sure if the side effects from the long-term use of Tramadol will ever revert my symptoms completely. I am taking it one day at a time and praying the normal sleep and everyday coping returns to a reasonable state. I never abused the drug but the long term use was highly addictive and began a snowball of added needs such as sleep aids and treatment for RLS. Even skipping 50mg a day would cause the brain zaps and nervousness.

  3. Petra

    I took Tramadol for a couple of years, 50mg slow release (had to cut up a 100mg tablet) twice a day as I was unable to tolerate the standard 50mg capsules.

    Withdrawal was over a few weeks until I got down to 1/4 tablet twice a day, then I had to stop suddenly because of an accident requiring hospital admission. Hospital policy made it impossible to get the dose I was on so I had only two options – go on a full dose or stop altogether.

    I have been off Tramadol for 9 weeks now and still experience brain zaps (parasthesia) almost every day and intermittend anxiety. I’d hate to think what it has done to my brains…

  4. CDF

    I have been taking large daily doses (400-600mg) of Tramadol daily for several years. On occasion I run out before getting more and I experience some withdrawal, though nothing like what many describe here. Mostly I have a lot of trouble sleeping, which makes me groggy.

  5. Ben

    I hope I can get help I’ve been taking tramadol for almost 10 years now. It started when I was a doctors visit for pain the doctor prescribed tramadol i took one 50 mg pill and that night when my spouse and i were intimate i noticed that i could perform a lot longer than normal. So because of the long sexual performance i fell in love with and became addicted. Now I take 10/11 50 mg each pills 5 days a week the other 2 days 7 pills 50 mg each since I started taking these I have insomnia I have gone before two days with no sleep and when I would get to the point of sleep I would sleep almost an entire day now I get maybe five days a week a good 2 to 3 hours a night of sleep and every day I have to take A nap around two hours or more I wish I never would’ve taken this drug I have lost so much time from my family for my selfish needs and desires intimately with my spouse . If I come home and take a nap and don’t wake up till the morning and go all night without taking tramadol I wake up wanting to vomit and have no energy whatsoever and when I don’t take them around the same time I normally do or if I take less then the nights before I start to get flu like symptoms I am so disgusted with myself every time ITake these pills but I can’t stop I’ve even tried to see if there is a vitamin or a pill that doesn’t cause any harm to me that looks just like the tramadol I take to psych myself out I haven’t found any yet if anyone knows anything like that that can help psych me out let me know. It’s gotten to the point that I have to take these every night in order for me to wake up in the morning and go to work and function I hope I get to help i need

    • Sandra H.

      I have been suffering from insomnia. Could it be the tramadol, along with gabapentin?

  6. Cricket
    North Carolina

    I have been taking tramadol time release once per day for a little over a year due to degenerative osteoarthritis in both knees. Since I am only just under 40 years of age, the doctors suggest that I wait 10 more years to permanently fix my knees with double knee replacement. To allow me to do my daily activities, I was prescribed tramadol which helps the pain inside my knee joints along with anti-inflammatory daily (along with gel shots every 6 months into both knees, periodic cortizone shots, and sometimes physical therapy). Every so often, I forget to take my meds first thing in the morning, and I started to notice in the mid afternoon I would suddenly experience the most horrible feelings both mentally and physically.

    Today was such a day. This seems to happen when the medicine has left my system. I have severe headaches, tightness in my chest, anxiety which makes me wring my hands, and a feeling of helplessness/loss of control followed by what I can only describe as what must be depression type feelings. Apathy, care about nothing, nothing can make me feel better, crying, body aches, and feel like I am physically heavier in the world, depressed by gravity itself. Unable to concentrate or work, and only gets better when I am able to get home, take my medicine, and en within about an hour, I feel just fine again. I am hoping to work with a pain specialist to wean off this medication very soon, as our state just passed legislation that our doctors can no longer prescribe it to avoid people abusing drugs, so I only have one refill left. I just hope they can help me safely wean off, as I only take it because of actual pain and quality of life, and am fairly terrified at what is upcoming for withdrawl, when just a few hours feels like an eternity.

    • Tim

      I have gout, fibromyalgia, and lower back pain plus I feel both rotators are almost gone in my shoulders. I had up until August 16′ been prescribed for pain Vicodin one month then Percocet the following month to alternate between the 2 so as to not develope dependence, since 2003. I think 2006 is when I was prescribed Tramadol. It worked for me great, Dr told me no concerns about becoming addictive ( I read the small print) so I thought all was well and the pain had stopped. Well after running out of Tramadol only once or twice I was in the worst shape I have ever been in and learned rather quickly to never run out again. Fast forward to opioid crisis and after going into the new money racket Pain Management Clinic, with 3 visits and a $70 copay to them, I was able to stop all opioids cold turkey, they had become addictive, there I was given a choice to choose either the Percocet to continue with or the Tramadol. I choose Tramadol knowing the consequences of stopping it and gave them my brand new 120 tablet Percocet prescription for them to destroy. Not the Tramadol however. It will take The Good Lord Himself to truly help get me off this stuff like He did with the opioids. I am 56 years old missing too much work to a drug that masks the pain and am sick of being looked upon by the Dr and his staff as a drug addict or as they used to say a dope fiend when I tell them I am hurting and in pain. Its so sad that decent and honest people unknowingly accept what their Dr gives them until they realize too late. But! We can, and we must all, start us all a tapering off period and fight this crap once and for all. Encourage anyone we know to NEVER USE TRAMADOL.

      • Tim

        Forgot to mention my Dr called the tramadol “good medicine” when I mentioned my concerns about it being habit forming. Again, I would mention I quit Percocet and/or Vicodin cold turkey. Not this stuff! And when I told him I needed at least 30 day supply of either for when I was having a pain flare up, his answer was to take 4 50mg tablets with 2 500mg Tylenol. I just don’t understand it. Do they get money from the drug companies for writing prescriptions for this???

    • Phyllis

      I am a 10 yr tramadol user. I get the feel-good energy from tramadol but also the severe insomnia. I began Lunesta to aid the sleepless nights. Overtime the combo gave me severe restless leg syndrome. So even though I would be tired enough to sleep the RLS prevented any sleep, which was more miserable. I have been one month cutting back by 50mg per day per week. Even with 50mg less per day I have brain zaps and flu-like symptoms. I came down to one 50mg tablet per day, and even it is difficult to stop.

      Tramadol is a highly addictive pain med plus a serotonin-altering brain changer. I think I am winning the fight from the opioid dependence, but the long-term sleep pattern and RLS is my next battle to overcome. I urge anyone who takes Tramadol, especially the ones like me who get the energy highs, to beware of the long-term consequences. Normal sleep and calm muscles and brain waves are more important in the long haul of everyday life.

  7. christy

    I have been prescribed tramadol after a hip replacement and I am horrified that when I try to quit taking it I get shortness of breath and heart palpitations. How can one get off safely?

  8. SID

    Well, ok. Now I don’t think I am crazy or will suddenly die. Glad to see this forum. I have taken Tramadol for many years because of a medical procedure and then several back injuries. I refer it as a ‘go, do’ pill. The pain is dulled and I can get something – errand, vacuuming, yard work – done although I still only can do for a few hours. I thought great. Then started seeing all the info that it is bad, people have strokes and such and felt this benefit of doing chores is not worth the risk. I am 60+ and have many tasks and travel planned yet. So, I’ve only taken 50mg or less each time and after last re-fill decided to not take them. Yes, I have all the symptoms other detail here. Lots of twitches, most recently have had crazy, active dreams and sweats, at most inappropriate times, and feeling my head swell then not and for past few days – a strangeness under my arms… both of them. My question – if anybody reads this… and yes I’ll check in with my Dr. (not the original prescriber), should I take ” a bit ” of the Tramadol just to quell my body issues or is that more dangerous !?

    • Phyllis

      I am weaning myself 50mg per day for a week at a time. I am one month into the process and only taking 50mg per day now. It still is brutal. Brain zaps, fatigue, flu like symptoms are my worst. I took Tramadol for 10 years. I suggest a slow weaning if you have been taking it for months. The longer you take, the more you will have other complications which will require more meds and more side effects. It only takes 24 hrs stoppage to know if you are addicted enough to need slow weaning. Skipping one dose will show miserable side effects. I hope I was some help to your question.

  9. Jean

    I have been prescribed tramadol for over 15 years. In the beginning, 50 mg 3x a day. I also supplemented with Tylenol and aspirin. Over the years I stopped cold turkey because of being prescribed an antidepressant or meds for blood clots. No perceived withdrawal was noticed. Over the years I have lost a few lbs. and dropped one of three BP meds and self-reduced to two, sometimes one, 50 mg of tramadol per day. Recently because of state oversight I had to go to Dr. every month in lieu of every three months (and subject to blood and urine checks — i.e. treated like an addict) for a script. I found this unacceptable so Dr. prescribed the normal one month amount with oral instructions to take accordingly to last 90 days rather than 30 days. I am now taking more Tylenol and aspirin and one 50 mg. (split) a day if needed to control back pain. This works so far just hope the aspirin does not eat a hole in my stomach!

  10. Jacqueline
    Manchester UK

    I was put on Tramadol 5 days before my shoulder operation August 2017 to replace the Naproxen that I had been on for a few years. I think it was something to do with my blood clotting during the op. I had only been taking the Tramadol for 5/6 weeks all together, last 2 weeks whilst in hospital I’d got dosage down to 50mg twice a day. After being in hospital 41/2 weeks I came home wasn’t in any pain so decided to stop taking it myself I was never warned by anyone about coming off it.

    The withdrawal symptoms were horrendous. To name a few. Feeling really cold, sweating, lose of appetite, tingly, feeling sick, sneezing, I could hear my eyes move and hearing sounds in my head, couldn’t sleep even in hospital know one picked up on that one, rash on legs, legs jumping just really feeling terrible. Got in touch with my GP who was really helpful, he set out plan for me to come off them over a period of a month. Finely I was Tramadol free.

    The only withdrawal symptom I’m left with since stopping is my head shakes more than it did before my operation as I had a slight shake, and sneezing I’ve sneezed every single day for the past 3 months now, hopefully it will stop sometime soon but that’s the least of my worries.

  11. Beth

    I was prescribed Tramadol back in Feb 2017 after having a disc fusion in my neck from the result of an auto accident. In the beginning I was taking 2 pills (don’t remember the dosage) 3x’s per day. Then I was put on the Tramadol Extended Release 300mg. All in all i took this for 10 months until I decided that I should probably get off the stuff, as I felt that I had had sufficient time to heal. I am now into my 6th day of withdrawals. I admit that I have been severely tempted into going back just to stop the leg cramps and the sleepless nights BUT I haven’t given in! I’m exhausted from sleep deprivation, and it’s so hard to function at times and to work a 40-hr week job with hardly no sleep. I quit cold turkey and am battling hard right now with only my faith that God will help get me through this. I pray for all of you that are in the midst of this battle as I am. We will get through this. Thank you for all of your testimonies,, as it has helped me just to know that I’m not crazy, and I’m not alone in this. People need to be educated on this drug before taking it. God bless all and Merry Christmas! ~ Beth

    • Isade

      I had hip replacement Tramadol is a great med, if taken as prescribed. My only problem has been the feet arms and back neuropathy like symptoms., very uncomfortable… but I also take two Motrins a day and helps a lot. I take only one Tramadol at night and have a no fuzz pain free sleep at night and wake up feeling rested. I’m 64 and in relative good health!

      • Debra

        Hi Isade,
        About the neuropathy you had in your feet, arms and back: what was the pain like? Was it a burning pain?

      • Sandra H.

        Isade, if it wasn’t for this site, I would have thought I was going crazy. I am going through all of the symptoms.

    • Phyllis

      I have the sneezing and brain zaps and can hear my eyes move. Zap, zap back and forth. That’s enough to drive you insane. The fatigue is getting better. I am slowly winning the withdrawal battle after a month of cutting back from 200mg per day to now 50mg a day. It’s been brutal, I agree. I now have severe restless leg syndrome from the withdrawal and need long-term sleep meds to compensate for the insomnia the Tramadol caused me. I caution anyone who take Tramadol long term. It’s highly addictive and causes long-term side effects.

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