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. B

    Found a infrared pain light that I bought over ten years ago. Never even opened it, have been using instead of tremadol, have had great results, thank God!!!!

  2. B
    USA-south carolina

    So glad to find this page. Have had some of these bad side effects related to tremadol. I have had the nerve jerking, depression, skin breakouts, out of body experiences,blurred vision,chills,sleep loss, fatigue. I did not connect it to the medicine, until a few days ago, I have been taking it for almost a year. I have never been on opioids, before.

    I have been dealing with a nerve, muscle condition??? for four years.thought that it was migraine headaches, at first. Kind of worked through that course, for six months, and it returned, with a vengeance.

    My doctor sent me to a newly established pain doctor in my area in July 2015 and he put me on tremadol.I am so glad that I found this Page, now I know the whys of all these strange things that I have encountered . And will seek a different path.

  3. steve

    stumbled across this site and haven’t read through it but i thought i would share my experience. maybe it will help someone. sorry if i am repeating something already written.

    i had shoulder surgery and dolcet was the pain killer given to me. first i.v. then pills. i was in the hospital for 2 days post-op, and then i took pills for 4 days (can’t remember my dosages but pills 3x daily). i stopped taking the pills because the pain wasn’t bad anymore (actually never was–maybe the tramadol was working well). i had no problems except when trying to sleep. i would then get a fairly intense sensation of “restless leg” where i couldn’t get rid of the sensation of needing to move my legs. so sleep was difficult. not an enjoyable experience– i would much rather have just dealt with the pain.
    the important part for me:
    went to the doctor and described what was happening and he nonchalantly said no problem and gave me a prescription for Lyrica 75 mg. PROBLEM SOLVED ON THE FIRST NIGHT. after 3 days i stopped the lyrica and all was well. i now keep some lyrica with me when i travel because i don’t want to experience those symptoms again.
    i’m sure those who’ve been using tramadol long term may have much rougher withdrawal than what i dealt with but if you haven’t tried the Lyrica it is certainly worth a try.
    i still take tramadol for some back and hip pain. it is a big help but of course i try and be careful with it. one half of a 75mg pill in the morning (if taken in the afternoon it affects my sleep), two days on and then a day without. may try and stretch to 2 days off but the pain then slows me down. so far no symptoms on the days i don’t take it.

  4. Sam
    New York

    The withdrawal off this drug is the worst I’ve ever experienced. I’m a long time poly drug addict and abused Tramdol at around 1000mg a day which is 20 50mg pills. I bought 200mg pills on the internet overseas through the darknet. After tapering to 400mg a day I ran out. I have no doubt that if i jumped at 1000mg I would have had to be hospitalized for the withdrawl.

    The drug lingers in your system longer than most opiates and builds up, making withdrawal worse. The drug targets multiple neurotransmitter systems and the withdrawal symptoms are very intense, diverse, and long lasting. The first week was absolute hell. Just unrelenting torture.

    The second night I was convulsing and jerking around like I was being electrocuted due to an awful restlessness in my arms and legs that made me move them around. I would try try to hug myself as hard as I could to stop it. I pulled muscles in the arms from shaking them and throwing them out so hard. Any clothes I wore would be soaked in 5 minutes. No sleep was possible. Forget trying to read or watch anything for longer than 30 seconds. I’d pace for hours while swinging my arms for a tiny bit of relief. By the 4th night I was literally screaming and pleading with God to make it stop. I contemplated suicide many times.

    On the 5th night I fell asleep for the first time. The restlessness stopped for a second while attampting to eat and bowl of cereal sitting in bed. I was out instantly. The cold milk hitting my lap woke me back up. I laid down thinking I could fall asleep. No dice. I started pacing again and would literally have microsleeps standing up between steps. Soon my body’s need to sleep overpowered the withdrawal and I got a few hours.

    If you’ve ever experienced withdrawal from some antidepressants you’ve probably had something called “brain zaps”, which is a withdrawal symptom from Serotonin. Since Tramadol also increases Serotonin you will feel this weird symptom. You will have these for at least a week to a month. You will have terrible fatigue. It took every ounce of strength and willpower just to walk my dog. And I may not treat myself too well but I love animals and especially him and would never neglect him. Sometimes I had a friend help me.

    On day 6 i got my hands on some Suboxone, which did help but not totally. Suboxone is made for withdrawal off herion and the like, not Tramadol, but it did take the worst of the edge off.

    I could go on, but this is already too long.

    Do not use this drug. It builds up in your systems and a taper is less effective. If you need to get off this you need a very long taper if possible and time to get through the worst of it.

    I’ve said ‘I’m never going to use this drug again’ to a few different drugs, but did again anyway. The promise will be kept with this one, I assure you.

  5. Mazie

    Lost 20 lbs in 5 months taking Tramadol. Have stopped now. Feel shaky and jittery but not taking any more. I’ll put up with the pain and just use Tylenol! I keep thinking I’m dying and I was only taking 50 mg 2x’s a day and sometimes only 1 a day. How could so little get me so messed up??

  6. Joan
    Kamloops BC Canada

    Just wondering why I should go off of Tramadol if it’s helping my symptoms. Is there a health hazard from taking it? I have been taking it for a number of years now.

    • Terdra
      Ashville, OH

      In my experience, Joan, the best reason for getting off them or not starting them in the first place is the terrible withdrawal symptoms when you can’t get them. I’ve been on them for 22 years, and my doctor let me be out two days before refilling my prescription (they were way past fill time), and by the evening of the 11th day (when he called it in to the pharmacy), I was a pain-wracked, floor-walking, jerky-legged, brain-fogged, half-blind mess. I’m still on mine because they work great for what ails me, and I can’t tolerate withdrawal, but they are extremely addictive. Like most other drugs, though, some people don’t have withdrawal symptoms when they quit tramadol, and if you ever want to quit, I honestly hope you’re one of them.

  7. Laura S.
    Lewistown Pa

    My Dr did a horrible thing to me with this medication of Tramadol 200 ER one a day for a month. Before that I was on Oxycodone 15 when he switched me to the Tramadol, but not before he caused me to go through withdrawal from the oxcycodone because he left me hanging for 6 weeks on NOTHING. Then after much suffering he gave me the Tramadol for a month. Now, I went back to get my refill but he said he couldn’t give me anything. So now it’s been 3 days on NOTHING again, and I’m going nuts. I had every muscle in my legs, feet, and groin hurt, and that kept me up screaming all night for two nights. This is my 3rd night, and I’m feeling like I can pass out. Getting dizzy and can’t sleep more than 2 hours at a time. I don’t know if going off cold turkey with nothing to take is going to cause me to end up in the ER tonight. I pray it’s not as bad tonight but I also have dizziness, shakiness, insomnia, stomach hurting, can’t eat very much, and I’m diabetic, and also take 5 blood pressure pills every day as I have a bad heart too. I have many health issues and have had a cage put in my neck and fusions that didn’t work and low back surgery. That was also another fusion that did not work. So I also have pins and rods in my low back.

    I have plenty of reason to be on pain meds but they are saying the government is deciding who gets meds and who doesn’t. Guess if you pay for them maybe they will let me have them but $240.00 for 14 pills? I don’t have that king of money. Not up to the Drs anymore so I’m 3 days, and this is my 3rd night, of withdrawal from the 200 ER tramadol. I’m very concerned about passing out tonight, and the pain is uncontrollable I have to be up at 5 am to go to an appt in Danville for another appt for a separate matter but how well can I handle going from Lewiston all the way to Danville on public transport. I will be crazy in pain and withdrawal symptoms. I just don’t know if I will be well enough to go. I’m scared as I can’t walk very well either.

  8. kay
    South carolina

    I was on a 300 mg dose of tramadol ( I think ER) for lower back pain. I took it at bedtime for over a year. A couple of times I missed a dose/ night & the next day was so sick & restless, especially restless leg if I tried to lay down. I didn’t figure this out until the third time this happened that it was related to skipping the tramadol. My back was doing so much better my doctor and I decided okay I could stop taking it. By the next morning I called and told them you CANNOT quit this cold turkey! The dr. Gave me a lower dose for aweek, then lower again. …plus a clonid in patch and something for nausea. The restlessness, restless leg, upset stomach was first, then when only on clonid in patch I had the sneezing and fatigue and upset stomach and still the insomnia. I resorted to taking 2 benadryl every night, which didn’t do much, but eventually I would fall asleep. I am so glad my doctor understood and gave me these patches for a month or I think I would have died from anxiety and restlessness.

  9. bab
    New Jersey

    I was on tramadol for 3 years 50 mg 2x’s daily….. never increased or decreased…. had surgery and surgeon stopped it. 10 days out and I broke in to hives head to toe and ended up in hospital for 5 days still feel very weak but no intention of ever taking this drug again…… flu like symptoms and no one knew about it…I never hid any of my medical records so surprised no one even considered it at all….. very rough drug to stop cold turkey.

  10. A

    So, I’ve been on and off tramadol for six years. I’ve gone through withdraw from it countless times. It’s evil.. for a medication to not feel like a typical “narcotic” but give you worse withdrawal than one is beyond me. I’ve gone up to a year without it, but have gone back on due to injuries or surgeries.

    High doses of gabapentin help. It will allow sleep. Also, Kratom. I’ve used it for my last two attempts at coming off. It works. I’ve slept for the last week since I stopped. Ive been active, my body temp stays regulated and the only symptom I feel is a general blah. It can be done. And it should be done sooner than later. I’ve never tapered, it doesn’t work for me.

    I used to think I needed them to do anything. But, I hardly did anything on them. I’ve been much more of an adult in the last week going through withdrawal and using kratom then the last year fully on tramadol at two or three pills a day three or four times a day.

    • Terdra
      Ashville, OH

      A, I’ve thought about Kratom, but I don’t know which one. What kind did you use? My sis and my son use two different kinds for different reasons.

  11. Chad
    Gaston, SC

    Didn’t order my Tramadol soon enough from the VA. Knowing there was some withdrawal I cut back a few days ago to stretch it till this week when my script comes. I went from 100 2x day to 50 2x day. Man, complete restlessness in legs and well pretty much whole body.

    Can’t sleep but that’s just the physical part. It really sucks when you feel like all you can do is walk from one end of the house to the other and back and forth.. Just restless but I can handle it. However, last Fri, Sat by brain went into doom and gloom mode. My mind brings up every bad moment in my life that I never want to think about again and just major depression, something that isn’t normally an issue for me…. enough so I jumped on the net looking for answers and ended up here.

    Everything everyone is saying is right on the money. I’ve made the decision when my script does come in that I am not taking more than I am right now. When I get use to this dose I’m gonna cut it again but in lower increments.

    Glad I found this today because at least now I know i’m not going crazy….. still feeling everything but not as bad. On my 5th day and I have had bouts with depression today but it hasn’t taken me over. I will come off of this as soon as I can but I know its going to take time…

  12. Stefani R

    My prescription for Tramdol has not been renewed for thtee weeks. I have been taking that medication for over 30 years. Under different names in the past,but always with the same effect…to reduce joint pain.

    Now, I am experiencing side effects such as flu symptoms…sneezing for one. Also blurred vision for several days.

    • Simona

      I’m so relieved to find that someone else experiences the sneezing and flu with Tramadol. I miss one dose and I have terrible flu like symptoms. When I tell people that I’m sneezing because I missed a dose of painkiller they look at me like I’m crazy 😂🙈

  13. Georgina
    West Yorkshire

    I am glad I found this comments section, it’s been really useful to learn about the withdrawal symptoms I am going through. I was given tramadol for fibromyalgia pain and migraines. According to the box I can take 50mg up to 4 x a day. I have never been brave enough to take more than 1 x twice a day. This is a really strong medication that doesn’t do as much for pain personally as it does for changing my outlook. I have been taking it for almost 2 years and reached a point that I know my body well enough, that it isn’t good for me.

    I have gone through the chills and night sweats without realizing it was tramadol. I started weaning myself off it about three weeks ago and am aiming to stop taking it over the next week. It’s a horrible drug and one I do not wish to use again. Thank you for all the comments, they have made me realize I am not crazy it’s the withdrawal. Good luck to everyone else coming off it too.

    • Eve
      Long island

      My rx had to be ordered, pharmacy was out. The sneezing , coughing and choking is awful. Just put it all together today. This has happened to me before. Ugh

  14. Brian
    Roseville, CA

    I just found out that my ex-girlfriend has been abusing Tramadol for about 2 years. She has been using animals to take to several vets, and then pick up a prescription. She is the mother of my 3 year-old daughter so its very scary. She is 29 years old, and in the last 2 months she has had 2 serious seizures. I just found out last week that she has been taking 25-30 50mg tramadol a day. Now she is trying to come off of them and is having severe problems and is wanting to get on suboxone. Basically she is a junky, and it’s disgusting that she is trying to act perfect and take custody of my daughter from me. My daughter has witnessed both of her seizures.

    • A

      Please don’t think she is a “junky.”

      Tramadol is a very weird drug. It doesn’t make you feel “high” in the typical sense. The high anti depressant aspect in it makes you feel competent while on it. The narcotic aspect is basically as strong as codiene. The withdrawal is said to worse then heroin.

      I’ve never done heroin so I can’t say, but it’s bad. You literally can’t imagine a worse feeling. That’s why people go to those lengths to obtain them. Having a child and stopping is almost impossible to some. The fear of not being able to take care of your child probably drove her to stop withdrawal at any cost.

      Remember, these pills are marketed as non addicting and non narcotic. Every single person that has been on these for over a month will experience some withdrawal, it doesn’t matter if you are not an “addict.” Give her some support, because it’s the hardest thing she will ever do.

  15. Melissa
    San pedro,Ca

    I have been taking Tramadol, 50 milligrams 4 times a day for six years. I was originally prescribed it for her pain from hip dysplasia and later on for fibromyalgia and rheumatoid arthritis. Eventually I also added Percocet 3 times a day along with a multitude of NSAIDs.

    I am recovering addict alcoholic and of come to a point in my recovery where I want to know that I’m only taking what I absolutely need. I need to know that my personality isn’t being affected by these medications. I just continue the Percocet with no issues whatsoever. I am now 7 days off of the Tramadol and from day one I have had runny nose, night sweats and insomnia, constant diarrhea irritability and agitation comma muscle aches and pains, and Mild depression with the unwillingness to get up and do anything. I detox myself from heroin over 15 years ago and alcohol 10 years ago and it wasn’t anywhere near as bad as this.

    Fortunately I am currently on disability and don’t have to worry about not going into work but my house is a mess my marriage is being affected but I do see a light at the end of the tunnel period Tramadol is no joke and I don’t ever want to be on it again

    • Melissa

      Discontinued Percocet. I no longer take any narcotics

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