Cognitive impairment in patients diagnosed with tramadol dependence compared to healthy controls

Abstract

Cognitive impairment is one of the consequences of substance use. We aimed to estimate the prevalence and correlates of cognitive impairment among patients with tramadol dependence in comparison with healthy controls. The sample consisted of 30 patients with tramadol dependence and 30 healthy controls. Cognitive functions were assessed using Benton Visual Retention Test- revised, Trail Making Test A and B and Wechsler Memory Scale. Patients were also subjected to the Structured Clinical Interview for diagnostic and statistical manual of mental disorders-fourth edition (DSM-IV) Axis I Disorder, the Structured Clinical Interview for DSM-IV Axis II Disorders and the Addiction Severity Index. Results showed that tramadol-dependence patients performed significantly worse than controls regarding cognitive functions, mainly manifested in impaired visual memory, visual reconstruction ability and processing, delayed memory, attention and processing speed, and visual, auditory, immediate, delayed and working memory. We found a nonsignificant negative correlation between cognitive performance and the age of patients or duration of tramadol use. Patients with tramadol dependence were more likely to have cognitive impairment than controls. This may have important clinical implications in determining the right academic and vocational programs for these individuals and adding skills training (e.g. problem solving) to their standard psychosocial treatment.

Does tramadol dependence impair cognitive functions?

“…Zakaryaee et al, (2012) found significant differences between the performance of tramadol-dependent patients and controls on the Wisconsin Card Sorting Test ('the paper test'), especially regarding categories completed and preservative errors. Using Trail Making Test Form B, Elrassas et al, (2021) found poor performance of tramadol-dependent patients in comparison to controls, which is in agreement with the present study.…”

“…In this study, tramadol-dependent patients showed some impairment in visuospatial memory when compared to controls. This is in agreement with Elrassas et al, (2021), who found that tramadol-dependent patients showed significantly lower performance of visual memory using the Benton Visual Retention Testrevised. In this study, no significant difference was found between tramadol and control groups regarding attention using the Go/No-Go PEBL test, although the control group's scores were generally better.…”

“…The average dose of tramadol in this study ranged from 600 mg to 2400 mg/day (1478.25 ± 893.25 mg). In Mahdi et al ’s 2018 study, the tramadol dose was 1061.67 ± 781.29 mg/day; in Elrassas et al ’s 2021 study, it was 530.2 ± 465 mg/day and in Bassiony et al ’s 2017 study, it was 1163.25 ± 902.25 mg/day.…”

“…In this study, no significant difference was found between tramadol and control groups regarding attention using the Go/No-Go PEBL test, although the control group’s scores were generally better. This agrees with Bassiony et al , (2017) and Mahdi et al , (2018) but is in contrast to the findings of Ahmed et al ., (2019) and Elrassas et al , (2021).…”

“…Despite that, in many countries, tramadol remains largely unregulated; in Egypt, tramadol has been moved from Schedule III to Schedule I which is ‘Substances Considered to Be Narcotic Substances’ (Elrassas et al , 2021).…”