Electrocardiographic changes in patients with tramadol-induced idiosyncratic seizures

Moghadam, Peyman Hafezi; Zarei, Najmeh; Farsi, Davood; Abbasi, Saeed; Mofìdi, Mani; Rezai, Mahdi; Mahshidfar, Babak

doi:10.1016/j.tjem.2016.08.005

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…Regardless of physiological differences between sexes, differences in the amount or duration of consumption between sexes may influence the occurrence of this finding, as some studies show that seizures are directly related to tramadol dosage (5,14). At the same time, studies show that the frequency of seizures is not dosage-dependent (9,19,21). Consumption and the occurrence of seizures were found to be higher in educated patients in this study.…”

Section: Discussionsupporting

confidence: 42%

Tramadol Abuse-associated Seizure: An Epidemiological and Electroencephalographic Study

Iranmanesh

Arvan

Ahmadipour

et al. 2023

Int J High Risk Behav Addict

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Background: Seizure is one of the most severe side effects of tramadol abuse that can be irreversible. Objectives: This study aimed to investigate the frequency of tramadol abuse-associated seizure and electroencephalogram findings in patients with seizures. Methods: This cross-sectional study was conducted on patients with generalized tonic-clonic seizures caused by tramadol abuse. After history examination and systemic and neurologic evaluation, patients with abnormality in the neurological examination, metabolic evaluation, or non-contrast CT scan were excluded. Electroencephalography was performed between the third and fifth days. Demographic data and electroencephalograph findings were recorded and analyzed. Results: A total of 356 patients with seizures were enrolled, and tramadol abuse-associated seizure was the initial diagnosis in 12.9% of the patients. Among them, 9.3% had tramadol abuse seizures, which followed the study protocol completely. Abnormal electroencephalography was found in 48.5% of the patients, and epileptic discharges were observed in 21.2% of them. The consumed amount of tramadol, the duration of consumption, and the time interval between the consumption of tramadol and the onset of seizure were associated with electroencephalogram abnormality. Conclusions: Tramadol abuse-associated seizures occurred in a significant number of the patients. Half of the patients had electroencephalogram abnormalities.

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Section: Discussionsupporting

confidence: 42%

Tramadol Abuse-associated Seizure: An Epidemiological and Electroencephalographic Study

Iranmanesh

Arvan

Ahmadipour

et al. 2023

Int J High Risk Behav Addict

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“…The compounds are frequently detected at around 100 ng L −1 levels (Chen et al 2016;Han and Lee 2017). Despite seemingly low concentrations, the high biological activity of both the parent compound and metabolite (Hafezi Moghadam et al 2016;Lagard et al 2016) justify this choice. Furthermore, O-DES-TRA is prevalent in water and shows tendency for bioaccumulation (Archer et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Ecotoxicity screening evaluation of selected pharmaceuticals and their transformation products towards various organisms

Grabarczyk

Mulkiewicz

Stolte

et al. 2020

Environ Sci Pollut Res

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The intensive development of medical science has led to an increase in the availability and use of pharmaceutical products. However, nowadays, most of scientific attention has been paid to the native forms of pharmaceuticals, while the transformation products (TPs) of these substances, understood herein as metabolites, degradation products, and selected enantiomers, remain largely unexplored in terms of their characterization, presence, fate and effects within the natural environment. Therefore, the main aim of this study was to evaluate the toxicity of seven native compounds belonging to different therapeutic groups (nonsteroidal anti-inflammatory drugs, opioid analgesics, beta-blockers, antibacterial and anti-epileptic drugs), along with the toxicity of their 13 most important TPs. For this purpose, an ecotoxicological test battery, consisting of five organisms of different biological organization was used. The obtained data shows that, in general, the toxicity of TPs to the tested organisms was similar or lower compared to their parent compounds. However, for example, significantly higher toxicity of the R form of ibuprofen to algae and duckweed, as well as a higher toxicity of the R form of naproxen to luminescent bacteria, was observed, proving that the risk associated with the presence of drug TPs in the environment should not be neglected.

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“…This analysis also suggests that with regard to the most important and serious potential adverse side effects tramadol at these low doses is a generally safe medication. Nevertheless, for some patients, there may be adverse risks, and idiosyncratic responses have been reported ,,,, for this medication. Thus, further clarification is needed to determine the level and incidence of such risks, especially the possible differences in risk and adverse effects (including possible association with all-cause mortality) within the therapeutic range between low dose (25–150 mg/day) and high dose (151–400 mg/day) tramadol.…”

Section: Discussionmentioning

confidence: 99%

Low-Dose Tramadol as an Off-Label Antidepressant: A Data Mining Analysis from the Patients’ Perspective

Bumpus

2020

ACS Pharmacol. Transl. Sci.

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The purpose of this analysis was to assess, from the patients' perspective, the effectiveness and relative safety of tramadol as an off-label antidepressant and to determine if patients' views and experiences are consistent with the biomedical literature. Method: A data mining approach was used to analyze databases available at drugs.com. Results: Tramadol was reported to be an effective or very effective antidepressant by 94.6% of patients (123/130) who provided ratings submitted to User Reviews for Tramadol to Treat Depression (https://www.drugs.com/comments/tramadol/ for-depression.html). When compared to 34 other antidepressants in the database titled Drugs Used to treat Depression (https://www.drugs.com/condition/depression.html), for which there were ≥100 individual reviews for each drug, tramadol was rated as being the most effective (effectiveness rating = 9.1/10). Phenelzine (effectiveness rating = 8.7/10) was the only other antidepressant having ≥100 individual reviews coupled with a very high (8.0−10.0) effectiveness rating. Eleven patients reported significant symptoms of withdrawal upon cessation of tramadol, and five patients reported loss or reduction of libido as a side effect. Most (57/72, 79.2%) patients who reported a dose consumed experienced relief from depression at low therapeutic doses (25−150 mg/day). Fourteen patients reported taking this antidepressant for 5−10 years, and four patients reported taking tramadol for 10 or more years. Results demonstrated that most patients' comments and beliefs are consistent with the biomedical literature. Conclusions: Patients' reviews coupled with a survey of the biomedical literature indicate that at low therapeutic doses in the absence of interactions with other drugs, adult patients found tramadol to be a generally safe, effective, and fast-acting medication for relief from depression.

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Electrocardiographic changes in patients with tramadol-induced idiosyncratic seizures

Cited by 7 publications

References 15 publications

Tramadol Abuse-associated Seizure: An Epidemiological and Electroencephalographic Study

Tramadol Abuse-associated Seizure: An Epidemiological and Electroencephalographic Study

Ecotoxicity screening evaluation of selected pharmaceuticals and their transformation products towards various organisms

Low-Dose Tramadol as an Off-Label Antidepressant: A Data Mining Analysis from the Patients’ Perspective

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