Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration

Taghaddosinejad, Fakhreddin; Mehrpour, Omid; Afshari, Reza; Seghatoleslami, Alireza; Abdollahi, Mohammad; Dart, Richard C.

doi:10.1007/s13181-011-0168-0

Cited by 91 publications

(83 citation statements)

References 27 publications

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“…9 Tramadol abuse is associated with addictive behaviors among adolescents. 10,11 Tramadol addiction is recognized to cause adverse and in some cases lethal health effects. 12 Cannabis, which is derived from the plant Cannabis sativa, has been tangled with human culture from the dawn of history.…”

Section: Introductionmentioning

confidence: 99%

A study of the neurotoxic effects of tramadol and cannabis in adolescent male albino rats

et al. 2016

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Background: Adolescence is a critical period for cerebral development. Exposure to addictive substances during this phase leads to various alterations in brain functions that persist into adulthood. The present study was designed to study the neurotoxic effects of tramadol and cannabis, alone and in combination, in adolescent male albino rats by studying their behavioral, biochemical, and histopathological neurotoxic effects and their long–term consequences after withdrawal.Methods: For this purpose, 132 adolescent male albino rats were divided into 5 groups (22 rats/ group). Group I (negative control), received only regular diet and tap water to measure the basic parameters, Group II (positive control; IIA&IIB); IIA, gavaged with normal saline. IIB, gavaged with olive oil. Group III (tramadol), gavaged with tramadol (42, 84 and 168 mg/kg/day) in the first, second and third ten days of the study respectively. Group IV (cannabis), gavaged with hashish extract (92, 184 and 368 mg/kg/day) in the first, second and third ten days of the study respectively. Group V (tramadol+cannabis), gavaged with tramadol and hashish extract in the same doses as Group III&IV. By the end of the first month, the half number of rats was subjected to performing behavior tests. Specimens from the brain were taken for performing biochemical and histopathological studies. All remaining rats were held for another 4 weeks non–dosing spontaneous recovery period after withdrawal of the treatment and were evaluated again by the same previous parameters.Results: Abuse of tramadol or cannabis, alone and in combination, caused antidepressant effect (sucrose preference test), impaired spatial memory (Morris water maze), elevated serotonin levels in the cerebral cortex and hippocampus, induced oxidative stress (significantly elevated malondialdehyde level and reduced catalase activity) as well as deleteriously altered brain histopathology and marked increase in brain Caspase–3 expression. However, abuse of both tramadol and cannabis conferred more antidepressant effect but more neurotoxic effect. After withdrawal, the antidepressant effect was reversed, no improvement of the spatial memory, marked depletion of 5–HT, more improvement in antioxidants and apoptotic markers and incomplete regression of brain histopathological alteration resulted.Conclusions: Abuse of tramadol and cannabis, alone and in combination, induced neurotoxicity which proved behaviorally, biochemically and histopathologically.

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Section: Introductionmentioning

confidence: 99%

A study of the neurotoxic effects of tramadol and cannabis in adolescent male albino rats

et al. 2016

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“…In developing countries, the incidence of pesticide poisoning has doubled during the past decades and accounts for a large number of fatal outcomes despite increased availability of ICU facilities [18][19][20]. Recently published data from Iran have shown an important increase in aluminum phosphate poisoning while tramadol and opioid poisoning still constitutes a major challenge for hospitals and poisoning centers [20][21][22][23][24][25][26][27][28]. Since Baharloo hospital is one of the main referral hospitals for poisoned patients in Tehran, Iran, [29] we conducted a prospective observational study including all patients with severe poisoning admitted to the toxicology ICU.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Treatment of Severe Poisoning in the Intensive Care Unit: Lessons from a One-Year Prospective Observational Study

Mehrpour¹

2012

J Clinic Toxicol

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“…The ability of tramadol to increase serotonin and norepinephrine in the brain is held responsible for the neurotoxicity that occurs with convulsions, especially when the drug is administered at high doses, above 500 mg orally or 300 mg intravenously [22]. However, our patient had never had seizures, although she had taken up to 850 mg/day of tramadol within a few hours.…”

Section: Discussionmentioning

confidence: 94%

“…At this dose, the mean peak plasma concentration of the M1 metabolite is 51.6 ± 5.7 ng/ml and occurs approximately 3 h after the dose [26]. Analgesic serum concentrations of tramadol range from 100 to 300 ng/ml [22]. …”

Section: Discussionmentioning

confidence: 99%

Tramadol Abuse in a Binge Pattern in a Young Depressed Woman

Ferrari¹,

Tiraferri²,

Palazzoli

et al. 2013

Eur Addict Res

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Background: Tramadol is a central analgesic with a unique pharmacological profile in that it is an opioid agonist and an inhibitor of serotonin and norepinephrine reuptake. We describe a case of abuse of tramadol in a binge pattern in a young woman who had initially received the prescription of tramadol as an analgesic as needed. Case Description: The patient had no history of drug or alcohol abuse, but suffered from depression. Over time, she had increased the doses up to 30 ml of tramadol 100 mg/ml oral solution a week. She took the drug in consecutive ‘pinches', from afternoon to evening. Tramadol improved her mood, gave her euphoria, but also caused constipation and urinary retention. Detoxification was carried out by partial replacement with tramadol 100 mg extended release and gradual reduction of the number of pinches. The patient found it hard to follow the program because of withdrawal symptoms of an opioid type and especially because of the worsening of depression. Conclusion: The action of tramadol on the monoaminergic system is believed to be a factor that limits abuse liability and gives advantageous antidepressant-like properties, but it also involves the risk of inducing abuse of the analgesic to improve mood as if it were a stimulant.

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Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration

Cited by 91 publications

References 27 publications

A study of the neurotoxic effects of tramadol and cannabis in adolescent male albino rats

A study of the neurotoxic effects of tramadol and cannabis in adolescent male albino rats

Epidemiology and Treatment of Severe Poisoning in the Intensive Care Unit: Lessons from a One-Year Prospective Observational Study

Tramadol Abuse in a Binge Pattern in a Young Depressed Woman

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