Posted by BrittPark on January 23, 2003, at 11:28:55
In reply to Re: opiates and major depression, posted by androog on January 23, 2003, at 11:11:34
The most dangerous outcome from tramadol use is seizures. In general tramadol seems to increase the likelihood of seizures 2-6 fold. That may sound like a lot but remember that original likelihood of seizures is quite low. Those who are taking certain antidepressants (TCAs eg) that lower the seizure threshold are somewhat more at risk but I haven't been able to find a number. I would advise caution.
Here are some Medline Abstracts
Tramadol and seizures: a surveillance study in a managed care population.
Gardner JS, Blough D, Drinkard CR, Shatin D, Anderson G, Graham D, Alderfer R.
Department of Pharmacy, University of Washington, Seattle 98195, USA.
STUDY OBJECTIVE: To investigate the occurrence of tramadol-associated seizures. DESIGN: Retrospective cohort and case-control studies. SETTING: UnitedHealth Group-affiliated independent practice model health plans, from different regions of the United States, contracting with large networks of physicians. INTERVENTION: Analysis of administrative data from a large U.S. managed care population. PATIENTS: A cohort of 9218 adult tramadol users and 37,232 concurrent nonusers. MEASUREMENTS AND MAIN RESULTS: Fewer than 1% of users (80) had a presumed incident seizure claim after the first tramadol prescription. Risk of seizure claim was increased 2- to 6-fold among users adjusted for selected comorbidities and concomitant drugs. Risk was highest among those aged 25-54 years, those with more than four tramadol prescriptions, and those with history of alcohol abuse, stroke, or head injury. A case-control study among users was conducted to validate incident seizure outcomes from medical records. Only eight cases were confirmed, and all had cofactors associated with increased seizure risk. CONCLUSION: In a general population, risk of seizure may be associated with long-term therapy with tramadol or the presence of cofactors, or confined to a small sensitive population subset.
Incidence of first-time idiopathic seizures in users of tramadol.Gasse C, Derby L, Vasilakis-Scaramozza C, Jick H.
Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, Germany.
STUDY OBJECTIVE: To assess the risk of idiopathic incident seizures among patients who ever took tramadol. DESIGN: Nested case-control design. SETTING: General Practice Research Database from November 1996-August 1998. PATIENTS: Eleven thousand three hundred eighty-three patients. INTERVENTION: Comparison of risks of idiopathic incident seizures during exposed and unexposed times among patients who had ever taken tramadol and other analgesics with 90-day follow-up. MEASUREMENTS AND MAIN RESULTS: Among the 11,383 subjects we identified 21 cases of idiopathic seizures, 10 of which were categorized as definite cases and 11 categorized as possible cases. Three patients were exposed to tramadol alone in the previous 90 days, 10 to opiates, three to both tramadol and opiates, one to other analgesics, and four to no analgesics. CONCLUSION: The risk of idiopathic seizures was similarly elevated in each analgesic exposure category compared with nonusers, suggesting that the risk for patients taking tramadol was not increased compared with other analgesics.
Whatever it takes,
Britt
poster:BrittPark
thread:81414
URL: http://www.dr-bob.org/babble/20030119/msgs/137184.html