Frequently Asked Questions About Tramadol

by Christina Lasich, MD Health Professional

For some reason, Tramadol is an overlooked, misunderstood drug. Even some doctors are confused about some facts that seem to be little known. Most know that tramadol is used to treat pain and comes in both short acting and time released formulas.

Various brand name drugs contain tramadol including: Ultracet, Ultram, Ultram ER, Ryzolt, and Rybix. Because these all contain tramadol, they are all worth considering even for the toughest to treat pain. But first, let's clear up some confusion about tramadol.

Is tramadol an opioid?

So many people have been lead to believe that tramadol is not an opioid medication. In fact, tramadol is considered an opioid medication because it like morphine and hydrocodone bind to and activate the mu opioid receptor. This mechanism provides the pain relieving, the analgesic effect. And like all the other opioids, the regular use of tramadol can lead to physical dependency. Thus, when this exogenous source of opioids is withdrawn suddenly, a person can experience withdrawal symptoms. If tramadol was not an opioid, then this would not happen. But it does because tramadol is an opioid.

Can people with a history of chemical addiction safely use tramadol without risk of relapse?

People ask this question primarily because of the confusion about whether or not tramadol is an opioid. If one is
lead to believe that tramadol is not an opioid, then he/she may then also believe that this drug does not have a risk of leading to addiction or relapse. This false sense of security can be an addict's undoing.
Do not be fooled, the use of tramadol like any other opioid needs to be monitored for signs of addiction and the risks need to be disclosed.

When is tramadol the best medication option to try?

Under certain circumstances, tramadol is an excellent choice
for treating pain that is not responding to over the counter medications. Of particular interest are the cases of nerve pain like Postherpatic Neuralgia (PHN) or Diabetic Peripheral Neuropathy. Tramadol works really well for nerve pain. Why? See the next question.

Why is tramadol so unique?

Tramadol is not only known to stimulate an opioid, analgesic effect, tramadol is also known to be a serotonin/norepinephrine reuptake inhibitor (an SNRI). Thus, tramadol has a weak anti-depressive effect. This mechanism of action is what enables this chemical to be effective against nerve pain. Many types of nerve pain respond to anti-depressants like Cymbalta and Elavil.

Tramadol is not just an opioid. Tramadol is an opioid and an anti-depressant. This dual action drug has a one-two punch against pain.

Is there another alternative to tramadol?

Just recently an alternative to tramadol became available. This new drug is called Nucynta. Like tramadol, Nucynta has the both the opioid binding ability and the serotonin/norepinephrine reuptake inhibiting effect. With fewer side effects than tramadol, Nucynta is a great drug in the pain relief arsenal.

Which side effects are most commonly seen with Tramadol?

Speaking of side effects, what do people usually experience with the use of tramadol? As a weak opioid, but opioid nonetheless, people can experience initial drowsiness and dizziness. Sometimes nausea and headaches are problems. Most of the time these side effects go away after the body gets used to the drug, sometimes not. All and all tramadol is usually a well tolerated pain medication.

Individual experiences with tramadol are going to be different. Ultimately, this unique opioid has tremendous potential in the right individual, but it is not the right choice for everybody. Once the myths are dispelled and the facts understood, tramadol can continue to serve a purpose in treating those with pain.

Christina Lasich, MD
Meet Our Writer
Christina Lasich, MD

Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.