Dizziness tramadol

Dizziness, vertigo, nausea, vomiting, constipation, and lethargy are all relatively common adverse events. These effects are more pronounced for several days after initiation and following upward dose titration. Seizures have been reported rarely the risk is dose-related and appears to increase with concomitant use of antidepressants, such as tricyclic antidepressants or selective serotonin reuptake inhibitors. Tramadol should be avoided in patients receiving monoamine oxidase (MAO) inhibitors because tramadol inhibits the uptake of norepinephrine and serotonin. 

Tramadol may cause blurred vision, dizziness, and drowsiness avoid tasks requiring mental alertness or motor skills until reaction to the drug has been established... 

Side-effects Typical side-effects of tramadol are nausea, sweating and dizziness. In rare cases seizures after high i.v. doses are reported, mostly in combination with other proconvulsant componds or in patients with reduced seizure theshold (Gardner et al., 2000). Tramadol shows a reduced level of opioid side-effects, especially respiratory depression and constipation are less frequent and severe than with standard opioids such as morphine. Tramadol has a very limited abuse potential and is not subject to narcotic control (Cossmann et al., 1997). 

The reported adverse effects of tramadol are nausea, vomiting, sweating, dry mouth, dizziness, sedation, headache, and hypertension (SEDA-17, 84) (SEDA-20, 81). The atypical analgesic effects of tramadol and its associated adverse effects profile have been reviewed (1). 

The role of tramadol in the treatment of rheumatologi-cal pain has been reviewed (33). Tramadol causes fewer opioid adverse effects for a given level of analgesia compared with traditional opioids. Common adverse effects, such as nausea and dizziness, usually occur only at the beginning of therapy, abate with time, and are further minimized by up-titrating the dosage over several days (34). 

Although associated with less respiratory depression than morphine at recommended doses, tramadol has a side-effect profile that in some ways is similar to that of the previously mentioned opioid analgesics (e.g., dizziness, euphoria, hallucinations, cognitive dysfunction, and constipation). Tramadol alone may enhance the risk of seizures. In addition, concomitant use with serotonin reuptake... 

Placebo-controlled studies The use of tramadol in neuropathic pain after spinal cord injury has been assessed in a double-blind, randomized, placebo-controlled study in 35 patients [186 ]. There were moderate to severe adverse events in 91% of patients on tramadol and 58% of those on placebo 48% of those taking tramadol were withdrawn from the study because of adverse events. The most common adverse events were tiredness, dry mouth, and dizziness. 

Tramadol 100 mg/day has been compared with ibuprofen and pregabalin in 20 healthy volunteers [173 ]. Tramadol was associated with mild adverse effects, mainly fatigue/drowsiness (eight episodes), nausea/ vomiting (seven), dizziness/headache/dijfi-culty in concentrating (seven). The NNTh for tramadol was 1.6. 

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