Seizure Prevalence and Its Related Factors in Tramadol Intoxication; a Brief Report
Archives of Academic Emergency Medicine,
Vol. 7 No. 1 (2019),
1 Dey 2019
,
Page e28
https://doi.org/10.22037/aaem.v7i1.365
Abstract
Introduction: Seizure is known to be a serious complication of tramadol consumption even in its therapeutic doses. The aim of this study was to determine the prevalence of seizure and its related factors in tramadol intoxicated patients referred to emergency department (ED).
Methods: In this cross-sectional study, all individuals, admitted to ED following tramadol intoxication were divided into two groups based on the presence or absence of seizures. Demographic data as well as clinical, electroencephalogram and imaging findings were compared between the two groups using SPSS software version 22.
Results: 167 patients with the median age of 23 (13-45) years were studied (85% male). Seizure was seen in 97 (58.0%) cases. Risk of seizure had increased 3.7 times in patients with a history of seizure (OR: 3.71 Cl 95%: 1.17 - 11.76). Tramadol dose was significantly higher in patients who had seizure more than once (Median: 2800 IQR: 1800-4000), compared to those who had one seizure episode (Median: 850 IQR: 1800-400) (p <0.0001).
Conclusion: Based on the findings of this study, history of seizure increased the risk of seizure in patients taking tramadol, and the increase in dose correlated with a significant increase in seizure frequency.
- Tramadol
- seizure
- toxicity
- emergency service
- hospital
- risk factor
How to Cite
References
Mood NE, Sabzghabaee AM, Safdari A, Yaraghi A. Clinical Signs, Hospitalization Duration and Outcome of Tramadol Intoxication. Journal of Isfahan Medical School. 2011;28(117).
Boostani R, Derakhshan S. Tramadol induced seizure: A 3-year study. Caspian journal of internal medicine. 2012;3(3):484.
Mannocchi G, Napoleoni F, Napoletano S, Pantano F, Santoni M, Tittarelli R, et al. Fatal self administration of tramadol and propofol: a case report. Journal of forensic and legal medicine. 2013;20(6):715-9.
Talaie H, Panahandeh R, Fayaznouri MR, Asadi Z, Abdollahi M. Dose-independent occurrence of seizure with tramadol. Journal of medical toxicology. 2009;5(2):63-7.
Sansone RA, Sansone LA. Tramadol: seizures, serotonin syndrome, and coadministered antidepressants. Psychiatry (Edgmont). 2009;6(4):17.
Afshari R, Majdzadeh R, Balaiâ€Mood M. Pattern of acute poisonings in Mashhad, Iran 1993–2000. Journal of Toxicology: Clinical Toxicology. 2004;42(7):965-75.
Koushesh H, Afshari R, Afshari R. A new illicit opioid dependence outbreak, evidence for a combination of opioids and steroids. Drug and chemical toxicology. 2009;32(2):114-9.
Afshari R, Tashakori A, Shakiba A, editors. Tramadol overdose induced CPK rise, haemodynamic and electocardiographic changes and seizure. Clinical Toxicology; 2008: INFORMA HEALTHCARE 52 VANDERBILT AVE, NEW YORK, NY 10017 USA.
Talaie H, Panahandeh R, Fayaznouri M, Asadi Z, Abdollahi M, editors. Seizure associated with tramadol use/abuse. CLINICAL TOXICOLOGY; 2008: INFORMA HEALTHCARE 52 VANDERBILT AVE, NEW YORK, NY 10017 USA.
Shadnia S, Soltaninejad K, Heydari K, Sasanian G, Abdollahi M. Tramadol intoxication: a review of 114 cases. Human & experimental toxicology. 2008;27(3):201-5.
Kroenke K, Krebs EE, Bair MJ. Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews. General hospital psychiatry. 2009;31(3):206-19.
Farzaneh E, Samadzadeh M, Shahbazzadegan B, Sayadrezai I, Mostafazadeh B, Sarbandi Farahani A, et al. Comparing the Frequency of Seizure in Patients Intoxicated with Tramadol Treated with or without Naloxone. Journal of Isfahan Medical School. 2012;30(197).
Soleymani F, Shalviri G, Abdollahi M. Pattern of use and adverse drug reactions of tramadol; a review of 336,610,664 insured prescriptions during 5 years. Int J Pharmacol. 2011;7(4):757-60.
Clarot F, Goulle J, Vaz E, Proust B. Fatal overdoses of tramadol: is benzodiazepine a risk factor of lethality? Forensic science international. 2003;134(1):57-61.
Clarot F, Proust B, Vaz E, Goullé J. Tramadol-benzodiazepines and buprenorphine-benzodiazepines: two potentially fatal cocktails? Journal of clinical forensic medicine. 2003;10(2):125-6.
Musshoff F, Madea B. Fatality due to ingestion of tramadol alone. Forensic science international. 2001;116(2-3):197-9.
Rahimi HR, Soltaninejad K, Shadnia S. Acute tramadol poisoning and its clinical and laboratory findings. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2014;19(9):855.
Hara K, Minami K, Sata T. The effects of tramadol and its metabolite on glycine, γ-aminobutyric AcidA, and N-methyl-d-aspartate receptors expressed in Xenopus oocytes. Anesthesia & Analgesia. 2005;100(5):1400-5.
Rehni AK, Singh I, Kumar M. Tramadolâ€Induced Seizurogenic Effect: A Possible Role of Opioidâ€Dependent γâ€Aminobutyric Acid Inhibitory Pathway. Basic & clinical pharmacology & toxicology. 2008;103(3):262-6.
Sun C, Mtchedlishvili Z, Erisir A, Kapur J. Diminished neurosteroid sensitivity of synaptic inhibition and altered location of the α4 subunit of GABAA receptors in an animal model of epilepsy. Journal of Neuroscience. 2007;27(46):12641-50.
Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clinical pharmacokinetics. 2004;43(13):879-923.
Gholami K, Shalviri G, Zarbakhsh A, Daryabari N, Yousefian S. New guideline for tramadol usage following adverse drug reactions reported to the Iranian Pharmacovigilance Center. Pharmacoepidemiology and drug safety. 2007;16(2):229-37.
Manocha A, Sharma KK, Mediratta PK. On the mechanism of anticonvulsant effect of tramadol in mice. Pharmacology Biochemistry and Behavior. 2005;82(1):74-81.
Shadnia S, Brent J, Mousaviâ€Fatemi K, Hafezi P, Soltaninejad K. Recurrent seizures in tramadol intoxication: implications for therapy based on 100 patients. Basic & clinical pharmacology & toxicology. 2012;111(2):133-6.
Brent J, Burkhart K, Dargan P, Hatten B, Megarbane B, Palmer R, et al. Critical care toxicology: diagnosis and management of the critically poisoned patient: Springer; 2017.
Jovanović-Čupić V, Martinović Ž, Nešić N. Seizures associated with intoxication and abuse of tramadol. Clinical toxicology. 2006;44(2):143-6.
- Abstract Viewed: 485 times
- PDF Downloaded: 323 times
- HTML Downloaded: 115 times
