Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Forensic Medicine-Toxicology

Background: Tramadol is a centrally acting analgesic that is used for the treatment of moderate to severe pain. The aim of this study: is to assess neuropsychological disturbance among tramadol users and to correlate these disturbances to the dose and duration of tramadol use. Subjects and methods: This study was performed on 80 tramadol abusers admitted to the Neurology department and (NECTR), This study group was sub-divided into 4 groups depending on the dose (using <or=600mg/day and using >600mg/day and duration (<or=6 months and tramadol>6 months). The following data was collected from all subjects (present history-physical examination-tramadol level in urine-EEG changes-psychological tests). Results: 46.2% of studied cases suffered from syncope, 81.2% of studied cases presented by convulsion, 72.5% of cases had psychological symptoms (52.5% had anxiety, 65.0% had mood disorder, 58.8% had aggression, 28.9% had hallucination and 60.0% had insomnia). As regard EEG changes, 35% of studied cases showed focal electrical activity. Conclusion: Tramadol abusers have neuropsychological effects eg., (convulsion with focal electrical activity and increase incidence of depression, anxiety and aggressive behavior). Duration of tramadol intake and tramadol level in urine show significant relation to these neuropsychological disturbance

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