Tramadol and seizures: An overview

This review aims to expose the myths and misinterpretations of data concerning the risks of Tramadol Hydrochloride (Tramadol) and seizures within the neurosurgical environment. Within the neurosurgical environment there are differing views on the safety of Tramadol and the risk of seizures. Since Tramadol’s release in Australia its unique biochemistry, pharmacodynamics and pharmacokinetics have resulted in it being one of the most widely prescribed analgesics and it continues to play an important role for neurosurgical patients. The non-controlled status and varied available routes of Tramadol administration also contribute to it being one of the most valued and widely prescribed analgesics. However the potential for seizures should not be underestimated, even when prescribed within the therapeutic range. Tramadol should be used cautiously and the benefits of treatment should outweigh the potential of seizures in patients who are at risk or taking other medications that lower the threshold for seizures. The phenomenon of seizures associated with Tramadol is likely to increase with increasing rates of analgesic and antidepressant use in the general population. Here lies two areas of importance for neuroscience nurses; managing patients admitted following seizures associated with Tramadol, and Tramadol administration to at risk patient’s. It is crucial that nurses have a comprehensive knowledge of the seizure risk of Tramadol.