Seizure Associated with Tramadol Dependence: A Cross-Sectional Study

background: Tramadol is reported to be the most misused drug among all illegal substances in Egypt. The likelihood of it inducing epileptic seizures remains contested. Objectives: The present study examined the prevalence of seizures in Tramadol-dependent clients and sought to identify any possible associated factors. Methods: A survey of all Tramadol dependent clients was conducted from October 2014 to September 2015. Following this, N=215 participants were interviewed using the Mini-International Neuropsychiatric Interview (M.I.N.I.), the Beck Depression Inventory (BDI), the Hamilton Anxiety Rating Scale (HAMA-A); and a drug urine screening. Fasting blood sugar, serum creatinine, serum glutamic oxaloacetic transaminase, glutamic-pyruvic transaminase were also assessed. Electroencephalography was done twice. Participants were then placed into two groups: seizure and non-seizure. Results: One third of participants using Tramadol developed seizure. There were no significant within group differences in relation to completed psychometric or lab tests. Mean duration of Tramadol use, high doses, ingestion on empty stomach, and couse with Tetrahydrocannabinol, antidepressants or drugs that could lower seizer threshold was found to be higher in the seizure group than the non-seizure group with statistically significant differences. Conclusion: The risk of epileptic seizure arising from Tramadol use cannot be ruled out and it is, therefore, recommended that Tramadol used in limited to circumstances where cost benefits are deemed worthwhile.