Tramadol Withdrawal Symptoms | Timeline & Detox

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on February 21, 2023

Prolonged use and discontinuation of the opioid painkiller tramadol may cause opioid withdrawal symptoms as well as withdrawal symptoms similar to antidepressant medications.

Tramadol is a synthetic opioid medication prescribed in different formulations to treat moderate to severe pain, including chronic pain. It is classified by the FDA as a Schedule IV controlled substance, and is sold under the brand names:

  • Ultram
  • Ultram ER
  • ConZip
  • Ultracet (tramadol and acetaminophen)

Although tramadol does act as an opioid pain reliever, it also has unusual effects related to serotonin and norepinephrine, which influence both how and when healthcare professionals use the drug, as well as the risks and withdrawal symptoms associated with it.

Symptoms Of Tramadol Withdrawal

Acute withdrawal from tramadol often involves flu-like symptoms that may include:

  • aggression
  • anxiety
  • body aches
  • chills
  • drug cravings
  • diarrhea
  • fatigue
  • feelings of depression
  • goosebumps
  • insomnia
  • muscle aches
  • nausea
  • restlessness
  • runny nose
  • stomach cramps
  • sweating
  • teary eyes
  • tremors
  • vomiting
  • yawning

Less commonly, tramadol withdrawal may also cause severe confusion, numbness and tingling, paranoia, panic attacks, hallucinations, psychosis, or seizures.

Tramadol Withdrawal Timeline

The process of withdrawal can vary a great deal from individual to individual, with differences in withdrawal severity and length depending on which drug a person was using, how long they were using it, their dosage, and their overall personal health.

A generalized withdrawal timeline for tramadol dependence includes:

8-24 Hours After Last Dose

As a short-acting drug, tramadol withdrawal symptoms will typically begin the same day the drug is discontinued.

1-3 Days After Last Dose

Physical withdrawal symptoms may intensify, often including anxiety, pain, watery eyes, headache, sweating, and problems sleeping.

4-10 Days

After peaking, physical withdrawal symptoms will tend to lighten and then resolve as the body fully adapts to the medication’s absence. However, psychological effects, including cravings, may persist.

14 Days +

Uncommonly, certain individuals may experience withdrawal symptoms, including prolonged cravings and other psychological effects, which recur over a period of weeks or months after discontinuation.

Known as post-acute withdrawal syndrome (PAWS), this condition is most likely to occur in cases of prolonged, high-dose drug abuse. And while there is no cure, PAWS will resolve on its own over time.

Tramadol & Opioid Dependence

All opioid/opiate drugs are habit forming. This means that the more a person uses opioids in high doses, the more the body becomes reliant on the drug to maintain a person’s normal internal chemical balance.

This condition is known as physical dependence, and as it forms the body naturally reduces the effect of a given dosage of opioid painkillers over time.

However, if a person experiencing opioid dependence stops taking the drug suddenly, they will experience potentially severe withdrawal symptoms collectively known as opioid withdrawal syndrome.

These symptoms can generally be alleviated using the long-acting opioid methadone, or the partial opioid agonist buprenorphine. 

Alternatively, many people will work with a healthcare provider to taper down their dosage slowly, giving their body time to adjust to the lower dosage without provoking severe withdrawal effects.

Why Tramadol Withdrawal Is Different

While the effects of opioid withdrawal are generally similar from drug to drug (e.g., oxycodone, morphine, fentanyl), tramadol is unique because:

  • it is a relatively weak opioid agonist, generally considered to be only 10% as potent as morphine by dose
  • it also acts as a strong serotonin and norepinephrine reuptake inhibitor (SNRI), similar to many other medications used as antidepressants

Because prolonged tramadol use not only influences a person’s endorphin and opioid receptor activity but also their natural serotonin and norepinephrine levels, tramadol withdrawal can cause strong effects related to mood and emotional health.

This explains why those going through tramadol detox will tend to experience typical and sometimes mild opioid withdrawal symptoms, along with classic symptoms of antidepressant withdrawal like: 

  • disturbed mood
  • flu-like symptoms
  • insomnia
  • nausea
  • impaired balance
  • sensory disturbances
  • increased physiological arousal

Additionally, tramadol use may include unusual side effects and precautions like an increased risk of serotonin syndrome.

Tramadol Detox & Addiction Treatment

Even in cases of severe tramadol addiction and chronic recreational drug use, acute tramadol withdrawal symptoms are not usually life-threatening. However, intense cravings can lead to relapse and increase the risk of overdose.

For this reason, it is strongly recommended that those attempting to withdraw from tramadol do so with the help of medical professionals in a formal medical detoxification program.

Detox programs are designed to support participants with healthy social contact, treatment for uncomfortable or dangerous withdrawal symptoms, counseling, creature comforts, and other help as needed. 

And medical detox is often used as a springboard for subsequent drug addiction treatment services provided in an inpatient or outpatient treatment centers.

If you or a loved one need an intensive treatment program for tramadol abuse or addiction, we can help. To learn about our inpatient treatment options for substance use disorder, please contact Ohio Recovery Center today.

  1. National Library of Medicine: MedlinePlus — Tramadol
  2. National Library of Medicine: StatPearls — Tramadol
  3. Substance Abuse and Mental Health Services Administration (SAMHSA) — Detoxification and Substance Abuse Treatment

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

Prefer Texting?
We've got you covered.

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.

Sign up for text support

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.
Let us walk you through the treatment process. We're here to help.
For 24/7 Treatment Help:
100% Free & Confidential. Call (419) 904-4158