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      Factors related to seizure in tramadol poisoning and its blood concentration.

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          Abstract

          This study examines the relation between seizure and plasma tramadol concentration in patients with tramadol poisoning, as a novel centrally acting analgesic used for the treatment of mild to severe pain. All patients admitted with a history of tramadol overdose accompanied by unconsciousness or seizures referred to Baharloo Hospital Poison Center, Tehran, Iran from March 2008 to March 2009 were included. Demographic information, clinical findings, and blood tramadol concentrations were studied. There were 401 patients with a history of tramadol overdose; 121 (30.2%) with a history of seizure and 14 (3.5%) with a history of unconsciousness were included. Most of overdoses involved men (83%). The mean age was 22.9 years (range, 14-50 years). Intentional overdose was the most common mode of poisoning (51.9%). The mean dose ingested was 1,511 mg (SD, 1,353; range, 200-7,000). Mean back-extrapolated tramadol blood concentrations were 3,843 ng/mL (3,715; 269-20,049). Back-extrapolated blood concentrations were correlated with dose (r = 0.313; P < 0.001) as well as blood concentration levels (r = 0.801; P < 0.001). Seizure was significantly correlated to higher reported dose (P < 0.001) and tramadol only to overdose (P < 0.001). However, it was neither related to higher tramadol blood concentrations, nor related to time elapsed, age, sex, history of addiction, and observed Glasgow Coma Scale of patients. Most patients experienced just one seizure (76%). The tramadol-induced seizure is dose dependent. Although higher doses of tramadol was related to higher blood concentration, blood tramadol concentrations was not associated with seizure.

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          Author and article information

          Journal
          J Med Toxicol
          Journal of medical toxicology : official journal of the American College of Medical Toxicology
          Springer Science and Business Media LLC
          1937-6995
          1556-9039
          Sep 2011
          : 7
          : 3
          Affiliations
          [1 ] Department of Forensic Medicine and Toxicology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
          Article
          10.1007/s13181-011-0168-0
          3550210
          21735309
          13ac7e32-a923-4ec8-b0a7-d1d89023c7b9
          History

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