Tramadol
and Anxiety

What is Tramadol?

Tramadol is a medication that is prescribed for moderate to severe pain. It is part of a drug class called opioid analgesics. It is most useful for those living with around the clock pain that has not responded well to milder painkillers.

Is Tramadol a Narcotic?

As of 2014, tramadol has been listed as a Schedule IV narcotic by the United States government.​​​1 Other countries around the world such as Great Britain also list it as a narcotic. The reason for this is because of the great potential for it to be abused.

Can Tramadol Cause Anxiety?

To understand if tramadol can cause anxiety, it is important to look at exactly what anxiety is and how it is currently treated. For many anxiety disorders, the medical community has associated levels of serotonin to the amount of happiness a person will feel. The higher the amounts of serotonin, the happier a person will be. The lower the levels, the more a person’s mood will be depressed which can cause depression and anxiety.

Medications to Treat Anxiety

Since the level of serotonin is directly proportional to the level of happiness one might feel, it is understandable that if one decreased these levels that anxiety would increase. The current classes of drugs used to treat anxiety do this in several ways. Selective Serotonin Reuptake Inhibitors (SSRIs) are one of the most common forms of anxiety medication. They block the absorption of serotonin, which makes more of it available to regulate your mood. Additionally, there are short term medications such as benzodiazepines that reduce the physical effects of anxiety such as reducing muscle tension.2

How Tramadol Compares to SSRIs

Tramadol works slightly differently. Because it is an opioid, it will bind to the various opioid receptors throughout the brain and nervous system. In turn, these opioid receptors produce what is called dopamine. Dopamine is different than serotonin in that it regulates pain and pleasure. Higher levels of dopamine mean higher levels of pleasurable feelings.

Because dopamine and serotonin are completely different processes in the body, it is not likely that an opioid such as tramadol would cause anxiety due to decreasing serotonin levels. However, a minority of patients have reported anxiety as a potential side effect with somewhere between 1 to 10% of patients reporting this occurring. While there is still much research to be done regarding tramadol, the one theory is that some people lack the enzyme that makes this medication effective which causes anxiety by not treating the underlying pain.

Can Tramadol Help Anxiety?

There are many more people that report positive effects of tramadol in treating their anxiety than in causing. However, it must be noted that what people might believe is treatment is simply covering up the immediate symptoms of the disorder. Tramadol works very similar to benzodiazepines in that the chemicals released from dopamine can make you feel relaxed and less pain. In turn, this could lower levels of anxiety temporarily.3

It’s also possible to feel that tramadol is treating anxiety effectively since they may also function similarly to Selective Serotonin Reuptake Inhibitors in a minority of patients. Again, this must be taken with extreme caution since a potentially life-threatening side effect of this medication is serotonin syndrome. Serotonin syndrome has many possible health risks but is caused by an uninhibited buildup of serotonin in the body.4

While this might seem beneficial in the short term, the long-term health implications are too large. For this reason, it is not typically advisable to take this medication to treat anxiety.

Why Might a Person Turn to Tramadol When Anxious?

Anxiety is a complicated issue that does not have a one size fits all treatment. People respond to different medications in various ways and a disorder like anxiety can be incredibly challenging to address. Effective anxiety treatment may require a mix of medical and therapeutic approaches.

However, some people may mistakenly try drugs not originally designed to address the underlying issue. However, using pain medication to treat anxiety without the guidance of a medical professional will likely lead to more issues as it will not address the underlying causes.

Can You Become Addicted to Tramadol?

Because tramadol is an opioid there is always a possibility of addiction.5 While there may have been less stringent rules in the past, numerous studies in countries all over the world have shown that tramadol is not as harmless as it was once marketed. In the past, tramadol was seen as a drug that functioned as a narcotic without being one.​​​6 The thinking behind this was to develop an extremely mild opioid that could be used to replace stronger opioids to lessen the chance of addiction.

Unfortunately, this proved to be hopelessly optimistic. Doctors soon realized that because tramadol was weaker than its counterparts, larger and larger doses would have to be administered to get the same pain relief as before.7 Patients would then build a tolerance to the drug and as time would go on would need more of it. This would occur even as they were supposed to be weaned off it.

Treating Tramadol and Anxiety

Fortunately for those dealing with tramadol addiction, there are a variety of options available for traditional opioid treatments. One of the most popular, and clinically proven methods, have been the use of buprenorphine and naloxone simultaneously. These two weakened forms of opioids are designed to gradually wean people off the drug and live a sober and healthy life. 

 Of course, using these drugs may only be done in a medically supervised setting and must begin with detoxification as well as outpatient therapy.

Resources


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