Alcoholism and Drug Addiction
eISSN: 1689-3530
ISSN: 0867-4361
Alcoholism and Drug Addiction/Alkoholizm i Narkomania
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abstract:
Original article

Investigation of clinical symptoms, paraclinical findings and outcomes in Iranian patients with tramadol poisoning: a 10-year retrospective study

Sahar Noruzi
1
,
Hamid Owlyaei
2
,
Reza Hossein Zadeh
3
,
Niloofar Deravi
4
,
Rasoul Hossein Zadeh
3
,
Mehrnoush Giahi Yazdi
5
,
Ilnaz Alavi
6
,
Farhad Farnaghi
7
,
Mehrdad Kiasi
1
,
Rozhina Shabani Anaraki
1

  1. Department of Medical Science, Yazd Branch, Islamic Azad University, Yazd, Iran
  2. Department of Forensic Medicine & Clinical Toxicology, Yazd Branch, Islamic Azad University, Yazd, Iran
  3. Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  4. Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. General Practitioner, Social Security Organization of Yazd, Iran
  6. School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  7. Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
Alcohol Drug Addict 2025; 38 (2)
DOI: https://doi.org/10.5114/ain.2025.156292
Online publish date: 2025/12/06
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Introduction
Tramadol is a synthetic analgesic with both opioid and non-opioid mechanisms of action, and its abuse has become a major public health concern in Iran. This study evaluated the clinical manifestations, paraclinical findings and complications of tramadol poisoning in Iranian patients from 2014 to 2023.

Material and methods
This descriptive cross-sectional retrospective study included 390 patients with a tramadol poisoning diagnosis admitted to two hospitals in Yazd, Iran. Data was obtained from hospital records for demographic information, history of addiction, clinical presentation, treatments and paraclinical results and outcomes.

Results
The patients’ median age was 26 years (IQR: 20-36), 68.2% were males and 73.0% of poisonings were due to tramadol abuse. Typical clinical findings were respiratory depression (26.2%) and seizures (23.1%). Paraclinical findings indicated respiratory acidosis (11.0%) and revealed rhabdomyolysis (3.1%). The mortality rate was 0.5% (n = 2).

Discussion
The demographic profile of patients in this study, particularly their young median age and male predominance, is consistent with findings from other Iranian studies. Simi­larly, the high incidence of seizures and respiratory depression confirms these are common and serious complications, which is a finding corroborated by other regional reports. The low mortality rate of 0.5% is also in line with pre­vious studies (0-1.1%), reflecting effective hospital treatment.

Conclusions
Our findings underscore that tramadol-poisoning patients in this cohort are typi­cally young male and often present serious clini­cal complications. The data reinforce the need for targeted public health interventions focused on prevention and stricter control over the availability of tramadol to mitigate this ongoing public health challenge.

keywords:

Tramadol, Poisoning, Seizure, Rhabdo­myolysis
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