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.