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Ultram/Side Effects

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At the suggestion of Connie, let me talk about the side effects of

Ultram (tramadol). According to the manufacturer, the commonest side

effects include dizziness and vertigo (26%), headache (18%), drowsiness

(16%) and central nervous system stimulation, e.g. anxiety, agitation,

tremor, euphoria, emotional lability and hallucinations. Ultram has

produced seizures in animals and there have been isolated instances of

seizures in patients receiving high doses or in patients receiving

antidepressants. Patients with an existing seizure disorder are most at

risk. Post-marketing surveillance revealed no association between

seizures and usual therapeutic dosages. In 1996 a warning was sent out

by the manufacturer warning of the possibility of drug abuse, seizures

and severe allergic reactions. In April, 1998, the FDA convened the Drug

Abuse Advisory Committee to review post-marketing surveillance data

since the drug's approval. I do not know the final opinion of this

Committee.

Dr. Levin

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