Stages of Tramadol Withdrawal Timeline & Symptoms
Tramadol dependence can occur in anyone who uses it for an extended period, even when they are taking it exactly as prescribed. Withdrawal becomes evident when someone misses a dose or tries to reduce their dose and uncomfortable physical symptoms develop. Common signs and symptoms associated with tramadol withdrawal include:
Serious physical and psychological symptoms associated with tramadol withdrawal are uncommon. However, approximately 10% of people will experience profoundly disturbing symptoms, including:
If you or someone you know is experiencing any of these latter symptoms, seek medical assistance immediately.
Initial Reaction
Tramadol has a half-life of 5-6 hours, meaning that it takes 5-6 hours for half of the tramadol in someone’s system to be metabolized into inactive byproducts. A general rule of thumb for estimating how long a drug will remain active in your system is to multiply the half-life by a factor of five. For tramadol, over 95% of the active ingredients will be metabolized within 25-30 hours.
Withdrawal symptom onset is a consequence of the half-life of a drug. With the passing of each half-life, smaller amounts of the active drug will be available for use. Tramadol withdrawal will often set in as soon as four hours after the last dose.
Onset of Symptoms
For many people who have developed a tramadol dependence, withdrawal symptoms may appear as soon as four hours after the last dose, although immediate release and extended-release formulations will have slightly reduced or increased timeframes, respectively.
Peak & Persistent Symptoms
Tramadol withdrawal symptoms often peak around one to two days after the last dose, after which time they gradually subside over the course of several days. Early symptoms often include:
Decrease in Symptoms
After the peak of symptom severity (usually within two days after the last dose), symptoms gradually reduce in intensity over several days. The vast majority of people will have near-total relief within two weeks.
Lingering Symptoms
In extreme cases of tramadol use disorders, symptoms may persist beyond two weeks. This is known as post-acute withdrawal. The most common symptoms associated with prolonged withdrawal include depression and anxiety. Genetic or other physiological predispositions to prolonged withdrawal may exist, but most cases are the result of serious dependence or addiction that occurs with chronic heavy tramadol abuse.