Prevalence and characteristics of tramadol-induced seizures in young adult emergency admissions.

INTRODUCTION: Tramadol is an opioid analgesic used to treat moderately severe pain. Overuse and recreational use of tramadol may cause seizures, but the extent of this problem remains unclear. This study evaluates admissions with tramadol-induced seizures (TIS) among young adults admitted to the emergency department (ED).

METHODS: A cross-sectional study was conducted on all patients aged 15-30 years with a seizure diagnosis admitted to the ED at Aarhus University Hospital from 1 January 2021 to 31 December 2022. Data were retrieved from a retrospective medical records review.

RESULTS: We identified 232 unique patients with 352 seizure admissions; 41 patients (17.7%) (38 male (92%)) with 62 admissions secondary to TIS. The mean (± standard deviation) age of persons with TIS was 20.34 years (± 3.19) compared to 21.88 years (± 4.45) for those with other seizure aetiologies (p = 0.00947). The median tramadol dose was 200 mg (range: 50-1,200 mg, IQR: 50-300 mg). A subgroup of 12 patients accounted for 33/62 (53%) of total TIS admissions. Concomitant cannabis use was common and was reported in 40% of TIS admissions. Among the 62 TIS admissions, only two patients had a prescription for tramadol. The mean time spent in the ED was 5.74 hours (± 5.12). A CT of the brain was performed in 33/62 (53%) of TIS admissions. A total of 31 ambulatory follow-up neurological evaluations were conducted.

CONCLUSIONS: Tramadol is a frequent cause of seizures among young adults admitted to the ED. Targeted interventions to reduce recreational use among young adults are urgently needed.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.