{"err":null,"data":[{"aliases":["tram"],"categories":["opioid","habit-forming","depressant","common"],"combos":{"2c-t-x":{"status":"Unsafe"},"2c-x":{"note":"Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.","status":"Unsafe"},"5-meo-xxt":{"status":"Unsafe"},"alcohol":{"note":"Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.","status":"Dangerous"},"amphetamines":{"note":"Tramadol and stimulants both increase the risk of seizures.","status":"Dangerous"},"amt":{"status":"Dangerous"},"benzodiazepines":{"note":"Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration is a risk when passed out, lay down in recovery position if ingested.","status":"Dangerous"},"caffeine":{"status":"Low Risk & No Synergy"},"cannabis":{"status":"Low Risk & Synergy"},"cocaine":{"note":"Tramadol and stimulants both increase the risk of seizures.","status":"Dangerous"},"dextromethorphan":{"status":"Dangerous"},"dmt":{"note":"Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.","status":"Unsafe"},"dox":{"note":"Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.","status":"Unsafe"},"ghb/gbl":{"note":"The sedative effects of this combination can lead to dangerous respiratory depression.","status":"Dangerous"},"ketamine":{"status":"Dangerous"},"lithium":{"note":"Tramadol and Lithium both increase the risk of seizures and serotonin syndrome.","sources":[{"author":"Steven C. Julius, Richard P. Brenner","title":"Myoclonic seizures with lithium","url":"https://doi.org/10.1016/0006-3223(87)90026-6"},{"author":"Charles DeBattista, Mehmet Sofuoglu, and Alan F. Schatzberg","title":"Serotonergic Synergism: The Risks and Benefits of Combining the Selective Serotonin Reuptake Inhibitors with Other Serotonergic Drugs","url":"https://doi.org/10.1016/s0006-3223(98)00161-9"},{"author":"Massot, O., Rousselle, JC., Fillion, MP. et al.","title":"5-HT1B Receptors: A Novel Target for Lithium: Possible Involvement in Mood Disorders","url":"https://doi.org/10.1016/S0893-133X(99)00042-1"},{"author":"Sameer Hassamal, Karen Miotto, William Dale, Itai Danovitch ","title":"Tramadol: Understanding the Risk of Serotonin Syndrome and Seizures","url":"https://doi.org/10.1016/j.amjmed.2018.04.025"},{"author":"Boostani R, Derakhshan S.","title":"Tramadol induced seizure: A 3-year study.","url":"https://pubmed.ncbi.nlm.nih.gov/24009919/"},{"author":"Lagard, C.; Vodovar, D.; Chevillard, L.; Callebert, J.; Caillé, F.; Pottier, G.; Liang, H.; Risède, P.; Tournier, N.; Mégarbane, B.","title":"Investigation of the Mechanisms of Tramadol-Induced Seizures in Overdose in the Rat ","url":"https://doi.org/10.3390/ph15101254 "},{"author":"Sansone RA, Sansone LA.","title":"Tramadol","url":"https://pubmed.ncbi.nlm.nih.gov/19724727"}],"status":"Dangerous"},"lsd":{"note":"Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.","status":"Unsafe"},"maois":{"status":"Dangerous"},"mdma":{"note":"Tramadol and stimulants both increase the risk of seizures.","status":"Dangerous"},"mescaline":{"note":"This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.","status":"Unsafe"},"mushrooms":{"note":"Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.","status":"Unsafe"},"mxe":{"status":"Dangerous"},"nbomes":{"note":"Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures","status":"Unsafe"},"nitrous":{"note":"Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.","status":"Caution"},"opioids":{"note":"Concomitant use of tramadol increases the seizure risk in individuals taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present","status":"Dangerous"},"pcp":{"status":"Dangerous"},"ssris":{"status":"Dangerous"}},"dose_note":" NOTE: Tramadol has a ceiling dose, where recreational effects are not increased. Risk of seizure at doses over 300mg. Tramadol decreases the seizure threshold, use extreme caution. Dosing insufflated is ineffective.","formatted_aftereffects":{"_unit":"hours","value":"1-12"},"formatted_dose":{"Oral":{"Common":"100-250mg","Heavy":"250-400mg","Light":"50-100mg"}},"formatted_duration":{"_unit":"hours","value":"5-7"},"formatted_effects":["euphoria","elevated mood","overall feeling of contentedness","itching","drowsiness","vomiting","urinary retention","nausea","constipation","risk of seizure above 300mg"],"formatted_onset":{"_unit":"hours","value":"1"},"name":"tramadol","pretty_name":"Tramadol","properties":{"after-effects":"1-12 hours.","aliases":["tram"],"avoid":"benzos, alcohol, and other opiates","bioavailability":"Oral 68-72% | Rectal 77%","categories":["opioid","habit-forming","depressant","common"],"dose":"Oral Light: 50-100mg  Common:  100-250mg  Heavy: 250-400mg | NOTE: Tramadol has a ceiling dose, where recreational effects are not increased. Risk of seizure at doses over 300mg. Tramadol decreases the seizure threshold, use extreme caution. Dosing insufflated is ineffective.","duration":"5-7 hours","effects":"euphoria, elevated mood, overall feeling of contentedness, itching, drowsiness, vomiting, urinary retention, nausea, constipation, risk of seizure above 300mg","onset":"1 hour first effects, reaching peak blood concentration at 4 hours.","summary":"A synthetic opioid analgesic, tramadol is used to treat moderate pain and can be considered a medium-strength opioid. Tramadol also has the unusual effect of being a serotonin releasing agent and a serotonin reuptake inhibitor, and as a consequence should not be taken in excess due to the risk of serotonin syndrome. Risk of seizures above 300mg doses."},"pweffects":{"Anxiety suppression":"https://psychonautwiki.org/wiki/Anxiety_suppression","Cognitive euphoria":"https://psychonautwiki.org/wiki/Cognitive_euphoria","Compulsive redosing":"https://psychonautwiki.org/wiki/Compulsive_redosing","Constipation":"https://psychonautwiki.org/wiki/Constipation","Cough suppression":"https://psychonautwiki.org/wiki/Cough_suppression","Difficulty urinating":"https://psychonautwiki.org/wiki/Difficulty_urinating","Itchiness":"https://psychonautwiki.org/wiki/Itchiness","Nausea":"https://psychonautwiki.org/wiki/Nausea","Pain relief":"https://psychonautwiki.org/wiki/Pain_relief","Physical euphoria":"https://psychonautwiki.org/wiki/Physical_euphoria","Pupil constriction":"https://psychonautwiki.org/wiki/Pupil_constriction","Sedation":"https://psychonautwiki.org/wiki/Sedation","Stimulation":"https://psychonautwiki.org/wiki/Stimulation","Thought acceleration":"https://psychonautwiki.org/wiki/Thought_acceleration"},"sources":{"_general":["High-concentration tramadol-induced vasodilation in rabbit aorta is mediated by both endothelium-dependent and -independent mechanisms - http://www.ncbi.nlm.nih.gov/pubmed/12740170","Supra-additive effects of tramadol and acetaminophen in a human pain model - http://www.ncbi.nlm.nih.gov/pubmed/17709207","Opioid and nonopioid components independently contribute to the mechanism of action of tramadol making it 'atypical' - http://jpet.aspetjournals.org/content/260/1/275.short"]}}]}