Characteristics of Patients with Tramadol Use or Abuse; a Systematic Review and Meta-Analysis

Introduction: Recently a growing number of studies has been reported an association between the incidence of seizures and using or abusing of tramadol.the aim of this study was to review the articles over the patients with tramadol induced seizure which reported their characteristics and consumed tramadol dosage
Methods: The following databases were searched from inception until 30October 2018: PubMed,EMBASE,the Cochrane Library,Scopus, Ovid,Proquest,and Science direct.All cross-sectional studies which were reported the tramadol dosage and individual characteristics in patients with tramadol induced seizure were included.The studies were assessed for any risk of bias using the adapted Newcastle-Ottawa Scale.The pooled estimates were reported using random-effects meta-analysis
Results: Our research resulted in an overall number of 3,275 articles and finally we pooled the data from 11studies involving 970patients. The included studies were all conducted in developing countries.the pooled data resulted in an estimated mean(±standard deviation)of 1,454.5±333.6mg for tramadol dosage inducing seizure in the patients.The average minimum dose of tramadol causing seizure showed an average of 169.5 ± 131.2mg from the pooled data. the mean age of them was estimated as 25.85 ± 0.86 years.Also,83.37±12.6 percent of the patients were male and the manner of poisoning in70.51±29.07 percent of the patients was suicide or abuse.
Conclusion: Our findings demonstrated that the prevalence of seizure following the consumption of tramadol was higher in male sex. Therefore,the probability of seizure should be considered by physicians in prescribing tramadol and the individuals receiving it,especially the ones in a higher risk of exposure,should be properly get informed about its complications.