Methadone detoxification of tramadol dependence

Tramadol hydrochloride is a centrally acting analgesic with a partial affinity for the opiate receptor (μ), having an analgesic potency estimated to be one tenth that of morphine. While preclinical investigations suggested that abuse liability associated with tramadol use is low, there are increasing numbers of cases reported to the U.S. Food and Drug Administration of abuse, dependence, and withdrawal associated with tramadol use. A case of a patient with tramadol dependence requiring detoxification with methadone is presented. Acute management of significant tramadol dependence has not yet been reported in the literature. Long-term treatment issues are also discussed. (C) 2000 Elsevier Science Inc.