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Moderate Severe Anxiety, Psychiatry & Medication, Severe Anxiety

Tramadol and Alcohol

 September 11, 2020

By  Natalie Kirilova

Medicinal Mushrooms

The Bottom Line

  • Tramadol is an opioid medication used for pain management.
  • A generic form of Tramadol is Ultram.
  • Available in tablets, capsules, and by injection.
  • Tramadol and alcohol are contraindicated to take together.

What is Tramadol? 

Tramadol is a medication prescribed to treat moderate to severe pain conditions, as well as pain after surgery. A doctor may occasionally prescribe it off-label to treat premature ejaculation, restless leg syndrome, or fibromyalgia. It may be prescribed for long-term treatment, however, caution is required as its regular use can lead to abuse and dependence.

The generic form of Tramadol is Ultram. It is available in tablets, capsules, and by injection. 

It is regulated under Schedule IV of the federal Controlled Substances Act.

What conditions is Tramadol taken for? 

The conditions that Tramadol is used for are moderate to severe pain in adults as well as pain after surgery. Off-label uses are linked to premature ejaculation, restless leg syndrome as well as fibromyalgia if no other medications have been responding or caused many severe side effects. 

Can you drink alcohol while taking Tramadol? 

It is not advised to take Tramadol and alcohol together. Tramadol and alcohol in large doses may cause severe side effects or be deadly.

Is there an interaction between Tramadol and alcohol?

Tramadol is an opioid medication, most commonly used as a painkiller. A doctor may usually prescribe it to treat moderate to severe pain or pain after surgery. It is believed to affect the central nervous system (CNS) and work on the brain’s neurotransmitters, including endorphins and enkephalins, to change how the body responds to pain. It belongs to the class of opioid analgesics and is only released under the Opioid Analgesic REMS program which controls its distribution. 

Alcohol is a depressant that is known to sedate the body and brain when consumed in small doses. When consuming alcohol in large doses, an individual may experience extreme sedation and long-lasting disconnection from reality. 

Mixing Tramadol and alcohol together may lead to life-threatening conditions, as an individual may overdose, experience difficulty breathing or long-term unconsciousness, among other severe side effects, such as: 

Enhanced effects of Tramadol and alcohol. 

Both Tramadol and alcohol act on the CNS which results in relief for the pain. When taken together in high doses, they enhance the effects of each other which may lead to extreme sedation, euphoria, or blackouts.

Suppressed functioning of heart, blood pressure, respiration. 

Tramadol and alcohol in large doses may both affect life-sustaining functions of the body. Mixing them may lead to a comatose state including low blood pressure, accelerated heart rate, and slow respiration which may be deadly.

Organ damage. 

When Tramadol and alcohol are taken together in high doses, they usually lower blood pressure which results in deoxidation of the organs like the brain. This may lead to brain damage, poor memory, and concentration, altered learning, and attention scores, as well as complex problem-solving. 

Overdose.

Mixing Tramadol and alcohol in high doses may lead to overdose, as these two enhance the effects of each other and may cause intoxication of the body.

Development of chronic diseases. 

Regular intake of Tramadol and alcohol together may increase the risk of developing certain medical conditions including cancer, ulcers, cirrhosis of the liver, dementia, arteriosclerosis, or stroke among others.

Uncontrolled behaviors. 

Taking Tramadol and alcohol in combination may increase risk of accidents, aggressive behavior, crime, unprotected sexual contact due to poor judgment, and misunderstanding of what is good or bad.

Sexual dysfunction.

Men who regularly mix Tramadol and alcohol have an increased risk of experiencing erectile dysfunction or impotence.

Malformations and abnormalities of the fetus.

Pregnant women who take Tramadol and alcohol together may give birth to children with multiple disorders or poor respiratory conditions.

Increased probability of mental health conditions.

Individuals who chronically abuse Tramadol and alcohol together may be at great risk of experiencing depression, anxiety as well as substance use disorder.

Increased probability of self-harm incidents.

Individuals who take Tramadol and alcohol in the long-term may experience suicidal ideation or behaviors.

Increased probability of hallucinations.

Tramadol and alcohol may cause hallucinations when taken in large doses. 

Tramadol and alcohol addiction treatment is available in certain medical centers. If you require help, speak to your doctor or seek a rehab clinic that provides a withdrawal treatment. 

The abuse of Tramadol and alcohol is a common concern within all age groups, however, the highest precaution when prescribing this pain killer should be given to young adults under 25 who may voluntarily misuse it.

Disclose a full list of medications and health supplements you already take as well as inform the doctor if you have had a medical history of abuse with Tramadol and alcohol or any other substances.

Can Tramadol be taken for Anxiety?

Tramadol is not classified as anxiolytic medication, however, a doctor may occasionally prescribe it to treat anxiety induced by pain when no other medications showed response or caused severe side effects. Other modalities are available to treat it.

Is Tramadol FDA approved for anxiety?

Tramadol is not approved for anxiety by the Food and Drug Administration (FDA).

Can Tramadol be taken for Depression? 

Tramadol does not have proof of efficacy for depression treatment. Other modalities are available to treat it.

Is Tramadol FDA approved for depression?

Tramadol is not FDA-approved for depression.  

What research supports Tramadol for anxiety? 

  • Tramadol was studied for anxiety/depression-associated behaviors induced by pain in rats. Elevated plus-maze test (EPM) – to record anxiety scores has been involved in the study. On the EPM, rats spent 45% less time than sham on the open arms of the maze. The results have demonstrated that this opioid medication reversed the changes in anxiety-related behaviors in rats, relieved chronic pain, and anxiety as a comorbid of this health condition.

What are the possible side effects of Tramadol? 

It may occasionally cause severe side effects when consumed solo or taken in combination with other medications, health supplements as well as alcohol.

The most common side effects when taking Tramadol are:

  • drowsiness;
  • headache;
  • nausea;
  • sweating;
  • agitation;
  • anxiety;
  • constipation;
  • hallucinations.

The common side effects when taking Tramadol and alcohol are:

  • increased probability of suicidal thinking;
  • vomiting;
  • organ damage;
  • mental and physical impairment;
  • sexual dysfunction.

Do not abruptly stop taking this medication without speaking to your doctor. Gradual discontinuation of the dosage is required.

Overdose incidents have been reported when taking Tramadol and alcohol in high doses. If you believe you have overdosed, seek emergency help immediately (call 911).

It may impair driving ability. Do not drive or operate heavy machinery until you know how it affects your body.

The full list of side effects and their severity depends on the individual’s medical history and treatment plan.

Always speak to your doctor before taking opioid-like pain killers.

Can you take Tramadol while pregnant or breastfeeding? 

Tramadol is not recommended to take while pregnant, as it has the potential to cause malformations and abnormalities in the fetus. Speak to your doctor if you are pregnant, as other modalities are available to treat pain.

The FDA does not approve the use of this pain killer in nursing mothers. 

Can children take Tramadol?

Children under 12 should not be prescribed Tramadol. The FDA warns about its potential for fatal outcomes in pediatrics. 

How to take Tramadol? 

The prescription of this pain killer is only available with the Opioid Analgesic REMS program. The dosage of Tramadol is tailored individually. Always speak to your doctor about the safe intake.

Use in adults:

  • for pain management. The initial dose is 50-100mg/every 4-6 hours.
  • for chronic pain management. The initial dose is 100mg/daily.

Use in geriatrics:

  • for pain management. The initial dose is 300mg/daily of an immediate-release capsule.
  • for chronic pain. The initial dose is 300mg/daily of an immediate-release capsule.

Do not adjust the dose without speaking to your doctor. 

Are there alternatives to Tramadol? 

Prescription medications as Alternatives to Tramadol for Anxiety

Tramadol is a medication prescribed to treat pain in adults. It is a controlled substance that has many precautions, contraindications, and is available only under the Opioid Analgesic REMS program. Speak to your doctor about other prescription medications, including:

  • Klonopin
  • Valium
  • Lexapro
  • Prozac
  • Buspirone
  • Inderal
  • Cymbalta
  • Tofranil
  • Hydroxyzine
  • Zoloft

There are various alternatives. If you’d like to learn more about whether Tramadol, another medication or treatment modality is right for you, we recommend that you speak with a licensed psychiatrist. Here are the best online psychiatry platforms so you can speak with someone right away!

Therapy as an Alternative to Tramadol

Learn more about different therapy options for anxiety here

Energy & Holistic Modalities as an Alternative to Tramadol

Learn more about different energy & holistics modalities for anxiety here

Tech & Devices as Alternative Treatments to Tramadol

Learn more about tech & devices for anxiety here

Disclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.


Natalie is a writer with a focus in medical research with over 10 years of experience

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