Chronic pain is the main indication for tramadol use. It is used for moderate to severe pain, and also can be administrated to treat rheumatoid arthritis and fibromyalgia.
This drug has a weak affinity for μ opioid receptors, producing its analgesic effects. Tramadol has synergistic effects with numerous other receptors, as it also affects nicotinic, muscarinic and NMDA receptors.
There are two enantiomers of tramadol, which are combined to make a racemic mixture. One enantiomer inhibits 5-HT (serotonin) reuptake and enhances its release. The other enantiomer inhibits NE reuptake. It is the modulation of these various receptors and neurotransmitters in combination that help tramadol exhibit its effects.
Tramadol has been shown to increase the risk of seizure by lowering the threshold in patients. This is a dose-independent side effect.
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