Withdrawal syndrome and dependence: tramadol too.

(1) Tramadol carries a risk of dependence and abuse, even in patients with no history of drug abuse. (2) Abrupt withdrawal of treatment with tramadol, even at the recommended dose, can induce withdrawal symptoms. (3) In practice, patients must be advised to stop their treatment gradually, especially after lengthy treatment periods. Prescription renewals are a good opportunity to re-assess the need for tramadol. Use of this opioid analgesic should not be trivialised.