Ingesting too high a dose of the painkiller tramadol can trigger seizures.
A new study now shows that tramadol is the cause of a surprisingly large share of seizure-related admissions among young people at the emergency department of Aarhus University Hospital (AUH).

The study, published in the scientific journal Danish Medical Journal, focuses on patients aged 15 - 30. The conclusion is that 62 out of 352 seizure-related admissions in this age group over a two-year period were due to tramadol use. That corresponds to 17.7%.

Doctors became suspicious

Anders Valentin Abildgaard Nielsen is a medical doctor and PhD student at the Department of Forensic Medicine at Aarhus University. While working in the emergency department at AUH, he and his colleagues noticed a pattern: Tramadol was the underlying cause for a portion of young patients admitted with seizures.

The published study reviewed all relevant patient records from 2021 and 2022, and the results strongly confirmed the pattern.
“When more than one-sixth of seizure admissions among young people are due to tramadol, it’s a problem both for the individuals and for the healthcare system,” says Anders Valentin Abildgaard Nielsen.

“These admissions, which could have been avoided, place additional strain on already limited resources in the emergency department, radiology, and neurology. But it’s also a tragedy for the young people themselves, who unfortunately typically are not interested in entering addiction treatment. They walk right back out the door once we’ve identified the underlying cause,” explains Anders Nielsen.

Almost all are men

Doctors cannot force patients to provide a urine sample for drug screening—it requires consent. In the vast majority of cases, information about tramadol use came from the patients themselves. For example, when they are told they are not allowed to drive and must undergo evaluation for a brain tumor and epilepsy.

Almost all of the young people admitted with tramadol-induced seizures during the study period were male. Only three percent had a prescription for tramadol. Concurrent cannabis use was reported in 40% of the admissions. Just 12 out of 41 patients accounted for over half of the admissions.

“This indicates that use is driven by a desire for euphoria or by self-medication, and it demonstrates a significant risk of readmission.,” says Anders Valentin Abildgaard Nielsen.

Harmful use of tramadol can occur when the drug is used without medical supervision to achieve euphoria or relaxation. Tramadol is equally addictive as other opioids, such as morphine, and can lead to physical dependence after just a few weeks of use.

“Tramadol overdose can cause seizures, decreased level of consciousness, and respiratory depression or arrest. It’s a difficult issue, as doctors can only encourage patients to seek help at a substance use treatment program . There’s a need for a different and better way to help this group—especially patients with multiple tramadol-related seizures. In the worst cases, it can be fatal,” the researcher says.

Behind the Research Findings 

• The study is a retrospective cross-sectional analysis based on clinical data from all patients aged 15–30 admitted with a seizure diagnosis at Aarhus University Hospital from 2021–2022.
• It is a collaboration between the Department of Forensic Medicine, Clinical Pharmacology, the Emergency Department, and the Department of Neurology at Aarhus University Hospital.
• Two co-authors have disclosed prior funding from the following foundations, which are unrelated to the study and had no influence on its design, reporting, or publication: the Novo Nordisk Foundation, the Lundbeck Foundation, and the Drug Committee of the Central Denmark Region.
• The study is peer-reviewed and available open access – read it here: https://ugeskriftet.dk/dmj/prevalence-and-characteristics-tramadol-induced-seizures-young-adult-emergency-admissions

Contact

M.D. and PhD Student Anders Valentin Abildgaard Nielsen
Aarhus University, Department of Forensic Medicine
Phone: +45 40 27 50 00
Email: anvanl@forens.au.dk

Associate Professor and Head Consultant Eva Aggerholm Sædder
Aarhus University, Department of Biomedicine
Phone: +45 78 46 36 80
Email: ea@biomed.au.dk

The study is mentioned in Ugeskrift for Læger on August 12, 2025, and in Dagens Medicin on September 26, 2025.