FROM THE ORTHO-McNEIL WEBSITE:
DRUG ABUSE AND DEPENDENCE
Tramadol may induce psychic and physical dependence of the morphine-type (µ-opioid). (See WARNINGS.) Dependence and abuse, including drug-seeking behavior and taking illicit actions to obtain the drug are not limited to those patients with a prior history of opioid dependence. The risk in patients with substance abuse has been observed to be higher. Tramadol is associated with craving and tolerance development. Withdrawal symptoms may occur if tramadol is discontinued abruptly. These symptoms may include: anxiety, sweating, insomnia, rigors, pain, nausea, tremors, diarrhea, upper respiratory symptoms, iloerection, and rarely hallucinations.
Clinical experience suggests that withdrawal symptoms may be relieved by reinstitution of opioid therapy followed by a gradual, tapered dose reduction of the medication combined with symptomatic support.

WARNINGS
Seizure Risk
Seizures have been reported in patients receiving tramadol within the recommended dosage range. Spontaneous post-marketing reports indicate that seizure risk is increased with doses of tramadol above the recommended range. Concomitant use of tramadol increases the seizure risk in patients taking:
• Selective serotonin reuptake inhibitors (SSRI
antidepressants or anoretics){EFFEXOR, et. al.},
• Tricyclic antidepressants {triptylines} (TCAs), and other
tricyclic compounds (e.g., cyclobenzaprine {FLEXERIL},
promethazine {PHENERGAN}, etc.), or
• Other opioids.
Administration of tramadol may enhance the
seizure risk in patients taking:
• MAO inhibitors (see also WARNINGS – Use with
MAO Inhibitors),
• Neuroleptics, or
• Other drugs that reduce the seizure threshold.
Concomitant use of SEROTONIN re-uptake INHIBITORS and MAO INHIBITORS may enhance the risk of adverse events, including
seizure (see WARNINGS) and serotonin syndrome.
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Funny that I was given this med considering I take Effexor XR, Flexeril, Amitriptyline AND Phenergan...

Makes me wonder if doctors even read these prescribing info documents???

Anyway, it doesn't work for me at all. Tylenol by itself is as effective in my opinion. But I also take methadone, so maybe that cancels out the Tramadol effectiveness?