Cognitive Profile in Tramadol Addicts | ||||
| Sohag Medical Journal | ||||
| Article 24, Volume 22, Issue 2, July 2018, Page 189-200 PDF (111.35 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2018.40127 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Saber Hadad Mahdi1; Hameed Mustafa Baddary2; Maha Wasfi Mobasher3; Tarek Desoky Ahmed1 | ||||
| 1department, of Psychiatry.Faculty of Medicine-Sohag University. | ||||
| 2department, of Psychiatry.Faculty of medicine-Sohag University. | ||||
| 3department, Psychiatry.Faculty of medicine-Cairo University. | ||||
| Abstract | ||||
| Background and Objective: Cognitive impairment is one of the consequencesof substance abuse. Tramadol abuse is a public health problemin Egypt. The objective of this study was to study the effect of tramadol addiction on cognitive functions, determine if cognitive impairment caused by tramadol is reversible or not and to study the impact of other related factors as duration of intake and dose of tramadol on cognition. Methods: This study included 30 patients with active tramadol abuse, 30 patients abstinent from tramadol for 3 to 6 months and 30 control subjects (matched for age, sex, and education) who were recruited from Kasr Al-Aini psychiatric and addiction hospital (from outpatient clinic and inpatient admitted patients), Egypt.The participants were interviewed using Montreal Cognitive Assessmenttest (MoCA), Trail making test A and B and had urine screening for drugs. Results: 53.33%(n=16) of active group had impaired total MoCA scores compared to 10 % (n=3) in control group.This was statistically significant with P value <0.0001.46.67% (n=14) of abstinent group had impaired total MoCA scores compared to 10 % (n=3) in control group. This was statistically significant with P value 0.002. As regard MoCAsubscores; we found statistically significant impairment in delayed recall and verbal fluency subscores in both the active and abstinent group. There was no statistically significant impairment in Trail making tests A and B.Therewas no association between cognitive impairment and sociodemographicor clinical factors. Conclusions: Cognitive impairment occurs commonly among tramadolabusepatients. Memory impairment and verbal fluencyare the most common cognitive domainsto be affected. Cognitive impairment is not reversible after 3 to 6 months.There is no effect of tramadol dose or duration of abuse on cognitive impairment. | ||||
| References | ||||
|
1. Abo-Elmagd, S., Kodera, A., Okasha, T., Gawad, T.,and Rawson, R. (2013). Tramadol use in Egypt: The emergence of a new public health problem. Canadian Journal of Addiction Medicine, 4(1), p5.
2. Bassiony, M., Youssef, U., Hassan, M. S., Salah El-Deen, G. M., El-Gohari, H., Abdelghani, M., Abdalla, A. & Ibrahim, D. H. (2017). Cognitive impairment and tramadol dependence. Journal of Clinical Psychopharmacology, 37(1),61–66.
3. Bates, M. E., Voelbel, G. T., Buckman, J. F., Labouvie, E. W. & Barry, D. (2005). Short-term neuropsychological recovery in clients with substance use disorders. Alcoholism, 29, 367-377.
4. Beatty, W. W., Tivis, R., Stott, H. D, Nixon, S. J. & Parsons, O. A. (2000). Neuropsychological deficits in sober alcoholics: Influences of chronicity and recent alcohol consumption. Alcohol ClinExp Res, 24, 149-154.
5. Carroll, C. P., Walsh, S. L., Bigelow, G. E., Strain, E. C., & Preston, K. L. (2006). Assessment of agonist and antagonist effects of tramadol in opioid-dependent humans. ExpClinPsychopharmacol, 14(2), 109-120.
6. Davies, S. J. C., Pandit, S. A., Feeney, A., Stevenson, B. J., Kerwin, R. W., Nutt, D. J., Marshall, E. J., Boddington, S. &Lingford-Hughes, A. (2005). Is there cognitive impairment in clinically ‘healthy’ abstinent alcohol dependence?. Alcohol Alcohol, 40, 498-503.
7. Davis, P. E., Liddiard, H. & McMillan, T. M. (2002). Neuropsychological deficits and opiate abuse. Drug Alcohol Depend, 67, 105-108.
8. Di Sclafani, V., Ezekiel, F., Meyerhoff, D. J., et al. (1995). Brain atrophy and cognitive function in older abstinent alcoholic men. Alcohol ClinExp Res, 19, 1121-1126.
9. Eckardt, M. J., Stapleton, J. M., Rawlings, R. R., Davis, E. Z. &Grodin, D. M. (1995). Neuropsychological functioning in detoxified alcoholics between 18 and 35 years of age. Am J Psychiatry, 152, 53-59.
10. Fein, G., Torres, J., Price, L. J. & Di Sclafani, V. (2006). Cognitive performance in long-term abstinent alcoholic individuals. Alcohol ClinExp Res, 30, 1538-1544.
11 . Lofwall, M. R., Walsh, S. L., Bigelow, G. E., & Strain, E. C. (2007). Modest opioid withdrawal suppression efficacy of oral tramadol in humans. Psychopharmacology, 194, 381–393.
12. Manning, V., Wanigaratne, S., Best, D., et al. (2008). Changes in neuropsychological functioning during alcohol detoxification. Eur Addict Res, 14, 226-233.
13. McLellan, A., et al. (1992). The fifth edition of the Addiction Severity Index. Journal of substance abuse treatment, 9(3), 199-213.
14. Medina, K. L., Shear, P. K., Schafer, J., Amstrong, T. G. & Dyer, P. (2004). Cognitive functioning and length of abstinence in polysubstance dependent men. Arch ClinNeuropsychol, 19, 245-258.
15. Mintzer, M. Z., Lanier, R. K., Lofwall, R. M., et al. (2010). Effects of repeated tramadol and morphine administration on psychomotor and cognitive performance in opioid-dependent volunteers. Drug Alcohol Depend, 111, 265-268.
16. Nasreddine, Z. S., Phillips, N. A., Bedirian, V., et al. (2005).The montrealcognitive assessment, MoCA: a brief screening tool for mild cognitiveimpairment. J Am GeriatrSoc, 53, 695– 699.
17. Ng, K. F., Yuen, T. S., & Ng, V. M. (2006). A comparison of postoperative cognitive function and pain relief with fentanyl or tramadol patient-controlled analgesia. J ClinAnesth, 18, 205–210.
18. Pitel, A. L., Rivier, J., Beaunieux, H., Vabret, F., Desgranges, B. & Eustache, F. (2009). Changes in the episodic memory and executive functions of abstinent and relapsed alcoholics over a 6-month period. Alcohol ClinExp Res, 33, 490-498.
19 . Qassem, T., Beshry, Z., Assad, T., Omara, A., &Abdmawgoud, M. (2003). Profiles of neurophysiological dysfunction in chronic heroin users. M.D degree thesis, faculty of medicine, Ain shams university.
20 . Rahman, T. T. and El Gaafary, M. M., (2009). Montreal Cognitive Assessment Arabic version: Reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo. Geriatrics and Gerontology International, 9(1), 54-61.
21 . Reitan, R. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271-276.
22. Rosenbloom, M. J., Rohlfing, T., O’Reilly, A. W., et al. (2007). Improvement in memory and static balance with abstinence in alcoholic men and women: Selective relations with change in brain structure. Psychiatry Res, 155, 91-102.
23. Shadnia, S., Soltaninejad, K., Heydari, K., Sasanian, G., &Abdollahi, M. (2008). Tramadol intoxication: a review of 114 cases .Hum ExpToxicol, 27(3), 201–205.
24. Sjogren, P., Thomsen, A. B., & Olsen, A. K. (2000). Impaired neuropsychological performance in chronic nonmalignant pain patients receiving long-term oral opioid therapy. J Pain Symptom Manage, 19(2), 100–108.
25. Sullivan, E. V., Rosenbloom, M. J., Lim, K. O. &Pfefferbaum, A. (2000). Longitudinal changes in cognition, gait, and balance in abstinent and relapsed alcoholic men: Relationships to changes in brain structure. Neuropsychology, 14,178-188.
26. Taghaddosinejad, F., Mehrpour, O., Afshari, R., Seghatoleslami, A., Abdollahi, M. (2011). Factors Related to Seizure in Tramadol Poisoning and Its Blood Concentration J Med Toxicol, 7(3), 183–188.
27. Ulusoy, H., Coskun, I., &Arslan, M. (2016). Effects of midazolam or tramadol premedication on early cognitive function in endoscopic retrograde cholangiopancreatography (ERCP): A randomized, controlled, double-blind study. Journal of International Medical Research, 44(3), 542–556.
28. Zacny, J. P. (2005). Profiling the subjective, psychomotor, and physiological effects of tramadol in recreational drug users. Drug Alcohol Depend, 80, 273–278.
29. Zakaryaee, H., Mollazadeh, J., Aflakseir, A., Khormaei, F., &Soofi, A. (2012). Cognitive Impairment in Methamphetamine, Buprenorphine and Tramadol Users. European Journal of Scientific Research, 68(3), 321-327.
30. Zinn, S., Stein, R. &Swartzwelder, H. S. (2004). Executive functioning early in abstinence from alcohol. Alcohol ClinExp Res, 28, 1338-1346. | ||||
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