Tramadol-Induced Seizures in an Elderly Patient Without Comorbidities: A Case Report

Background Tramadol is a widely used analgesic for moderate to severe pain due to its dual mechanism of µ-opioid receptor agonism and monoaminergic reuptake inhibition. While generally perceived as safe, it has been increasingly associated with neurotoxic side effects, particularly seizures. These adverse effects are commonly reported in patients with epilepsy, polypharmacy, or organ dysfunction. However, seizure events in elderly individuals without known risk factors are rare and underreported. Case Presentation: We describe a 72-year-old woman with no prior medical history who developed a generalized tonic-clonic seizure after administration of tramadol for an upper respiratory tract infection. She had received three therapeutic doses of tramadol. Her laboratory investigations and neuroimaging were unremarkable. Following withdrawal of the drug, the patient made a full recovery with no further seizure activity. Discussion Elderly patients are particularly vulnerable to adverse drug reactions due to altered pharmacokinetics and pharmacodynamics associated with aging. This case highlights the potential for tramadol to induce seizures even in the absence of predisposing comorbidities or drug interactions. Clinicians should be vigilant when prescribing tramadol to older individuals and should consider alternatives for pain control. Conclusion Tramadol should be prescribed with caution in elderly populations, regardless of apparent baseline health. Clinician awareness of tramadol’s seizure risk even at therapeutic doses is essential to patient safety.