The Possible Effect of Acute Suicidal Tramadol Overdose on CD4+ Percent

Document Type : Original Article


1 Fellow of clinical toxicology,Poison Control Center, Ain Shams University Hospitals, Cairo, Egypt.

2 Fellow of biochemistry, Poison Control Center, Ain Shams University Hospitals, Cairo, Egypt.


Background: Opioids can produce several well-known adverse events, and recently has been recognized to interfere with the immune response. However, from several studies it emerges that not all opioids induce the same immune-suppressive effects, some opioids have little effect on immunity, others can be immune-suppressive or immune-stimulant. Evaluating each opioids profile is important for appropriate analgesic selection. Analgesic drugs devoid of immune-suppressive effects might offer a good alternative to morphine for the treatment of postoperative pain.
Aim: This study aimed to evaluate the effect of tramadol on immune system by measuring CD4+ percent in patients presented with acute suicidal tramadol overdose.
Methods: This study included 40 candidates divided into 2 groups, tramadol group consisting of 30 patients with acute suicidal tramadol overdose and control group consisting of 10 healthy non-smoker persons. Lymphocytes % and Expression of CD 4+ % were assessed after admission to detect effect on immunity.
Results: The results revealed that there is significant decrease in the lymphocytic percent and CD4+ expression in the tramadol group.
Conclusion: We can conclude that tramadol overdose had suppressive effect on lymphocyte proliferation and CD4 expression and other studies are needed to test the effect of different doses of tramadol on immunity to document its safety as analgesic in immune-compromised patients.