Evaluation of distribution of genetic polymorphism CYP2D6*10 in tramadol poisoning with seizure: A Case-Control study

Document Type : Research Paper


1 Medical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Ashkezar, Yazd, Iran

2 Pharmaceutical Research Center, Department of Toxicology and Pharmacology, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran.

3 Influenza and other respiratory virus research department, Pasteur Institute of Iran, Tehran


Background and Objective: Tramadol overdose is inappropriately prevalent in Iran and is one of the most common causes of hospital admissions in recent years. Tramadol is both a codeine family and a weak opioid receptor agonist (AG) that is used at regular doses as an analgesic and may lead to seizures. The aim of this study was to investigate the relationship between physiological effects of high dose tramadol administration and cytochrome c enzyme gene polymorphism. CYP2D6 (p450) was surveyed in patients with tramadol intoxication referred to the poisoning ward of Razi Hospital, Ghaemshahr city, Mazandaran province.
Method: This case-control study was performed on 121 patients admitted for poisoning by Tramadol only in 2016. These patients did not have any previous underlying diseases such as cardiac and renal complications. Sixty of the patients had seizures due to tramadol. At first, the demographic data of patients were collected via a questionnaire and from each patient 5cc blood was taken. After preparing the blood samples, RFLP-PCR was used to evaluate the CYP2D6 gene polymorphism (rs1065852).
Results: The mean age of patients was 25 years. 78% of them were smokers. P<0.05 was considered as the level of significance. Serum tramadol concentration was higher in those with and without convulsion. There was no significant difference between the two groups in terms of genotype CC. Therefore, it can be concluded that tramadol-induced seizures are not related to the locus of techno-nucleotide polymorphism (rs1065852).
 Conclusion:These healthy young people were probably poisoned due to their size and arbitrary consumption. Therefore, more comprehensive laws and restrictions on the distribution and consumption of tramadol in the community should be formulated.