Tramadol: Relieves Pain, Improves Mood, Induces Mania

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To the Editor: Corticosteroids and antidepressants are known to induce manic episodes in predisposed individuals. Manic episodes in bipolar patients triggered by tramadol have also been reported.

Tramadol acts as an opiate agonist by activating the μ-opioid receptor and as a promotor of serotonin and norepinephrine activity by modulating their transport.