. Effect of Tramadol Dependence on The Immune System In A Sample Of Egyptian Male Patients

Abstract

Background: Tramadol is an atypical, mixed-mechanism analgesic involving both opioid and catecholamine processes that appears to have low abuse potential and may be useful as a treatment for opioid dependence. Aim of the work: to determine the effect of tramadol dependence on the immune system function to determine the effect of abstinence from tramadol dependence on the immune system and to determine the effect of the opioid antagonist naltrexone on the immune system. Patients and Methods: This study comprised 61 male patients with tramadol the main substance of abuse, admitted in the inpatient addiction treatment unit in Maadi Military Psychiatry Hospital. Results: There was a statistically significant difference (P<0.05) between naltrexone-free and naltrexone-prescribed group in the level of IgA after 3 months, with the naltrexone-prescribed group showing higher levels of IgA. There was no difference as regards the other parameters. There is a statistically significant difference (P<0.05) between naltrexone-free and naltrexone-prescribed group in the level of IgA after 6 months, with the naltrexone-prescribed group showing higher levels of IgA. When comparing the means of the immunological parameters over the 6 months period, there was a high statistically significant difference (P<0.05) in the levels of IgM and IgA over the 6 months period in the naltrexone-free, naltrexone-prescribed group and total patients. The patients in all groups showed statistically highly significant differences (P<0.05) when the level of IgM and IgA at 3 months was compared to its level at baseline, and when its level at 6 months was compared both to that at baseline as well as to that at 3 months. The levels of IL-2 were increasing while the levels of IL-6 were decreasing in a statistically significant manner. Conclusion: Abstinence from tramadol dependence for 6 months has effects on some of the immunological parameters. The use of naltrexone 50 mg orally as an opioid antagonist in patients with tramadol dependence for 6 months seems to have no effects on the immunological parameters studied in the current study. The use of naltrexone 50 mg orally in patients with tramadol dependence for 3 months may increase the serum level of IgA.