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Hear my song: auditory hallucinations with tramadol hydrochloride

BMJ 2000; 321 doi: (Published 23 December 2000) Cite this as: BMJ 2000;321:1608
  1. Paul W Keeley (, specialist registrar⇓,
  2. Gillian Foster, hospice physician,
  3. Lesley Whitelaw, specialist palliative home care sister
  1. Strathcarron Hospice, Denny, Stirlingshire FK6 5HJ
  1. Correspondence to: P W Keeley

Tramadol hydrochloride is a weak opioid with effects on seratoninergic and adrenergic neurotransmission.1 It is reported to have fewer opioid adverse effects than conventional opioid analgesia.2 We report an unusual but important adverse effect not previously reported with the drug.

Case report

A 74 year old man with lung cancer was referred to the palliative care team for symptom control. He had pain in the left side of his chest and was advised to take tramadol hydrochloride 50 mg four times daily at home. Soon after starting the tramadol, he …

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