Acute-withdrawal restless legs syndrome following abrupt cessation of short-term tramadol

We report a young man who had received tramadol for pain control and experienced an uncomfortable sensation in both legs immediately after tramadol withdrawal that worsened at rest and at night, and which could be relieved only by moving the legs. He suffered from insomnia and paced up and down in his house every night. Readministration of tramadol dramatically resolved his symptoms of restless legs syndrome (RLS), but they reappeared after tramadol withdrawal. Tramadol was therefore replaced with ropinirole, which was discontinued after several weeks, and there was no recurrence of his RLS symptoms. This patient appeared to have developed tramadol- withdrawal-induced RLS, and this case report emphasizes the importance of monitoring for withdrawal-type symptoms like RLS when tramadol intake is being stopped.