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Abstract
Objective: This study is an observational, analytic, case-control study aiming at assessment of the cognitive functions and neurophysiological changes in tramadol dependent patients and finding correlation between cognitive functions impairment and seizures in the same patients. Method: Subjects participating in this study were 100 subjects divided into 2 groups: Patient group: (n = 50) patients using tramadol as a primary substance of dependence according to DSM IV TR diagnostic criteria of substance dependence (American psychiatric association, 2000), control group: (n=50) healthy control subjects with negative current and past history of substance abuse/dependence. All participants gave written consent and were subjected to the following interviews, assessments and investigations (except addiction severity index (ASI) done only for patient group: Psychiatric assessment using The Mini International Neuropsychiatric Interview (M.I.N.I), addiction severity index (ASI), wechsler memory scale-revised (WMS-R), boston naming test-2 (BNT-2) verbal fluency tests (Letter fluency and category fluency), wisconsin card sorting test (WCST-computer-administered version), urine sampling using drug screening strips, event related potential (P300) and electroencephalography (EEG). Results: Tramadol dependent patients showed significantly worse Wechsler memory, worse boston naming test, worse verbal fluency test and decreased P300 amplitude than the healthy control. Conclusion: Tramadol dependence is associated with deterioration in certain domains of cognitive performance, mainly the general memory assessment, attention, concentration, psychomotor speed, visuospatial function and visual naming ability