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Though less addictive than most true opiates, tramadol is a synthetic opiate analogue. Incidences of withdrawal and habituation are rare, but do occur. Dizziness, occurs in more than 10 % of patients, but hallucinations, confusion, sleep disturbance and nightmares. Psychic side-effects may occur following administration of tramadol, which vary individually in intensity and nature (depending on personality and duration of medication). These include changes in mood (usually elation, occasionally dysphoria), changes in activity (usually suppression, occasionally increase) and changes in cognitive and sensorial ability (e.g. decision behaviour, perception disorders), though all of these are rare, affecting less than 0.1% of patients.
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