Tramadol is used to treat moderate and severe pain and most types of neuralgia, including trigeminal neuralgia.[citation needed] It has been suggested that tramadol could be effective for alleviating symptoms of depression Tramadol Hcl and anxiety because of its action on GABAergic, noradrenergic and specifically serotonergic systems. However, health professionals have not yet endorsed its use on a large scale for disorders such as this Tramadol Hcl Tramadol undergoes hepatic metabolism via the cytochrome P450 isozyme CYP2D6, being O- and N-demethylated to five different metabolites. Of these, M1 is the most significant since it has 200 Tramadol Hcl times the affinity of tramadol, and furthermore has an elimination half-life of nine hours, compared with six hours for tramadol itself. In the 6% of the population who have slow CYP2D6 Tramadol Hcl activity, there is therefore a slightly reduced analgesic effect. Phase II hepatic metabolism renders the metabolites water-soluble and they are excreted by the ki'dneys.Tramadol Hcl Thus reduced doses may be used in renal and hepatic impairment.
