Background: Tramadol misuse and poisoning are serious health concerns in regions with limited prescription regulation, including Iran. Beyond its toxicologic effects, the pharmacologic properties of tramadol and associated psychosocial factors may contribute to elevated suicide risk. Accordingly, this study aimed to assess suicide risk using the SAD PERSONS scale among patients presenting with acute tramadol poisoning to the emergency department. Methods: This descriptive cross-sectional study evaluated 80 patients with confirmed tramadol poisoning presenting to Sina Hospital during 2021–2022. Demographic data, motives for tramadol use, adverse effects, and SAD PERSONS scores were collected, and suicide risk was categorized as low (0–4), moderate (5–6), or high (7–10). The obtained data were analyzed using descriptive and inferential statistical tests. Results: The mean age of participants was 36.25±6.81 years. Overall, 66.25% and 61.25% were male and single, respectively. The average daily tramadol dose was 912.96±245.16 mg. The mean SAD PERSONS score was 6.85±2.37, with 43.75%, 28.75%, and 27.5% categorized as high, moderate, and low risk, respectively. Moreover, pleasure-seeking (40%), depressive symptoms (33.75%), and sexual performance enhancement (27.5%) were the most frequently cited motives for use. Eventually, dizziness (60%), nausea (55%), and seizures (31.25%) were the most commonly reported adverse effects. Conclusion: A substantial proportion of tramadol-poisoned patients demonstrated moderate-to-high suicide risk, highlighting tramadol poisoning as a toxicologic emergency and a psychiatric crisis. Integrating structured suicide screening and timely psychiatric evaluation into emergency care is essential for early detection and prevention of recurrent self-harm.
Aghajani et al. (Thu,) studied this question.