The manufacturer of the opioid tramadol (Ultram and Ultracet) recently added a warning on their label for people who are suicidal or prone to addiction. Apparently, there have been some tramadol-related deaths in such people. The manufacturer says that you need to be very careful about taking their product if you are also taking tranquilizers or anti-depressants, you drink (alcohol) a lot or if you have depression or emotional disturbance. Talk to your doctor if you are not sure you should be taking tramadol.
And please, only take the dose prescribed by your doctor. Taking more may lead to serious health consequences, including death.
According to press materials, addiction specialist Dr. Alexander Walley says that while caution and the labeling is appropriate, "excluding all patients 'prone to addiction' from treatment with tramadol for pain will leave many prescribers with the false impression that other opioid...s are less dangerous." He also says some patients could derive benefit from tramadol, even though they may be at risk for addiction or suicide. Because of their exclusion from taking tramadol, he says, they may not get full treatment for their pain.
Here's the FDA's safety information on this label change announcement.
News Release. Tramadol Label Updated to Include Risks for Suicide and Overdose. Physician's First Watch. Massachusetts Medical Society. 2010.