People have seizures on <200mg of tramadol all the time. It's prescribed carelessly by GPs and even surgeons as an alternative to schedule 2s and 3s. Go to an ER on any given day and see how many ppl comin in Grand Mal seizing having their tramadol immediately discontinued... It's a nasty drug and a shitty one too.
Take a benzo with high doses.
To the dude I quoted, your advice sucks dick bro. Not everyone hooked on tramadol takes over 400mg either.
My advice, which one? Saying 'I don't think that taking < 400mg/day is so risky (unless you are prone to it.)' is not a fucking advice! I would never advice anyone to take Tramadol just for fun.
What you claim that happens in ERs sounds crazy, but I can accept it... Though my personal experience is very different, and I think I have some.
It is not a nasty drug. It is nasty when taken irresponsibly. I think it can be a really good option for short term pain management. Also it can help depressed people, but it is probably not a good Idea to use it as an antidepressant. There were studies about this, and lot of people reported it helped them when nothing else couldn't. I have noticed on my self that it really helps with depression. In my case this worked only when I was taking it from time to time, usually just few times per month. This effect would last up to few days after taking it, and I was able to notice it only when I was taking at least 150 or rather 200 mg.
That atitude 'You are a moron, I know everything better than you' is also quite stupid. I know that seizures happen, but it seems to me it has been a bit exaggerated. I could be wrong, and god knows how many factors are involved in the issue. As you mentioned ER I will mention the fact that in a country I am from, one didn't need a prescription for it until recently. So we were able to buy it at price approx. 0.8$/50mg, for years. So I really do know many people who were/are taking it, and I never ever heard that anyone ever suffered a seizure (What doesn't mean it didn't happen, I know that.).
Later I got in touch with some groups of people who became addicted because they were taking it for pain relief (most of them regularly with prescription, at least for a while.) some of them for 10 years and even longer. Even here it took a while until I met those that suffered seizures. For me, the main concern was for my kidneys because I noticed more than a few, who use tramal longer than 5-6 years, and who started having issues with their kidneys. Maybe people in some parts of the world are more sensitive to that nasty side effect from those in other parts of the world?
It would be great if we could get more information about people habits, like food, medications, sickness, etc. so we could maybe notice a pattern or some important facts/info about all this...