Introduction: Tramadol* is a synthetic opioid agonist used as an analgesic. Despite its minor potential of addiction, it created recently a lot of concern. Its misuse may be motivated by a need to control the pain or by looking for her euphoric character. The aim of our study was to proceed a psychopathological reading of a case of addiction to Tramadol in a sickle cell patient with histrionic personality traits. Methods: We report the case’s management of a patient with addiction to Tramadol in a sickle cell patient with histrionic personality traits. The diagnosis was based on the DSM IV criteria. The review was done in the model of semi-structured interviews. Observation: Miss DP is 23 years old, sickle cell patient (AS profile). It is addressed to us for the management of an excessive consumption of Tramadol* started 4 years ago. Because of the difficulties of care in outpatient, we conducted hospitalization. The interviews highlight the histrionic personality traits and disruption of family dynamics. Discussion: Painful chronic diseases require a long analgesic treatment. It is a factor of dependence specially when the patient has a personality disorder. Multidisciplinary treatment between psychiatrist and addiction specialist and medical doctor is a guarantee of success.
References
[1]
Cassier, V. (2014) Etude retrospective des intoxications aiguês au tramadol (2007-2013) à partir des données du centre antipoison et de toxicovigilance de Bordeaux: Impact du retrait du dextropropoxyphène. Thèse pour l’obtention du Diplome d’état de docteur en pharmacie Présentée et soutenue publiquement Le 7 mai 2014.
[2]
Maiga, D.D., Seyni, H., Moussa, A.O. and Sidikou, A. (2012) Mesusage du tramadol par les adolescents et jeunes adultes en situation de rue. The Pan African Medical Journal, 13, 55.
[3]
Chèze, M. (2016) Opiacés, opioides et produits de substitution: Toxicologie. EMC-Biologie Médicale, 11, 1-13.
[4]
Organisation mondiale de la Sante (OMS) (2003) Comite OMS d’experts de la pharmacodépendance. http://libdoc.who.int/trs/WHO_TRS_915_fre.pdf
[5]
Thiam, L., Drame, A., Coly, I.Z., Diouf, F.N., Seck, N., Boiro, D., Ndongo, A.A., Basse, I., Niang, B., Deme/Ly, I., Sylla, A., Diagne, I. and Ndiaye, O. (2017) Profils epidemiologiques, cliniques et hematologiques de la drepanocytose homozygote SS en phase inter critique chez l’enfant a Ziguinchor, Senegal. Pan African Medical Journal, 28, 208. https://doi.org/10.11604/pamj.2017.28.208.14006
[6]
Vuillet-A-Ciles, H., Buxeraud, J. and Nouaille, Y. (2013) Les médicaments de la douleur: Les antalgiques de palier II. Actualités pharmaceutiques, 52, 27-30.
https://doi.org/10.1016/j.actpha.2013.03.016
[7]
Lanier, R.K., Lofwall, M.R., Mintzer, M.Z., Bigelow, G.E. and Strain, E.C. (2010) Physical Dependence Potential of Daily Tramadol Dosing in Humans. Psychopharmacology, 211, 457-466. https://doi.org/10.1007/s00213-010-1919-3
[8]
Daniel Guelfi, J. (2007) Frederic Rouillon l’examen clinique. In: Julien Daniel Guelfi, Frederic Rouillon Manuel de Psychiatrie, Elsevier Masson, Paris, 101-105
[9]
Prochaska, J.O. and DiClemente, C.C. (1983) Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change. Journal of Consulting and Clinical Psychology, 51, 390-395. https://doi.org/10.1037/0022-006X.51.3.390
[10]
Lusher, J., Elander, J., Bevan, D., Telfer, P. and Burton, B. (2006) Analgesic Addiction and Pseudo Addiction in Painful Chronic Illness. The Clinical Journal of Pain, 22, 316-324. https://doi.org/10.1097/01.ajp.0000176360.94644.41
[11]
American Psychiatric Association (2015) Manuel diagnostique et statistique des troubles mentaux DSM V. Elsevier Masson, Paris, 1200.
[12]
Apert, B., Benzerouk, F. and Rigaud, A. (2015) Trouble de l’usage du Tramadol chez un jeune adulte. Alcoologie Et Addictologie, 37, 327-332.
[13]
Cupples, N. and Moore, T.A. (2013) A Case of Tramadol Dependence and Successful Treatment with Buprenorphine/Naloxone. Mental Health Clinician, 3, 283-285.
https://doi.org/10.9740/mhc.n183348
[14]
Prakash, J. and Saini, R. (2010) Tramadol Dependence: A Case Report. Medical Journal Armed Forces India, 66, 93-94.
https://doi.org/10.1016/S0377-1237(10)80114-5
[15]
Haute autorité de la santé (2004) Stratégies thérapeutiques pour les personnes dépendantes des opiacés. Place des traitements de substitution, conférence de consensus, 23 et 24 juin 2004.
[16]
Bruno, D. (2003) Facteurs de résilience dans les toxico-dépendances. Psychotropes, 9, 61-75. https://doi.org/10.3917/psyt.091.0061
