Come on, give us a song

Whenever you wake in an armchair and find the television still on, one of the nightmare experiences is finding yourself watching one of the shows set in a summer camp. Your timing is impeccable. One of those perky leaders has everyone sitting expectantly round a camp fire and she calls for a song. OK, so how many times has that happened to you? Right! It's pure fantasy for something I'm writing on Halloween. But I did come across a very rare event reported in the British Medical Journal (BMJ) and, as a collector of weird trivia, I'm passing it on to you. Tramadol hydrochloride (hcl) is a weak opioid used as a painkiller. No matter what you read, the usual story is that it has fewer side effects than any of the other painkillers. Thus, it's one of the most widely prescribed painkillers in the world and, even though I'm about to report an unusual event, it's the exception that proves the rule. Tramadol hcl has fewer side effects than the other painkillers. So let's travel north to Scotland and meet an elderly patient just approaching his 75th birthday. He takes a cocktail of different drugs to control his lung cancer and has no unexpected side effects. None of the possible interactions affect him. But when the hospital decide to introduce tramadol hcl, he began to hear someone singing. This was distressing to a man of his age. He thought his mind had finally given up and he was demented. When the tramadol hcl was withdrawn, the music faded and was gone after two days. Musical hallucinations are not uncommon in the elderly, more usually affecting women, the depressed and those with hearing difficulties. But, this is the first time that we have a verified auditory hallucination caused by tramadol hcl. So, to the usual list of side effects of drowsiness, dizziness, sweating, nausea and physical trembling, we can now add the incredibly rare possibility of you suddenly hearing a group of teenagers bursting into song around a campfire. If this should happen to you, do not panic. Either you have left your television on, or you are an almost unique person reacting to tramadol hcl with an auditory hallucination.