The article you requested is

Novel Use of Tramadol Hydrochloride in the Treatment of Tourette’s Syndrome

J Clin Psychiatry 1997;58(4):174-175 [letter]

Letter to the Editor

Sir: Studies have demonstrated that symptoms of Tourette’s syndrome can be attenuated by modulation of the opioid system. However, the response to opioid agonists or antagonists is often limited by side effects and the development of tolerance. Additionally, these compounds have significant abuse potential. The opioid tramadol hydrochloride (Ultram) has low abuse potential, low physical dependency, and mild tolerance. It binds to opioid receptors and also inhibits the reuptake of norepinephrine and serotonin. We report the successful use of tramadol in the treatment of a patient with severe Tourette’s syndrome.