I have abused tramadol for around 10 years. (taking around
I would explain as follows:
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that orthostatic hypotension can be an adverse effect of tramadol, since in the first days of starting it.
This adverse effects usually disappears after a week of stopping tramadol.
Anyway, if orthostatic hypotension persists weeks after stopping tramadol, other causes underlying this condition should be considered: chronic autonomic neuropathy, adrenal gland dysfunction, etc..
For this reason, if your situation does not improve in the next months, may be it could be related to an irreversible damage to the autonomic nervous system or to the adrenal gland.
Anyway, stopping tramadol is necessary to help exclude this possible cause.
You should discuss with a specialist of this field, because it is necessary stopping it gradually in order to avoid withdrawal syndrome.
Hope to have been helpful!
I remain at your disposal for any further questions whenever you need!
Dr. Ilir Sharka, Cardiologist