Elrassas HH, Elsayed YA, El Nagar ZM, et al. - Patients with tramadol dependence were compared with healthy controls regarding the prevalence and associations with cognitive impairment. A total of 30 patients with tramadol dependence and 30 healthy controls comprised the sample. Using Benton Visual Retention Test- revised, Trail Making Test A and B and Wechsler Memory Scale, they identified significantly worse performance of patients with tramadol-dependence vs controls in terms of cognitive functions, mainly impaired visual memory, visual reconstruction ability and processing, delayed memory, attention and processing speed, and visual, auditory, immediate, delayed and working memory. A nonsignificant negative association was observed between cognitive performance and the age of patients or length of tramadol use. Per these findings, cognitive impairment more frequently occurs in patients with tramadol dependence vs controls. These findings seem to have applicability for determining the appropriate academic and vocational programs for these individuals and adding skills training, like problem solving, to their standard psychosocial treatment.