I was originally prescribed tramadol for arthritic pain in my knee. I had no idea at the time what to do about fatigue which could come and go. I didn't think more of it. The tramadol helped greatly. No side effects. I was fearful to tell my doctor about that tramadol was helpful for fatigue. In fact I told a internest about my fatigue and the strange feeling of saddness and he said it was all in my head and should see a shrink. After that I kept my mouth shut to this day. I told my primary in general clunical terms about experiencing depression. So over the years I have tried 10 or 12 different antidepressants. SSRI, DOPA RI, TRICYCLICS etc, etc. All had side affects that were nasty. I feared the clinic doctor would discontinue the tramadol because of the opioid crisis. But eight years later I still take one 50 mg morning and noon. That along with 2 to three cups of coffee per day I have moderate fatigue a couple times per week. My body creates some accustom but not total. Thats why I stick with this dosage and am able to work with what I have got. I feel sorry for people who can't find relief. As a note, my fatigue started after two years of extreme mental trama that caused me to live in a constant state of hypersympathetic.
Without the relief the tramadol gives I'd be divorced and living under a bridge. Also, I have spent thousands on private counseling with multible thearapies. For me it did not change my fatigue. Everybody is different. Keep that in mind all the time when seeking or giving an opinion.