# tramdol + zoloft ...is it risky?



## ntdc (Jun 29, 2011)

i was prescribed tramdol for an injury...dr was told i take zoloft. pharmacist was unclear if it was safe....anyone know if the risks are significant?

75mg zoloft, 50mg tramdol


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## Under17 (May 4, 2010)

I wouldn't do it. My pdoc also strongly warned against such a mix. But, that's not to say it's not possible. I've known someone taking on the same combo with 100 mg tramadol and 100 mg sertraline a day


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## DK3 (Sep 21, 2011)

ntdc said:


> i was prescribed tramdol for an injury...dr was told i take zoloft. pharmacist was unclear if it was safe....anyone know if the risks are significant?
> 
> 75mg zoloft, 50mg tramdol


I agree with the last poster, very bad idea to take an anti-depressant with tramadol because tramadol acts on serotonin pathways or certainly raises sertonin levels..you can end up having a "serotonin crisis" on tramadol..I've had mild ones even by mixing "natural" serotonin boosting agents like 5-HTP and St John's Wort. With a prescription med it will probably be much more intense and worse..wouldn't risk it.


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## ntdc (Jun 29, 2011)

thx for the advice

i called the doc back based on the replies here and got a diff doc at the clinic she said no way dont take the tramadol they will re-prescribe me tylenol 3

again, thx disaster averted


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## rik (Jan 4, 2010)

I was prescribed 100mg Tramadol and Amitriptyline. Nothing bad happened. But I think that says nothing


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## jonny neurotic (Jan 20, 2011)

The setraline will prevent O-demethylation of the tramadol. O-desmethyltramadol is a far superior drug to tramadol. IMO O-desmethyltramadol is a far better drug than any SSRI. If you were to stop with the setraline and use something to prevent N-demethylation you will get a higher dose of O-desmethyltramadol which is an SNRI as well as an opioid agonist, an NMDA antagonist *AND* a 5HT2c antagonist. A far better option than setraline for depression and SA IMO, as well as being a more potent analgesic than tramadol.

You can use a high potency milk thistle extract to inhibit N-demethylation. I have used such to good effect.


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## Noca (Jun 24, 2005)

I have many many possible serotonin syndrome interactions with my meds but nothing has ever happened. Then again, I don't care if I die. So.. Even taken Tramadol 100mg with Paxil/or Lexapro many times before. I wouldn't recommend this though if you want to play it safe.


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## The Professor (Jul 31, 2011)

Under17 said:


> I wouldn't do it. My pdoc also strongly warned against such a mix. But, that's not to say it's not possible. I've known someone taking on the same combo with 100 mg tramadol and 100 mg sertraline a day


Would you say that tianeptine and buspirone is a dangerous mix?


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## ntdc (Jun 29, 2011)

jonny neurotic said:


> The setraline will prevent O-demethylation of the tramadol. O-desmethyltramadol is a far superior drug to tramadol. IMO O-desmethyltramadol is a far better drug than any SSRI. If you were to stop with the setraline and use something to prevent N-demethylation you will get a higher dose of O-desmethyltramadol which is an SNRI as well as an opioid agonist, an NMDA antagonist *AND* a 5HT2c antagonist. A far better option than setraline for depression and SA IMO, as well as being a more potent analgesic than tramadol.
> 
> You can use a high potency milk thistle extract to inhibit N-demethylation. I have used such to good effect.


zoloft is working well, anyway i only have 15 pills of tramdol

unfortunately i think zoloft does something to codine because it seems very ineffective , i had to take 60mg to get any kind of relief unfortunately they didnt give me very much of that either


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## ntdc (Jun 29, 2011)

Dr House said:


> I have many many possible serotonin syndrome interactions with my meds but nothing has ever happened. Then again, I don't care if I die. So.. Even taken Tramadol 100mg with Paxil/or Lexapro many times before. I wouldn't recommend this though if you want to play it safe.


the doc was more concerned about seizures then seratonin syndrome, my psychiatrist also said seratonin syndrome is rare hes only had a few patients that it was a problem for


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## Noca (Jun 24, 2005)

ntdc said:


> the doc was more concerned about seizures then seratonin syndrome, my psychiatrist also said seratonin syndrome is rare hes only had a few patients that it was a problem for


I have epilepsy and I've never had a seizure due to wellbutrin, tramadol, or any other seizure threshold lowering med.


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## jonny neurotic (Jan 20, 2011)

ntdc said:


> zoloft is working well, anyway i only have 15 pills of tramdol
> 
> unfortunately i think zoloft does something to codine because it seems very ineffective , i had to take 60mg to get any kind of relief unfortunately they didnt give me very much of that either


Yeah, codeine and tramadol are very similar. They are both metabolised by the same enzymes and both are basically useless unless they ar O-demethylated. O-demethylated codeine is morphine. Zoloft inhibits the enzyme that O-demethylates them. Your doctor should prescribe you a different painkiller because both codiene and tramadol will be rendered useless with zoloft in your system.


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## ntdc (Jun 29, 2011)

jonny neurotic said:


> Yeah, codeine and tramadol are very similar. They are both metabolised by the same enzymes and both are basically useless unless they ar O-demethylated. O-demethylated codeine is morphine. Zoloft inhibits the enzyme that O-demethylates them. Your doctor should prescribe you a different painkiller because both codiene and tramadol will be rendered useless with zoloft in your system.


damn oh well not much chance of that happening...new laws here in my state because its the #1 worst for prescription painkiller abuse ...nobody will write you a script for vicodin even tho i have a bad injury i basically had to beg to get 10 pills of codine


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## hannuraina (Oct 13, 2011)

~edit~


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## jonny neurotic (Jan 20, 2011)

Sorry to bump this but;

I realise a piece of the info I posted is wrong. O-desmethyltrmadol is *not* a serotonin reuptake inhibitor as tramadol is.

Interestingly, the 2C antagonism may inhibit anxiety directly and not as a result of dopamine disinhibition.

http://www.sciencedirect.com/science/article/pii/S0006899303033845

No fluoxetine is purported to be a mild 2C antagonist. Perhaps, if fluoxetine and O-desmethyltramadol were combined, this would prove a very nice SA combo. Must try this at some point...


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## baranok (Nov 17, 2011)

was on fluvoxamine (luvox) and was taking tramadol, dosing as i liked
it was okey but once...felt strong dejavu and then my first seizure, was on floor someone was holding me i thought i was kidnapped by aliens was in utter shock was screaming and then i looked up and there were emergency guys :-D embarrassing moment ...they were scared by my eyes ...they IV'd me valium , did brain CT, was ok got home
i have no epilepsy

i didnt see it coming but i knew about it can happen, so watch for the pre-seizure symptoms and lay to bed so you dont crush your head


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