Tramadol and Drug Interactions

[Other]

My regular doctor has given me Tramadol (50mg) to be taken three times daily. I am also on Seroquel (50mg 3/day) and Pristiq (50mg 1/day). My doctor is aware of what my medicines my psychiatrist has put me on - but I have recieved questioning looks every time I say "Pristiq" or "desvenlafaxine". Not from the doctor, though I didn't discuss it in depth with her, but from nurses and therapists that I have seen. Apparently it is either newish or rarely used?

I haven't found a lot of literature on the interactions with the other two and the Tramadol, but what I have found says it could be a bad thing. I can't really translate all of the medical jargon, but there seems to be problems with seratonin-affecting drugs or something of that nature.

Has anyone else taken these in combination in part or full and did it have a negative effect?

-Other

 

[empowered]

Hi Other,

Asking the pharmacist that filled the prescription about possible interactions would be something you could do.

 

[Other]

Hi empowered -

Thanks for the reply. I have several printouts from the pharmacist about possible interactions, and the two medications I am on are not a part of that list, although the list only contains common anti-depressants. It is difficult for me to ask the pharmacist directly - I have some agoraphobia problems, and I don't normally interact with a pharmacist. But I can ask my psychiatrist later this week during a scheduled appointment.

The Tramadol was given for pain, since I cannot take most regular pain relief meds over the counter (NSAIDs I think they are called). So I'm hoping to find some answers before my appointment - I need something, but I'm afraid to take these.

-Other

 

[cherryblossom]

Hi Other.

I'm not a Doctor or a pharmacist, but I am a medic. My best advice would be to talk to your Doctor about any concerns that you have. Also if you are concerned about the possible interaction of Tramadol with your other drugs, then do not take it until you have been able to put your mind at rest.

However, to the best of my knowledge Tramadol is a type of opioid analgesic, but it also enhances serotoninergic and adrenergic pathways. Pristiq is an SNRI (serotonin and noadrenaline reuptake inhibitor). So both will influence the levels of serotonin in you CNS (central nervous system). This means that there is a possibility of an interaction. This does not mean that these drugs can never be taken together, but you should definately speak with your Doctor about the possibility of an adverse reaction and what possible symptoms you should look out for, which may suggest you have too much serotonin in your system.

You may find this site useful.

drugs.com/drug-interactions/pristiq_d07113_tramadol_d03826.html

I am not very familiar with seroquel, so cannot help you with this.

I also have to re-iterate that the best person to talk to about this would be your Doctor or pharmacist. Perhaps you could telephone the pharmacist to ask about it, or get someone to see them or phone on your behalf.

Best of luck and if in doubt, don't take the tramadol. (but don't stop taking the drugs from the psych, without first talking to them, because stopping these abruptly can cause side efffects.)
Take care

 

[2quilt]

One of the best things about this forum is the many highly knowedgeable people we have here, like Cherryblossum!

 

[Other]

Thank you for the information, cherryblossom. I think I will just wait to take the Tramadol until I get a chance to talk to a doctor about it.

-Other

 

[lrs]

I am a pharmacist, I work as a clinical pharmacist, in a setting where this topic has frequently been discussed.
Both drugs increase levels of serotonin, so taking these together can increase the risk of a condition known as "serotonin syndrome".
It does not happen often, but I have seen it personally. It's pretty bad, can even be life threatening. If you like, you can do a google search and read about it.
We generally try to get dr's to use another narcotic analgesic for pt's taking ssri's or snri's. Many dr's discount, or minimize the risk. I think it's foolish, but I have seen it a lot. I personally suspect there are cases of unreported or misdiagnosed serotonin syndrome.
I would discourage the concurrent use of tramadol and any ssri or ssnri.

 

[2quilt]

Irs, what happens to the person when they have seratonin syndrome? What does it feel ike when you are having it?

 

[lrs]

I have not had it myself, so I could not really say what it felt like. Here are some symptoms:
Rapid heart beat, shivering, dilated pupils, tremor or twitching,
hyperactive bowel sounds, high body temperature, sweating, mental confusion, nausea, and diarrhea.

 

[wattle]

I take 150mg tramal SR and a further 2x 50 if i need them, plus I'm taking Prozac 80 mg along with several other things. When the doctor first prescribed the Prozac her computer started setting of an alarm and flashing lights, which was kind of worrying at the time. I asked the doctor and she pretty much said I'd be fine, don't worry about it, not a problem! Anyway I asked the pharmacist, who gave me a print out on the side effects etc and told me to speak to the doc again if I was worried, well yes I was still worried. So I used the computer and found the side effects and the seratonin syndrome stuff, it didn't put my mind at rest and in fact I still get very anxious about the meds. I honestly believe the Tramal makes me more depressed, for me it's not an option to stop the Tramal however and I've also read that they are highly addictive. So for me if I'm having a good to middling patch and my pain level is within livable limits, I don't take the tramal at all, that can be for a week or several days.

 

[Lucy Loo]

I know this wasn't asked by the OP, but I just wanted to let you know that tramadol can be, for some people, highly addictive. I don't think doctors are even aware of how addictive it can be for some people. Note that I said "some", because it doesn't appear to be this way for everyone who takes it, only some.

I was on tramadol for a while and when it came to stop, I had terrible withdrawal symptoms and the most awful depression for quite a long time afterwards. I went online to find out more, come to find out that there are many other people out there that find this drug quite addictive in nature.

Sorry, I don't mean to scare you, but more just wanted to warn you since some doctors don't seem to understand its potential effect.

 

[lrs]

That is also true LL.