Lou asked
Can you take tramadol along with Zoloft? I got them prescribed from different doctors.
Answer
There is a potential major interaction between tramadol and Zoloft (sertraline). If taken together, Zoloft and tramadol have the potential to cause serotonin syndrome.
Tramadol - Zoloft Interaction
Serotonin syndrome is characterized by a distinctive group of symptoms that can occur with the use of multiple serotonergic drugs, like Zoloft and tramadol. The symptoms can range from mild to severe and include but are not limited to the following:
- Hyperthermia
- Shaking/tremors
- Nausea
- Vomiting
- Agitation
- Delirium
- Confusion
- Rapid heart rate
While serotonin syndrome is relatively rare, it is a medical emergency if it occurs and needs to be treated immediately.
There have been several case studies that have reported serotonin syndrome after the administration of tramadol with Zoloft. Other case studies have reported similar interactions between tramadol and different SSRI drugs as well.
In addition to the potential for serotonin syndrome, the combination of SSRIs, like Zoloft and tramadol, have been associated with an increased risk of seizures. This is most likely due to Zoloft inhibiting the metabolism of tramadol, which can have significant serotonergic activity.
Interaction Summary
Due to the potential risk of serotonin syndrome and the increased risk of seizure, caution is advised in combining tramadol and Zoloft. In most cases, the combination should be avoided but if you are prescribed both, be sure that you are aware of the symptoms of serotonin syndrome and that you are being monitored by your doctor.
Zoloft (Sertraline) Information
Zoloft is a selective serotonin re-uptake inhibitor (SSRI) and works by increasing the amount of the neurotransmitter serotonin in the brain. It is used most commonly for the treatment of depression and anxiety disorders. Common side effects of Zoloft include:
- Drowsiness
- Nausea
- Dizziness
- Diarrhea
- Insomnia
Zoloft needs to be used cautiously with other drugs that increase serotonin, as discussed above.
Tramadol Information
Tramadol is structurally similar to codeine and is classified as an opioid analgesic. While the majority of analgesic effect is thought to be due to its activity on opioid receptors, it also is thought to increase the neurotransmitters serotonin and norepinephrine. Common side effects of tramadol include:
- Constipation
- Dizziness
- Drowsiness
- Headache
- Nausea
- Vertigo
- Flushing
- Dyspepsia
