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Re: Has Anyone Taken Tramadol (Ultram) With An SSRI?

Posted by bleauberry on July 21, 2009, at 5:11:12

In reply to Has Anyone Taken Tramadol (Ultram) With An SSRI?, posted by Brainbeard on July 21, 2009, at 4:50:17

As you are apparently aware, combining tramadol and ssri is a risky idea. Serotonin toxicity syndrome is a real risk with this, as is as an increased risk of heightened side effects.

I would be more inclinced to try something known for both pain and depression. I am assuming depression is a factor here since zoloft is on board? Or anxiety? Both? Either way, doesn't matter, what med is routinely prescribed for both pain and depression and anxiety and has a track record of dependability spanning half a century? Nortriptyline. What med happens to partner very well with zoloft? Nortriptyline.

That's where I would start. I can say from experience that pains which were helped only minimally by Advil or Tylenol, and minimally by tramadol, vanished within about 36 hours of starting a tiny 5mg dose of nortriptyline.

Zoloft+nortriptyline makes a whole lot more sense to me than zoloft+tramadol. Though nortriptyline is classified as an antidepressant, most people who take use it for pain instead.

I would put tramadol on the shelf for another day if this approach does not work out. Try simpler and safer first.

The other thing with tramadol is the significant risk of becomiing tolerant, needing higher doses, and eventually suffering horrible withdrawals if and when you ever need to decrease the dose or get off it. Even stopping it after being on it just a week or two is quite unpleasant.

I think it would be easy to go the nortriptyline route. Your doc could probably agree to that on the phone and call it in to your pharmacy. I think most doctors would be a whole lot more comfortable with that than tramadol.

Taking the lowest effective dose is a good strategy, so you might find that a simple half of a 10mg capsule is enough. If not, most people seem to end up in the 25mg to 50mg range, with a few in the 100mg to 150mg range. At askapatient.com it is apparent that low supposedly subtherapeutic doses of nortriptyline provide considerable improvement in about 70% to 80% of cases.


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poster:bleauberry thread:907706
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