Several case reports describe the development of
serotonin syndrome, in patients taking fluoxetine,
paroxetine or sertraline with
tramadol. Another patient developed hallucinations when taking
tramadol with
paroxetine.
There would seem to be little reason for totally avoiding the concurrent use of the
SSRIs and
tramadol but it would clearly be prudent to use the combination cautiously and monitor the outcome closely.
Tramadol should be used with caution with
SSRIs because of the possible increased risk of seizures.