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Tramadol and SSRI serotonin toxicity — GPhC CRA MCQ

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HardCNS TherapeuticsTramadol and SSRI serotonin toxicityGPhC CRA

A 40-year-old woman takes sertraline 100mg daily and has been prescribed tramadol 50mg four times daily after dental surgery. She asks whether it is safe with her antidepressant. What is the most important interaction to flag?

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Correct answer: D — Tramadol with sertraline may increase serotonin toxicity and seizure risk

Tramadol has serotonergic activity and can lower the seizure threshold. Combining it with an SSRI increases concern for serotonin toxicity and seizures. The pharmacist should consider contacting the prescriber for an alternative analgesic. Hyperkalaemia and vitamin K deficiency are not expected interaction outcomes.

Reference: BNF