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Tramadol and SSRI — GPhC CRA MCQ

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ModerateCNS TherapeuticsTramadol and SSRIGPhC CRA

A 41-year-old man taking sertraline is prescribed tramadol for acute back pain. He asks whether it is safe to take both because he has felt agitated on medicines before. What is the most important interaction to flag?

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Correct answer: C — Serotonin syndrome and seizure risk may increase with the combination

Tramadol has serotonergic activity and can lower seizure threshold. Combining it with an SSRI increases the risk of serotonin syndrome and seizures. The prescriber should consider an alternative analgesic and the patient should be counselled about agitation, sweating, tremor and confusion.

Reference: BNF