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Tramadol in epilepsy — GPhC CRA MCQ

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HardCNS TherapeuticsTramadol in epilepsyGPhC CRA

A 34-year-old man with epilepsy controlled on levetiracetam asks for tramadol for acute back pain after codeine made him nauseated. He also takes sertraline 100mg daily. What is the most appropriate alternative?

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Correct answer: A — Suggest prescriber review for a non-tramadol analgesic option

Tramadol can lower seizure threshold and has serotonergic activity, creating concern in epilepsy and with sertraline. A prescriber should consider safer analgesic options based on pain severity and cause. Levetiracetam does not remove the seizure risk from tramadol. Stopping antiepileptic therapy would be hazardous.

Reference: BNF