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Serotonin syndrome risk — GPhC CRA MCQ

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HardCNS TherapeuticsSerotonin syndrome riskGPhC CRA

A 46-year-old man taking sertraline 100mg daily presents a private prescription for tramadol 50mg four times daily for back pain. He also takes ramipril and atorvastatin. He reports previous agitation and sweating when a painkiller was added after dental surgery. What is the most important interaction to flag?

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Correct answer: A — Tramadol may increase the risk of serotonin toxicity

Tramadol has serotonergic properties and can increase the risk of serotonin syndrome when combined with SSRIs. Symptoms may include agitation, sweating, tremor, diarrhoea and hyperreflexia. His previous symptoms make the interaction especially concerning. The prescriber should be contacted to consider a safer analgesic plan.

Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment