Interaction between Tramadol and SSRI’s: do we care?

Abstract

e43 vs. PsA63% and 37%). The longest duration of biologic therapy was in AS patients (47 months). Regardless of diagnosis, 31% patients required switching to another biological due to non efficacy (94, 1%). TNFα inhibitors were switched in 73% cases and etanercept in 27% patients. Seven patients discontinued treatment due to complete remission, serious infection, chemotherapy, cerebrovascular insult, newly diagnosed psychiatric disorder, moving to another city and private reason. There were 21 adverse drug reactions: infections ( 16), leucopenia and anemia (4) and pharyngeal carcinoma (1). Conclusion: Six biologic agents with different mechanism of action (TNFα inhibitors (4), anti-CD20 (1) and IL6 inhibitor (1)) are used in treatment of RA. For AS and PsA, four TNFα inhibitors were used what is in accordance with Croatian clinical practice guidelines. More frequent switching between different TNFα inhibitors is consistent with similar reports.

Potential for Drug-Drug Interactions with Adjunctive Tramadol Use in Treatment of Obsessive-Compulsive Disorder

“…5 If tramadol is included in future clinical practice guidelines for OCD, potential interactions with other medications recommended as first-line treatments should be clearly described, especially as recent evidence suggests that clinician awareness of the potential for interactions between tramadol and SSRIs is low. 7 While tramadol is suggested as an adjunctive therapy in the existing CPA guidelines, only a single case report is cited to support its combination with another recommended treatment. Conversely, a broader array of case reports 5 suggests a risk of serotonin syndrome when tramadol is coprescribed with SSRIs, including paroxetine, fluoxetine, and sertraline-first-line treatments for OCD but inhibitors of CYP2D6.…”