Ultram (tramadol) with an SSRI antidepressant can end up with serotonin syndrome

Patients who combine the analgesic Ultram (tramadol) with an SSRI antidepressant can end up with serotonin syndrome.

This reaction can occur within a few days...generally causing nausea, sweating, muscle weakness or tremor, and confusion.

We usually don't think of analgesics as affecting serotonin...but Ultram can inhibit the reuptake of serotonin and norepinephrine.