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Doctors Lounge - Psychiatry Answers
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| bgcase
- Fri Oct 16, 2009 5:45 pm |
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I've been taking fluoxetine (20 mg/day) for about 10 years for moderate depression. I have recently started taking tramadol (75 mg/twice per day) for back pain. My doctor alerted me to the possibility and symptoms of serotonin syndrome. It seems to me that serotonin syndrome occurs because tramadol also has a serotonin stimulant effect on the brain and that produces an additive effect to the fluoxetine. If that's true, could I simply stop the fluoxetine and take tramadol on an on-going basis?
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| Debbie Miller, RN
- Sat Dec 19, 2009 6:38 pm |
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 Hello,
It is usually not a good idea to stop an antidepressant cold turkey and really should only be done with the guidance of your doctor, if at all. There is a serious risk of rebound depression. The degree of antidepressant effects you would get with only the tramadol may not be in the therapeutic range so you really need to decide with your doctor about the best course of action, perhaps changing one of the medications. However, in some cases the additional SSRI present in the Tramadol may be quite safe and so are sometimes prescribed together. Your doctor is probably letting you know the possible side effects, as he should with any treatment so you can make an informed decision regarding your treatment.
The two drugs can be used with caution, meaning you should report to your doctor any new or bothersome side effects.
Best wishes
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