Taking Tramadol With Zoloft

In our latest question and answer, the pharmacist discusses the drug interaction between tramadol and Zoloft (sertraline).

Question

Can you take tramadol along with Zoloft? I got them prescribed from different doctors. 

Asked by Lou On Mar 27, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Mar 31, 2018

Tramadol Zoloft InteractionThere is a potential major interaction between tramadol and Zoloft (sertraline). If taken together, Zoloft and tramadol have the potential to cause serotonin syndrome.


Tramadol - Zoloft Interaction

Serotonin syndrome is characterized by a distinctive group of symptoms that can occur with the use of multiple serotonergic drugs, like Zoloft and tramadol. The symptoms can range from mild to severe and include but are not limited to the following:

  • Hyperthermia
  • Shaking/tremors
  • Nausea
  • Vomiting
  • Agitation
  • Delirium
  • Confusion
  • Rapid heart rate


While serotonin syndrome is relatively rare, it is a medical emergency if it occurs and needs to be treated immediately.


There have been several case studies that have reported serotonin syndrome after the administration of tramadol with Zoloft. Other case studies have reported similar interactions between tramadol and different SSRI drugs as well.


In addition to the potential for serotonin syndrome, the combination of SSRIs, like Zoloft and tramadol, have been associated with an increased risk of seizures. This is most likely due to Zoloft inhibiting the metabolism of tramadol, which can have significant serotonergic activity.


Interaction Summary

Due to the potential risk of serotonin syndrome and the increased risk of seizure, caution is advised in combining tramadol and Zoloft. In most cases, the combination should be avoided but if you are prescribed both, be sure that you are aware of the symptoms of serotonin syndrome and that you are being monitored by your doctor.


Zoloft (Sertraline) Information

Zoloft is a selective serotonin re-uptake inhibitor (SSRI) and works by increasing the amount of the neurotransmitter serotonin in the brain. It is used most commonly for the treatment of depression and anxiety disorders. Common side effects of Zoloft include:

  • Drowsiness
  • Nausea
  • Dizziness
  • Diarrhea
  • Insomnia


Zoloft needs to be used cautiously with other drugs that increase serotonin, as discussed above.


Tramadol Information

Tramadol is structurally similar to codeine and is classified as an opioid analgesic. While the majority of analgesic effect is thought to be due to its activity on opioid receptors, it also is thought to increase the neurotransmitters serotonin and norepinephrine. Common side effects of tramadol include:

  • Constipation
  • Dizziness
  • Drowsiness
  • Headache
  • Nausea
  • Vertigo
  • Flushing
  • Dyspepsia

About the Pharmacist

Dr. Adam DeRue Pharm.D

Dr. Adam DeRue is a Doctor Of Pharmacy and registered pharmacist.

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