Serotonin Syndrome. Serotonin syndrome?

Very unlikely with just one ..it depends on so many factors ur genetics, tolerance level,duration of drugs intake,their plasma concentration Many case reports exist of patients taking SSRIs or SNRIs who developed serotonin syndrome while taking concurrent tramadol. Reported cases involved combining tramadol with citalopram, fluoxetine, paroxetine, nefazodone, sertraline, and venlafaxine. Some evidence suggests that mirtazapine also may interact with tramadol, but confirmation is needed. Available evidence suggests that higher plasma concentrations of tramadol and/or SSRIs increase the risk of serotonin syndrome. Some patients have tolerated the combinations, only to develop serotonin syndrome when the dose of one or both drugs is increased. Also, tramadol is metabolized by CYP2D6, and some SSRIs are moderate- to-potent inhibitors of CYP2D6 (eg, fluoxetine, paroxetine, duloxetine). Finally, genetic deficiencies in the CYP450 isozymes that metabolize tramadol or SSRIs may increase the risk of serotonin syndrome by increasing plasma concentrations. One patient who developed serotonin syndrome following tramadol and citalopram had decreased activity of the isozymes involved in the metabolism of both tramadol (CYP2D6) and citalopram (CYP2C19).

stop tramadol..ask alternative stop worrying also