Tramadol Research Paper

Tramadol was the first medication in its class to produce dual analgesic effects, acting synergistically as an opioid agonist and monoaminergically as a serotonin and norepinephrine reuptake inhibitor11. It acts on the μ-opioid receptor as a weak agonist and acts on serotonergic and noradrenergic nociception. Tramadol has two chiral centers and is used as a 1:1 racemic mixture of two enantiomeric diastereomers, the R,R-enantiomer ((+)-tramadol) and S,Senantiomer
((-)-tramadol). The (+)-tramadol enantiomer is the most potent serotonin reuptake inhibitor, while the (-)-tramadol enantiomer is the most potent norepinephrine serotonin