TRAM Causes Serotonin Toxicity

The second issue raised by several reports is that TRAM causes “serotonin toxicity”. A review of one such U.S. based primary study18 that reported a single case of serotonin toxicity after TRAM was used revealed that, TRAM was co-administered with other drugs (i.e., venlafaxine and mirtazapine)18. The study performed a causality assessment and reported that, serotonin syndrome was observed after adding Tramadol to the existing medication regime (of venlafaxine and mirtazapine). Based on the analysis of results, a combination of multiple drugs caused the serotonin syndrome and serotonin release by Tramadol (which certainly contributed) cannot be solely attributable to the adverse drug event. In addition, the case study only included one patient (a 47 year white male with a history of antidepressant medications) which limits the generalizability of the results. A more recent primary study17 also evaluated whether serotonin toxicity is associated with Tramadol use? This study analyzed a single case of a 45-year old woman who consumed a large amount of TRAM dose (1000 mg) along with other acetaminophen (hydrocodone) in a short span of time (2 days). The patient had a history of migraine but had altered mental state (that led to hallucinations) when admitted to the hospital’s ER. Upon …show more content…
vs. Other Countries show that, TRAM overdose is more commonly occurring phenomenon in developing countries14, 15, 16. In U.S. studies, the clinical study results showed that TRAM has a low abuse potential and is less potent than some other opioid drugs in the same class. The studies recommend that, a moderate dose of 100 mg should be administer to the patients. In light of the evidence presented in this paper that, if TRAM is not controlled (and is made available without prescription), it is significantly more likely to be abused (as seen in countries where it is not a scheduled drug), TRAM should be prescribed carefully and be