[1dixie]

I take 30mg morphine ER twice daily and 15mg morphine IR for breakthrough pain. Also take 50mg tramadol five times daily, 60mg cymbalta daily and 50mg zoloft daily. Worried about serotonin syndrome! Should I be? Thanx

[mpvt]

I would be more worried about having a siezure from the tramodol then anything else.It doesn't make sense that your taking a sustained release morphine along with a quick release morphine and then taking tramodol on top.The tramodol is nothing compared to the morphine.Also your taking alot of tylenol.As far as the serotonin are relating to endorphin production.After extended use of opiates your endorphin production drops off quite abit which usually leads to depression.....Dave