Why would it be dangerous to take Ultram and Zoloft? Aren't they two totally separate drugs? I was prescribed both by the same doctor - one Ultram ER 200 a day, and one zoloft 30 mg. a day. Why would the same doctor prescribe both if there is an issue? It was the pharmacist who said they shouldn't be taken together, but I'm wondering why - what happens? [?]

[EasyMeds]

There is a difference between taking both medications in the same day and taking them together each day. I may be off here, but most likely the pharmacist recommended that you don't take them at the same time because they can both cause you to become drowsy. Or it is possible that there is something in them that will not be effective if taken at the same time.

I know a lot of people who are on anti-depressants and pain medications at the same time and I've never heard of an issue.

David

Something about a seratonin overload that could prove to be potentially fatal. I just don't understand why.

[angelacvoss]

Zoloft and Ultram are not to be prescribed together because the combination can cause seizures. They are contrindicated (sp) because of that.

It doesn't matter what time of day you take the zoloft and what time of day you take the ultram.

It says on the pharmaceutical printour of the ultram to NOT take if you are on zoloft as it may increase the risk of seizure.

This happened to me and I had a grand mal seizure. Thanks a lot doc.

Angela

[circa9870]

It is not seizures that are the problem as angelacvoss says, but he is close and I'm not sure if they result, they may. And you are close with a serotonin overload, it is something like that. Both zoloft and tramadol act on serotonin and effect the way it acts. Because of this it is possible for a person to develop Serotonin Syndrome, which is basically an overload of serotonin in the brain, and yes it can be lethal. Here is some info from http://www.antidepressantsfacts.com/...ndrome-ADF.htm

" The Serotonin Syndrome is a potentially lethal condition caused by excessive serotonergic activity and is diagnosed by the presence of at least 3 of 10 symptoms: mental status changes (confusion, hypomania), agitation, myoclonus, hyperreflexia, diaphoresis, shivering, tremor, diarrhea, incoordination, and fever.
Source: Journal of Clinical Psychiatry

Symptoms: euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, mental status changes were frequent (including confusion and hypomania - a "happy drunk" state), shivering, diarrhea, loss of consciousness and death.
Source: American Journal of Psychiatry, June 1991 "The Serotonin Syndrome" "

There is some info for you, taking both of those meds together simply increases your risk of serotonin syndrome, I think that there is some risk of it even just taking any serotonin acting med, although it is very low. You should definitely ask your doctor about this because it is very important thing to know about. The pharmacist is right. When the pharmacist tells you something, take it seriously, pharmacists know their stuff, they are not dummies, they're whole job is knowing drug interactions and knowing about medications. Trust them.

Good luck and I hope that everyone is having a pain-free day,
Circa

[antoan.smith]

Although side effects from Ultram are not common, they can occur. The most frequently reported events were in the central nervous system (Migraine, Speech disorders) and gastrointestinal system (Gastrointestinal bleeding, Hepatitis, Stomatitis, Liver failure). Tell your doctor if any of these symptoms are severe or do not go away: dizziness, headache, drowsiness, blurred vision, upset stomach, vomiting, and diarrhea. If you experience any of the following symptoms, call your doctor immediately: fast heartbeat, redness, swelling, and itching of the face, numbness or tingling of the hands and feet, difficulty breathing, changes in urination, seizures.

If you experience any of the following serious side effects, stop taking Zoloft and contact your doctor immediately or seek emergency medical treatment: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); an irregular heartbeat or pulse; low blood pressure (dizziness, weakness); high blood pressure (severe headache, blurred vision); or chills or fever. If you experience any of the following less serious side effects, continue taking Zoloft and talk to your doctor: headache; tremor, nervousness, or anxiety; nausea, diarrhea, dry mouth, or changes in appetite or weight; sleepiness or insomnia; or decreased sex drive, impotence, or difficulty having an orgasm. Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Before taking Zoloft, tell your doctor if you have liver disease; kidney disease; suffer from seizures; or suffer from mania or have suicidal thoughts. You may not be able to take Zoloft, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Zoloft is in the FDA pregnancy category C. This means that it is unknown whether it will be harmful to an unborn baby. Do not take Zoloft without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether Zoloft passes into breast milk. Do not take Zoloft without first talking to your doctor if you are breast-feeding a baby.