I have taken Paxil, Prestiq, Effexor, Lithium, Gabapentin and Anafranil. None of them worked for my anxiety or depression. All of them made me gain weight and all of them made me tired. Last, they all really decrease libido. Tramadol has no side effects. I just do not understand the taboo of using Tramadol for anxiety or depression. When anxiety and depression are life long conditions to be dealt with, what exactly is the problem with using Tramadol long term ?