... release and tramadol together. My doctor said if I just take the 50mg of tramadol every once in a while it should be fine. I looked up the interactions and it is on high warning with mixing because of seratonine syndrome. My doc also told me that is very rare so rare in fact that he has never had a patient get it. Because I get panic attacks on top of my depression and lack of sleep I look everything up and obsess over it. I still take it every now and then because my tension headaches are so bad I have to take them. I also take lorazepam .5mg at night to help me sleep. Any one who has taken this please let me know is it really safe?