Hi, I've been suffering from anxiety and depression for more than 30 years, also high-blood pressure (7 years), and since May 2012 arthrosis of left knee. I cope very well with everything except the pain in my knee, the specialists I've seen for this have told me I'll need a prosthetic knee-joint at some stage in the future, but meantime I'm taking Tramadol, 100mg at night and 5 drops in water of the same during the dat whenever the pain is too much. I was told about the possible reaction between Tramadol and Effexor causing Serotin Syndrome and, having read about this, I'm really scared something terrible might happen to me. What can I do? I can only walk about 100 metres before my knee hurts like hell, so am almost confined to my home 24/7. The doctors won't even put me on the waiting list for a prosthetic knee (No money in the health service), and I have no private insurance to go down that route. It's making my life a misery and I can't see any future, I'm 56 years old and already had to retire early from teaching (20 years ago) due to my anxiety/depression.