What could it be?

I was wondering if taking 100mg of  Tramadol at night along with 60 mg Cymbalta and 50 mg of Topamax could cause Serotonin Syndrome? I have recently had several of the symptoms but I was treated for Post Traumatic Stress. The more I think about it, it sounds like SS.

[M4Y0U]

Looking at the possible interactions we should exclude Topamax, I don't think it could interfere badly with the Cymbalta even if there's a small interaction there.

Indeed, Tramadol have SNRI proprieties just like Cymbalta but to a lesser extant. If the doctor prescribed those to you it's ok since serotonin syndrome is very unlike. Serotonin syndrome is a rare medical condition that rarely cause trouble. If you experience fever and agitation I would report ASAP at the ER. Since you are on a considerably high dose of tramadol yes, the interaction is significant and can indeed cause serotonin syndrome, Also since Cymbalta is a potent SNRI. Was the tramadol prescribed with by a doctor knowing you were using tramadol as such high dose and vice versa?

Reading that is serotonin syndrome on the internet won't improve your situation. I repeat serotonin syndrome is a medical condition that rarely cause trouble. If you experience fever then its time to go to the ER. If you have any doubt I would not hesitate to call the pharmacist or report to the ER.

Here I cannot tell you to stop tramadol since I can't give medical advices but I would call my pharmacist ASAP or report to the ER in any doubt of serotonin syndrome. 100mg of tramadol with 60 mg of Cymbalta could indeed cause serotonin syndrome. Everyone have different tolerance to drug but yeah I repeat your tramadol dose is high enough to cause serotonin syndrome with the Cymbalta due to the potency of Cymbalta too.

Like I said, in case of severe tremor, fever, very high BP, hallucinations I would report immediately to the ER.

M4

[M4Y0U]

I hope you take Cymbalta in the morning since it was not clear in your post. Chances are less likely for serotonin syndrome if you take your Cymbalta in the morning and tramadol at night. But I still find the 100mg tramadol dose considerably high.

[trw1115]

all the med were prescribed by the same MD but I had been taken the Cymbalta at nite with the tramadol nite and in the am too to control pain. I have since stopped taking the tramadol at all unless i am hurting then and there. And  I now take the Cymbalta in the AM because I am now on Remeron for depression. I think i might have been taken the tramadol to keep from hurting rather than if I was hurting and I was hooked on it. The  SS thing I was asking about was because I had not started having the fever and bad stuff yet but had started the mild things like nausea, mood swings, insomnia (even though i was taking Ambien!), sweating, then having chills, look it up on the Mayo Clinic site (google Serotonin Syndrome and go to Mayo site). I'm feeling much better now and  will have a talk with my MD that prescribed the Cymbalta and tramadol.  By the way I did go to the ER and was having MAJOR anxiety at the time with these  things happening to me!  Thanks for the input!  TR

[M4Y0U]

Excellent, with Remeron you have no chance of SS (can actually treat SS) and it's good you are off the tramadol.

M4