Opioids Tramadol + Citalopram

[theplacidcasual]

My friend has been on Citalopram for the last year now, not a very big dose, 10mg a day for anxiety. Recently he got hold of some Tramadol and took about 250mg one night. He told me that the buzz he got off the Tramadol was really, really nice, far nicer than he's felt on it before. He was wondering if the combination of both serotonergic drugs enhanced the high. He had taken Tramadol before he was put on Citalopram and said it was nowhere near as nice. Also, he's aware of the dangers of mixing these kinds of drugs. How dangerous is this though? It seems to be a bit 50/50 on the internet, some reporting nasty side-effects and some saying they have been on the combination for a long time without any problems. So 2 questions:

• Would the Citalopram enhance Tramadol's effects?
• How dangerous is mixing these drugs?

All the best!

 

[pasha]

Tramadol is a serotonin releasing agent, and citalpram is a reuptake inhibitor. Generally speaking, reuptake inhibitors blunt the effects of releasing agents. What your friend experienced is the tramadol effect, not an additive effect between the two.

The combination is extremely dangerous, not only do both drugs lower the seizure threshold, but both are serotonergics, which means the possibility of serotonin syndrome when mixing both drugs (especially in high doses) is very likely.

Don't practice this combination and if you do, exercise extreme caution.

 

[AlphaMethylPhenyl]

tramadol is also a re-uptake inhibitor, though; anecdotally I can say that two re-uptake inhibitors taken together augment each other. it also wouldn't be crazy to suggest a releasing agent and re-uptake inhibitor would do the same (a la MDMA). you probably experienced a synergistic effect. and we know its you.

 

[Alex000]

Mixing those two drugs is extremely dangerous. It is just not worth it, and there would be no pleasant synergistic effects, really, if you got lucky and it didn't throw you into serotonin syndrome. Serotonin syndrome is a condition which can be fatal, and is often the result of drug combinations such as these. Please, listen to advice that might save your life; don't combine!

 

[pasha]

tramadol is also a re-uptake inhibitor, though; anecdotally I can say that two re-uptake inhibitors taken together augment each other. it also wouldn't be crazy to suggest a releasing agent and re-uptake inhibitor would do the same (a la MDMA). you probably experienced a synergistic effect. and we know its you.

Perhaps the example is escaping me but which releasing agents and reuptake inhibitors exactly work together synergisticly, and which reuptake inhibitors augment each other (maybe methylphenidate and SSRI drugs)? If this is true, then why is it that people don't combine SSRI's, or tricyclics?

Tramadol and antidepressants. The coadministration of antidepressants with tramadol appears to heighten the risk for seizures. When Boyd examined 83 cases of tramadol-associated seizures, he found that nearly half occurred in the presence of other prescribed drugs; more than 50 percent of these coadministered drugs were antidepressants (i.e., selective serotonin reuptake inhibitors [SSRIs], tricyclic antidepressants [TCAs], venlafaxine, bupropion).19 Therefore, in individuals taking tramadol, concomitant treatment with antidepressants, especially TCAs or SSRIs, should be undertaken with caution.20

Tramadol as a factor. Like the risk of seizures, SS may occur with tramadol monotherapy but appears to be more common following either excessive use/overdose or with the coadministration of other medications, particularly antidepressants. With regard to the antidepressant interactions, SS has been reported with combinations of tramadol and the following: fluoxetine,26–28 sertraline,29–31 paroxetine,32–35 citalopram,36 fluvoxamine,37 venlafaxine,38,39 and TCAs.40 In addition, Gnanadesigan et al41 reported four cases of SS among residents in a long-term care facility, all who were prescribed tramadol in combination with either SSRIs or mirtazapine.

Source:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

They don't augment each other, they're a recipe for death. I can also tell you anecdotally that SSRI drugs take away from a huge portion of tramadol's effects, and I've been doing it for almost 10 years. There is no synergistic effect.

Please don't practice this combination, despite others attempts to glorify it.