Tramadol‐induced mania in a patient with depression

Abstract

It is not unusual for patients with co‐occurring chronic pain and depression to receive concurrent administration of an antidepressant (e.g., a tricyclic antidepressant [TCA], selective serotonin reuptake inhibitor [SSRI], or serotonin‐norepinephrine reuptake inhibitor [SNRI]) and tramadol, which is sometimes preferred in place of more potent analgesics. However, tramadol also can have an inhibitory effect on serotonin and norepinephrine uptake, and concurrent administration of an antidepressant and tramadol could result in undesirable side effects associated with increased serotonin and norepinephrine neurotransmission.