Tremor tramadol

Serotonin syndrome SSRIs, second generation antidepressants, MAOIs, linezolid, tramadol, meperidine, fentanyl, ondansetron, sumatriptan, MDMA, LSD, St. John s wort, ginseng Hypertension, hyperreflexia, tremor, clonus, hyperthermia, hyperactive bowel sounds, diarrhea, mydriasis, agitation, coma onset within hours Sedation (benzodiazepines), paralysis, intubation and ventilation consider 5-HT2 block with cyproheptadine or chlorpromazine... 

A 70-year-old woman, who had been taking citalopram 10 mg/day for 3 years for depression, began taking tramadol 50 mg/day) for pain relief and rapidly developed tremor, restlessness, fever, and confusion (121). 

An 88-year-old woman taking sertraline 50 mg daily (later increased to 100 mg daily), as well as several other medications was given dextropro-poxyphene with paracetamol and tramadol 200 mg daily increased to 400 mg daily for pain relief after a fracture. Ten days after starting tramadol she became confused, with alterations in cognitive function, tremor, problems with co-ordination and muscle weakness. The serotonin syndrome was suspected and therefore sertraline was withdrawn over a period of 2 days, the dose of tramadol was reduced from 400 to 200 mg daily, and the patient recovered over a period of about 2 weeks. ... 

Nervous system A 74-year-old man with Parkinson s disease was given tramadol 100 mg qds and his tremor worsened after 2 weeks, causing significant functional impairment [176 ]. There was rapid improvement within 2 weeks of tramadol withdrawal. The authors speculated that the mechanism of this adverse effect might be related to effects on serotonergic pathways. 

Mellor K, Ahmed A, Thomson A. Tramadol hydrochloride use and acute deterioration in Parkinson s disease tremor. Mov Disord 2009 24(4) 622-3. 

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