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Carbamazepine is reported to diminish the analgesic activity of tramadol by reducing serum concentration. The risk of seizures is increased if tramadol is administered concomitantly with other drugs that have the potential to lower the seizure threshold.
Tramadol inhibits reuptake of nonadrenaline and serotonin and enhances serotonin release and there is the possibility that it may interact with other drugs that enhance monoaminergic neurotransmission including lithium, tricyclic antidepressants and selective serotonin reuptake inhibitors; it should not be given to patients receiving MAOIs or within 114 days of their discontinuation.
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