Possible increase in anticoagulation with warfarin. Increased risk of seizures with SSRI, TCA. Increased risk of serotonin syndrome with mirtazapine, venlafaxine, SSRI and MAOI; tramadol should not be given to patients receiving MAOIs or within 14 days of their discontinuation. Reduced analgesic efficacy of tramadol with carbamazepine, 5-HT3-receptor antagonist e.g. ondansetron. Increased respiratory and CNS depression with CNS depressants e.g. alcohol, opioids, anaesthetic agents, narcotics, phenothiazines, tranquilisers or sedative hypnotics.
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