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Cjonb and I have spent the last two days researching this. The results are as follows:This mixture may cause seizures...What apparently happened was that this problem was not noted in clinical trials of the drug, but was later reported in the field after the drug was approved. And so the labels were changed.A little background is necessary:* Tramadol itself can cause seizures, especially if the patient is overdosing* Trycyclic antidepressants are pretty extreme, as they have some nasty side effects. They're not quite the drug of last resort, but they're getting there.* If someone on tricyclics and tramadol seizes, it's very hard to identify the exact process that caused the seizure -- maybe the tramadol; maybe the psyche med; whoknows?* The Cyclobenzaprine molecule, like quite a few other compounds, has three rings in attached to a central structure, as do tricyclics. This alone would usually not be enough to counterindicate -- but in this oddball case, it is, or should have been.* These two meds were often prescribed together, and even today, probably still are.* The seizure risk, while extant, is not extreme.* Taking any drug means you're accepting a desired effect, and a few undesired ones. It's pretty much never purely all benefit. Tramadol is like this.

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13y ago

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