attempting to potentiate tramadol
can be dangerous if you take CYP2D6 inhibitors:
"Besides significantly weakening the opiate
-like effects of tramadol, CYP2D6 inhibitors also increase the risk of serotonin syndrome
and seizure, because these are caused by tramadol itself (and CYP2D6 inhibitors make the metabolization of tramadol slower).
CYP2D6 inhibitors include: fluoxetine
, other first-generation antihistamines (in high doses), bupropion
, amiodarone, haloperidol, ritonavir, indinavir, methadone
, quinidine, celecoxib, cimetidine (Tagamet), DXM
(the latter two are probably only relevant in recreational doses).
As a side note, codeine
and tramadol has been reported to cause a seizure, while codeine after the tramadol peak (when levels of O-desmethyltramadol are highest) is reported to be quite enojyable (for both reports, search for "codeine tramadol synergy").