Posted by Sunnely on August 5, 2002, at 23:51:10
In reply to Ultram as antidepressant, posted by paxvox on August 5, 2002, at 20:46:53
Tramadol (Ultram) is a central nervous system acting pain killer that activates the mu receptor and enhances the action of serotonin and norepinephrine via reuptake inhibition. Incidentally, like codeine, it is a "pro-drug" and it needs to be converted to its active metabolite called M1 to be an effective analgesic (pain killer).
It has been suggested that Ultram may have antidepressant effect. It shares a number of molecular and pharmacological features with venlafaxine (Effexor), an antidepressant.
In view of Ultram's serotonin and norepinephrine reuptake inhibition, theoretically it may induce manic relapse in patients with Bipolar Disorder; may induce serotonin syndrome if combined with an SRI (Prozac, Paxil, Zoloft, Luvox, Celexa, Effexor, Anafranil, etc.). The combined use of Ultram and SSRIs may also increase the risk of a seizure episode.
On a related note, sibutramine (Meridia), a weight-loss agent, has similar pharmacological make up as Ultram and Effexor (i.e., serotonin and norepinephrine reuptake inhibition). Theoretically, Meridia could be an effective antidepressant. This could also be true with ziprasidone (Geodon), an atypical antipsychotic with both serotonin and norepinephrine reuptake inhibition.
Ultram may also be useful in the treatment of obsessive-compulsive disorder (OCD). Also, a case of anorexia nervosa treated with Ultram has been reported.
Finally, duloxetine, an antidepressant soon to be released has both serotonin and norepinephrine reuptake inhibition, similar to Effexor. Unlike Effexor, its serotonin and norepinephrine reuptake inhibition is achieved at any dose, hence immediate dual-action. It has been suggested that it is particularly beneficial in patients whose depression is accompanied by pain syndromes (i.e., analgesic effect like Ultram).
> OK, I know similar post regarding opiate and opioid therapy for depressive illness have been made. But having just recently been scribed some Ultram for pain, I read where it is an inhibitor of serotonin reuptake and norepinephrine....hmmmm......me thinks there is some sort of connection here. Anybody? Anybody?
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> PAX
poster:Sunnely
thread:115349
URL: http://www.dr-bob.org/babble/20020731/msgs/115365.html