Author(s): Fonseca, Suzana ; Franco, João
Date: 2018
Persistent ID: http://hdl.handle.net/10400.26/57812
Origin: Instituto Nacional de Medicina Legal e Ciências Forenses, IP
Subject(s): Tramadol; Serotonergic antidepressants; Interactions; Post-mortem cases
Background & Objectives Tramadol is very often prescribed for pain management in patients with depression in treatment with selective serotonin reuptake inhibitors (SSRI). Serotonergic antidepressants and its concomitant use with tramadol can lead to a drug–drug interaction, resulting in a decrease in the tramadol analgesic effect and a higher risk of serotonin syndrome caused by the accumulation of serotonin in the central nervous system. These interactions can also change the post-mortem concentrations of the therapeutic drugs and its metabolites, increasing the difficulty in the interpretation of forensic toxicology results, mainly when the concentrations are higher than the therapeutic level. The aim of this study was to review a five-year period of post-mortem cases, in order to examine the prevalence of concomitant use of tramadol and SSRI and the influence in the concentrations found.
