title: Pain management discussion forum: serious interaction among frequently used drugs for chronic pain.
abstract: A query and response regarding a patient who was taking high-dose tramadol and duloxetine is presented. The patient developed serotonin syndrome. Risks for this clinically important drug interaction and management of the syndrome are discussed.
authors.forename: Harald
authors.initials: H
authors.lastname: Breivik
mesh_terms: D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D000068736:Duloxetine Hydrochloride; D005260:Female; D006801:Humans; D008875:Middle Aged; D020230:Serotonin Syndrome / Q000139:chemically induced*; D013876:Thiophenes / Q000009:adverse effects* / Q000627:therapeutic use; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D013876:Thiophenes; D014147:Tramadol; D000068736:Duloxetine Hydrochloride
keywords: cyproheptadine; drug; duloxetine; interaction; pain; serotonin syndrome; tramadol