Serotonin syndrome in advanced cancer patient treated with tramadol and antidepressants

Serotonin syndrome is potentially life-threatening syndrome associated with excessive serotonergic activity within the central nervous system. Serotonin syndrome is associated with medication use, drug interactions, and overdose. While serotonin syndrome is often associated with the use of selective serotonin inhibitors (SSRI), an increasing number of reports are being presented involving the use of tramadol. With tramadol increasing popularity, the goal of this article is to make physicians more alert and aware of this potential side effect. Serotonin syndrome may be difficult to diagnose. A case of serotonin syndrome caused by the combination of tramadol and antidepressants in a patient with advanced cancer is presented and discussed. The importance of early diagnosis of this syndrome is emphasized. Palliat Med Pract 2019; 13, 3: 161–164