MajorAtypical antipsychotics×Other opioids
Updated · Methodology
Mechanism
Additive CNS depression plus seizure threshold reduction (tramadol lowers it, quetiapine at high doses).
Symptoms
Deep sedation, drowsiness, ataxia. Seizures (especially with prior epilepsy) are possible. Older patients: fall risk.
Management
Avoid the combination with quetiapine above 300 mg. For analgesia on quetiapine, use paracetamol, an NSAID, or morphine/oxycodone (without serotonergic activity).
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Tramadol hydrochloride tablet (Amneal Pharmaceuticals NY LLC) – Prescribing Information (2017)– ; DailyMed setid 8ec4e4e5-a56e-4198-8428-6b770b9bf27d