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October 09.2025
2 Minutes Read

New Study Warns of Seizure Risks with Antidepressant and Tramadol Combo

Nurse assisting person in wheelchair at healthcare facility.

Understanding the Risks: Antidepressants and Tramadol in the Elderly

New research has shed light on the potential dangers of combining commonly prescribed medications for seniors. A recent study highlights the increased risk of seizures among elderly nursing home residents who are prescribed both tramadol, a popular pain medication, and certain antidepressants known as CYP2D6 inhibitors. This news is particularly concerning due to the widespread use of these drugs among older adults managing chronic pain and depression.

What the Study Reveals

The study examined more than 70,000 nursing home residents and found that those starting a CYP2D6-inhibiting antidepressant while already using tramadol had a 9% increased risk of experiencing seizures. This risk rose to 6% for those adding tramadol to an existing antidepressant regimen. The incidence of seizure-related medical encounters was notably higher compared to the general population of nursing home residents.

The Importance of Medication Awareness

As older adults may frequently receive prescriptions for tramadol to alleviate pain, it's crucial for healthcare providers to be aware of the associated risks. Notably, the study calls for clinicians to consider prescribing alternative antidepressants that do not inhibit CYP2D6 when necessary. These include medications like fluoxetine and duloxetine, which the researchers propose may lessen the risk of seizures.

Understanding CYP2D6 and Its Impact

CYP2D6 is an important enzyme system in the liver that helps metabolize several medications. Antidepressants that inhibit this enzyme can increase the concentration of tramadol in the bloodstream, heightening the risk of adverse effects, including seizures. The FDA already warned about these risks back in 2016, yet the use of tramadol and antidepressants continues among older adults, underscoring the need for greater awareness of their potential interaction.

Strategies for Safer Prescriptions

This study serves as an urgent call to action for caregivers and healthcare providers. They should carefully evaluate the potential for adverse interactions when prescribing medications to elderly patients, especially those with cognitive impairments or cardiovascular diseases that may further complicate their health outcomes. Regular reviews of medication regimens can help mitigate risks and enhance patient safety.

Final Thoughts

The findings of this research remind us of the delicate balance required when managing the health of the elderly, particularly in nursing and care settings. By staying informed about risks associated with medication combinations, healthcare professionals can make safer choices that better protect one of our most vulnerable populations.

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