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Summary: Since chronic pain syndromes and depression simultaneously occur in many patients, it is likely that tramadol and an SSRI will be used together. However, concomitant use of these drugs is known to increase the risk for seizures and serotonin syndrome (see the figure below).
Tramadol is a prescription-only medicine that you can buy only after obtaining medical prescription from a GP. ... In this case, you order Tramadol without a prescription from your GP but with an online prescription from an online pharmacy.

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