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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).
The extended-release form of tramadol is for around-the-clock treatment of pain. This form of tramadol is not for use on an as-needed basis for pain. You should not take tramadol if you have severe breathing problems, a blockage in your stomach or intestines, or if you have recently used alcohol, sedatives, tranquilizers, narcotic medication, or an MAO inhibitor (isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others).
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Give tramadol exactly as it was prescribed for your pet. For pain relief, the usual dose in dogs is 0.45-1.8mg per pound of pet’s weight given by mouth every 8-12 hours. For treating chronic cancer pain in dogs, the usual dose is 0.45-1.8mg per pound of pet’s weight given by mouth every 6 hours.

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