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Original Research 
RMJ. 2018; 43(4): 738-742

Serotonin syndrome and concomitant use of tramadol and metoclopramide

Humera Khatoon, Mehreen Muzammil, Sana Sarfaraz, Subia Jamil, Humera Anser.

Objective: To identify drug combinations with serotonergic potential and help clinicians to avoid combined use of serotonin-augmenting drugs.
Methodology: This experimental study was conducted on thirty Wistar albino mice, divided into 3 equal groups (I, II, III) treated with distilled water, tramadol+metoclopramide and tramadol only bid for 15 days. Animal behavior, exploratory and locomotor activity were checked using sticky label, novel object and open filed tests. Results were analyzed by two-way ANOVA followed by Scheffe test.
Results: Difference in animal behavior was significant with respect to rearing (p≤0.01, p≤0.001), freezing (p≤0.001, p≤0.05) and grooming (p≤0.01, p≤0.001) when group II was compared with I and III, respectively. Difference was also significant (p≤0.001) when group III was compared with I. In open field test, animals of II and III groups showed hyperlocomotion (p≤0.001) when compared with group I. Difference between II and III was also significant (p≤0.001). In novelty-based tests (novel object and sticky label test), animals showed high level of vigilance (p≤0.001) in groups II and III as compared to group I.
Conclusion: Identification of serotonin-enhancing drugs and combinations is important to ensure patient safety. Animals can act as useful models for such identification.

Key words: Concomitant use, metoclopramide, serotonin syndrome, tramadol.

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