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[70] Due to tramadol's serotonergic effects, tramadol has the potential to contribute to the development of an acute or chronic hyper-serotonin state called serotonin syndrome when used concurrently with other pro-serotonergic medications such as antidepressants (SSRIs, SNRIs, tricyclics, MAOIs), antipsychotics, triptans, cold medications containing dextromethorphan, and some herbal products such as St

9 23 In a recent RCT in Bangalore, India, daily maternal vitamin B 12 supplementation (50 g/day) during pregnancy through 6 weeks postpartum substantially improved maternal vitamin B 12 status and increased breast milk and infant plasma vitamin B 12 concentrations

References: Bouida W et al

Although most of these side effects tend to fade with time, seeking medical advice if they persist or worsen is recommended

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