I had a bottle of tramadol left over from a dental procedure and decided to try a higher dose recreationally after reading online that some people find it euphoric. I was also taking sertraline (Zoloft) 100mg daily for anxiety, which — as I learned afterward — was an incredibly dangerous combination that I somehow failed to research.
T+0:00 — Took 200mg (four 50mg capsules) on a mostly empty stomach. I had taken 50mg before for pain and felt barely anything, so I figured 200mg would be more interesting.
T+0:45 — A definite mood lift. More pronounced than the prescribed dose. Felt sociable and chatty — texted several friends, which is unusual for me. Mild warmth in my body. Slight nausea.
T+1:30 — This is where it got good for about 20 minutes. Genuine warmth throughout my body, a pleasant buzzy feeling behind my eyes, music sounded better, I felt at peace with everything in my life. I understood why people chase this.
T+2:00 — My right hand started twitching. Not voluntarily — rapid, rhythmic muscle contractions in my thumb and index finger. I noticed my jaw was clenching. My heart rate was elevated and I was sweating heavily despite my apartment being cool.
T+2:15 — The muscle twitching spread to my right arm and I felt a wave of overwhelming heat wash through my body. My vision flickered. For about 3-4 seconds I genuinely believe I was on the verge of a seizure — a rolling muscular tension that started in my extremities and seemed to build toward something catastrophic. I was terrified.
T+2:20 — The near-seizure sensation passed but I was shaking violently with adrenaline and fear. I called a friend who is a nurse. When I told her I had taken 200mg of tramadol while on sertraline, there was a long pause followed by words I will not repeat. She told me I was exhibiting signs consistent with serotonin syndrome and that the muscle contractions were myoclonus — a classic symptom.
She stayed on the phone with me for three hours. I did not seize, but the myoclonic jerks continued intermittently for about two hours. My temperature was elevated. I sweated through my shirt twice.
I never took tramadol recreationally again. I stopped the leftover pills down a medication takeback site the next day. The combination of tramadol and an SSRI is more dangerous than most people realize. I got lucky. Some people with this combination have not.