OPIOID ANALGESICS AND SEROTONIN TOXICITY
When a person is already on Prozac-like antidepressant, he should be careful to select a pain-killer from among the opioids. This is because some opioids (meperidine, methadone, tramadol, dextromethorphan, propoxyphene) possess serotonin reuptake inhibitor activity. Combination may raise serotonin level to toxic levels: agitation, clonus, hyper-reflexia, hyperthermia, and risk of death. Other opioids (codeine, morphine, oxycodone) don’t seem to have serotonergic property.