Department of Social Sciences, University of South Carolina Beaufort, One University Boulevard, Bluffton, SC 29909, USA.
Exp Clin Psychopharmacol. 2011 Apr;19(2):123-30. doi: 10.1037/a0022721.
Tramadol (Ultram, Ultracet) is a centrally acting synthetic opioid with analgesic efficacy comparable to codeine. Antinociception is attributed to low but effective affinity for the mu-opioid receptor (μ), as well as reuptake inhibition of the monoamines norepinephrine (NE) and serotonin (5HT). Dual action antidepressants mirtazapine (Remeron), duloxetine (Cymbalta), and most notably venlafaxine (Effexor), which tramadol is closely related to in structure, also inhibit NE and 5HT reuptake. These medications are proven effective antidepressants and this shared monoaminergic action resulted in the research of tramadol as a potential treatment for depression. The present article intends to substantiate the use of tramadol in this manner by analyzing several decades of research which is presented as an illustration of neuronal theories, as well as lab work and case studies of both the supporting ideas and potential hazards. Finally, the article promotes the benefits of acute action in comparison to modern antidepressants and the documentation of low abuse rates while maintaining an object view of the risks, most notably, the risk for addiction from agonist action on μ-receptors.
曲马多（Ultram，Ultracet）是一种具有中枢作用的合成阿片类药物，其镇痛效果可与可待因相媲美。其镇痛作用归因于对μ-阿片受体（μ）的低亲和力但有效，以及对单胺去甲肾上腺素（NE）和 5-羟色胺（5HT）的再摄取抑制。米氮平（Remeron）、度洛西汀（Cymbalta）等双重作用抗抑郁药，尤其是与曲马多结构密切相关的文拉法辛（Effexor），也抑制 NE 和 5HT 的再摄取。这些药物已被证明是有效的抗抑郁药，这种共同的单胺能作用促使人们研究曲马多作为治疗抑郁症的潜在药物。本文旨在通过分析几十年来的研究来证明这种使用曲马多的方法，这些研究作为神经元理论的说明，以及实验室工作和支持性思想和潜在危害的案例研究。最后，本文比较了曲马多与现代抗抑郁药在急性作用方面的优势，以及记录了低滥用率，同时对风险保持客观看法，尤其是曲马多对μ受体的激动作用所带来的成瘾风险。
