SSRI antidepressants, such as Prozac and Paxil, interact with opioid medications to make them less effective at providing relief from chronic pain. Tramadol relies on activation of the CYP2D6 enzyme to control pain, but SSRIs inhibit this enzyme. Researchers suggest prescribing different classes of antidepressants which do not suppress the enzyme may benefit those in need of opioid medications. Alternatively, non-opioid pain killers should be considered for those who can not switch from SSRIs.
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A new study links antidepressant use during pregnancy with birth defects.