A 35-year-old female asked:
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i take ultram for fibro, zoloft and xanax (alprazolam) for panic anxiety disorder, and a ambien at night for sleep is this a safe combo?

4 doctor answers
Dr. Shahid Rafique
43 years experience Internal Medicine
No: Ultram and zoloft are generally not effective in fibromyalgia syndrome. Xanax (alprazolam) is generally not recommended for long term management of panic disorder. Ambien is safe and effective for sleep. There is no best combination. Your doctor will try various combinations and see what suits you best in terms of effectiveness and side effects.
Answered on Sep 28, 2016
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Dr. Brian Writer
15 years experience Psychiatry
Potentially: Ultram taken with zoloft can result in symptoms including gastrointestinal distress, confusion, changes in heart rate/blood pressure & temperature as well as involuntary movements ("myoclonus"). At the extreme, this condition (serotonin syndrome) can progress to death. Ultram, xanax (alprazolam) and Ambien taken together can result a dangerous level of sedation. Consider discussing risks with your doctor.
Answered on Jun 24, 2014
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Dr. Douglas Bey
56 years experience Psychiatry
Probably: Ultram & zoloft (sertraline) both raise serotonin & there are cautions about the possibility of a serotonin syndrome but i've seen many pts taling ssris & ultram with no problems.
Answered on Nov 3, 2013
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Dr. Imad Khreim
38 years experience Psychiatry
Xanax (alprazolam): I don't really recommend short acting benzos like xanax (alprazolam) for panic, they are associated with inter-dose withdrawal, faster tolerance and gradual elevation of baseline anxiety , discuss the issue with your psychiatrist, otherwise the combination is ok.
Answered on May 7, 2016
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