Im taking 25 mg paxil (paroxetine) and the doctor has prescribed 37.5mg tramadol for migraines prn . are these safe together ?

Well,: you still have to be cautious, although you are taking low dose of both drugs, this is rather a judgement call by your physician and yourself, that's probably the logic behind prescribing the tramadol, low dose on as needed basis, however if you aren't comfortable, ask your doctor for an alternative of tramadol. Good that you asked, always exercise caution with multiple medications

Drug interactions.: Although I have seen very few cases of Serotonin Syndrome over my career - almost all of them involved adding tramadol to an SSRI.

If Tramadol was: prescribed for chronic use or more than a week, then best to change your antidepressant to something else such as Wellbutrin (bupropion). Reference: http://www.ebmconsult.com/articles/tramadol-interaction-ssri-serotonin-syndrome-mechanism