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53 As shown On this examine, CYP2D6 inhibition diminished tramadol clearance and exposed a participant for the merged serotonergic outcome on the antidepressant and markedly elevated levels of the serotonergic (+)-tramadol enantiomer, which may attain supratherapeutic degrees. Desmetramadol can have a decreased chance of serotonin syndrome when coupled with antidepressants as the serotonergic (+)-tramadol enantiomer is absent, and since plasma levels of its active enantiomers bear clinically insignificant improvements in response to CYP2D6 and CYP2B6 inhibition.

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