depression
"I have run through the entire wringer on SSRI's, an MAOI, and an SNRI. Lexapro in combination with low dose tramadol has been the most effective duo for me. Low dose 100mg once daily tramadol, with intermittent 'breaks' (from acclimation to the medicine) has worked well for me over the past 5-6 years in mood stability, energy, motivation, and concentration with no euphoric effects. All of these are very important in my line of work. I do think that an XR formulation might be more useful in stabilizing plasma concentrations and perhaps mitigate some issues with medicine resistance and tendencies to take higher doses (not a good idea). At any rate, use should be monitored. "