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I am a treatment resistant depressive and have always gotten adverse side effects from conventional antidepressants that I've taken.

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Granted Tramadols's M1 metabolite is about 6 times more potent and M1's affinity for Mu has been stated at up 200 times that of Tramadol itself, that is still only an affinity 1/25th that of Morphine, tho M1's affinity is often quoted at MUCH lower levels.

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In the 6% of the population who have slow CYP2D6 activity, there is therefore a slightly reduced analgesic effect.

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