I did take cymbalta and tramadol together. I did not get serotonin syndrome doing so. However, as Mrs. D. pointed out there is a real chance of it happening. I questioned both my neuro, rheumo, and pharmacist before choosing to take the drugs together.

If you go the tramadol only route you can always take the lowest dose that works for you and then add to it from there. I always take 100mgs in the morning. I'm suppose to use that dose 4x/day but I never have. If my pain gets bad during the day I usually take 50mgs. I do the same at night if I need it. That is the thing with tramadol you don't have to take the same dose all the time. I would talk to your doctor about using the tramadol based on what your pain level is.