Hi Jess--
I take Tramadol on a PRN basis for Endometriosis and ovarian cysts (it doesn't have any effect on the nerve pain... ). Like you, initially I was afraid to combine the Tramadol with Elavil--especially after reading about them online & the fact I also have epilepsy (siezures can be a side effect of the combination); but my GYN assured me the chance for interaction was really low given the small dose of Elavil I was on and the fact that I don't take the Tramadol on a regular basis. I decided to go ahead and trying it-- the endometriosis and/or cysts were causing much more pain and making me much more miserable than any of the OTC stuff.... Thankfully, I didn't/don't have any problems with either drug and the combination.

But, I have no experience with Lexapro...

Hope thing go well for ya-- L2L