Hi,

The ER docs are not careful with psych meds.
Tramadol / Ultram is an SNRi.
Was she already taking Effexor, Pristiq, Cymbalta, or another SNRi?
Tramadol can also lower the seizure threshold as can the SSRIs and the tricyclic antidepressants.

It appears that the Tramdol was too agitating because of the way it works with Norepinephrine.
Before I took ANY medication I would talk with my pdoc, a neurologist, or a pharmacist.

Anyway, that is my guess. A real expert not involved in the case would give you a different opinion perhaps.

I hope that your relative is going to be O.K.

M