I've just had an emergency GP appointment on the phone as I'm really struggling with neck and thoracic pain. I've a 1 and 2 year old so rest is out of the question! Anyway he's given me tramadol and dihydracodeine but I'm also in venlafaxine. The pharmacist seemed quite concerned by this combination and told me to watch out for muscle spasms and not to drive! I think the GP might have missed that I'm on venlafaxine when he prescribed the tramadol and now I'm a bit scared!!