Hello sir, We are sorry to hear the news of your wife s demise. Let me try to help you out on medications. Lexapro (escitalopram) is a selective serotonin reuptake inhibitor. When used along with tramadol, there is increased risk of a condition called serotonin syndrome. I would ask my patients to reduce the dose of tramadol to half if they want to take lexapro also. I would also monitor blood pressure, heart rate, confusion, restless among my patients if they are taking both the drugs together. The second option is to change tramadol to other drugs like ibuprofen or others for pain management. You can discuss the above options with your caregiver and decide. Hope the above information helps you. Thanks.