Hi, Thanks for posting in HCM. I understand your concern. Zoloft contains sertraline, which is an antidepressant belonging to group of drugs called selective serotonin reuptake inhibitors (SSRIs). Tramadol is a narcotic-like pain reliever, which is used to treat moderate to severe pain. Combining these medications could cause major interaction and can increase the risk of a rare but serious condition called the serotonin syndrome . This may also increase the risk of seizures. Hence, it would be advisable not to use the two drugs together, unless reviewed and advised by an medical expert. You must contact your doctor immediately if you experience any unusual or varying symptoms while taking the medications. Hope the information provided would be helpful. All the best.