Lexapro decreases the analgesic effect of Tramadol because it reduces the breakdown of the active metabolite of Tramadol this is responsible for analgesia.. Yes/and no you should be worried about seitonin syndrome, personal expierence i in the past have taken severel meds with that contraindication and never developed S.S. but everyone is different. if you are worried stop taking it it's not helping anyways, go see a general doctor and tell him your meds you take, what going on with you and your concerns. when and if you get S.S. there is nothing the doctors can really do for you anyways you just have to ride it out till your body depletes the exsess seritonin.(depending on how sever it is)