Hello! Alpha lipoic acid is vitamin like supplement. It is an antioxidant, and is used as weight loss and energy supplement, in diabetic neuropathy and wound healing. Its antioxidative cellular action may preserve the neurons functions, but research has not shown an effect in people with dementia. Regarding the interactions, alpha lipoic acid may interfere with chemotherapy, (by decreasing the their effectiveness), when used with oral antidiabete drugs may lower the blood sugar. There has been not any research to study interction between alpha lipoic acd, mrapexin and tramadol. In my opinion if you are sensing any changing in the effectivenessh of the previous medication, at first you should stop alpha lipoic acid, then see your doctor to exclude or reveal other causes that may have change the medication impact. I hope i have been of help.