Background: I am now 74 years of age, and have recently diagnosed with Congestive Hearth Failure. I was put on Paxil about 13 years ago, not really for depression, but as standard treatment for newly diagnosed Fibromyalgia. It was presumed to help with the generalized pain of Fibro. Until now no doctor has questioned or reviewed the Paxil at 20MG. In October my family doctor added Tramadol, 37.5/325MG, to help cope with rather debilitating back pain. I immediately noticed sleep disturbance including painful muscle spasms in my legs and buttock. When I told my doctor about this he assumed some neurological disturbance and added Gabapentin, 100MG. Three nights on this went okay but did not relieve the symptoms. After night four on 200 Mg I woke up feeling like a Zombie - my thinking sluggish and my movements wobbly, having to wall surf. I stopped the drug. Now after doing some research I have discovered that Paxil and Tramadol are a serious medication mismatch that can create the symptoms I am experiencing and can lead to Serotonin Syndrome - no laughing matter. I am now on day five without Tramadol but there has been no improvement. Question One: How long will the Tramadol effect persist? Could it be permanent? Question Two: Might I we wise to stop the Paxil and if so - what is a safe, workable schedule for tapering off? Final word - This is not the first medication fiasco I have suffered through with this medical clinic. Frankly - I no longer trust my recent doctors very much and I really don t know where to go for help from someone who actually pays attention - sigh!