Concomitant use of ULTRAM® with SSRIs increases the risk of adverse events, including seizure (see Seizure Risk ) and serotonin syndrome. When co-administration of ULTRAM® and SSRIs is indicated, monitor the patient for seizures and possible early signs and symptoms of serotonin syndrome. Early symptoms of serotonin syndrome may include myoclonus , tremors, hyper- reflexia, diaphoresis, fever, tachycardia , tachypnea , labile blood pressure, altered mental status (agitation, hallucinations, coma, excitement) and /or gastrointestinal symptoms (., nausea, vomiting, diarrhea).
The placebo effect is related to the perceptions and expectations of the patient; if the substance is viewed as helpful, it can heal, but, if it is viewed as harmful, it can cause negative effects, which is known as the nocebo effect. In 1985, Irving Kirsch hypothesized that placebo effects are produced by the self-fulfilling effects of response expectancies, in which the belief that one will feel different leads a person to actually feel different.  According to this theory, the belief that one has received an active treatment can produce the subjective changes thought to be produced by the real treatment. Placebos can act similarly through classical conditioning , wherein a placebo and an actual stimulus are used simultaneously until the placebo is associated with the effect from the actual stimulus.  Both conditioning and expectations play a role in placebo effect,  and make different kinds of contribution. Conditioning has a longer-lasting effect,  and can affect earlier stages of information processing.  Those that think that a treatment will work display a stronger placebo effect than those that do not, as evidenced by a study of acupuncture.  
These are unwanted effects that you consider are linked to taking a medicine. Side effects also include any effects from: misuse, abuse, an error in the way the medicine has been given or overdose (taking too much medicine). Reports can be made for any medicine (including specials and unlicensed products), any vaccine, herbal product, and complimentary remedies such as homeopathic remedies, blood factors (. factors I to XIII) and immunuloglobulins (. anti-D (RHO) immunoglobulin). You can even report suspected side effects from a drug you think might be happening as a result of interactions with food and drink.