Because it hits the opiate receptors, Ultram's side effects are those common to opiates, mainly nausea, sedation, dizziness, constipation and sweating. As it is totally synthetic, it does have freaky rare side effects
, it can make you go deaf or mimic the effects
of flesh-eating bacteria. Like Buprenex the antidepressant hypothesis is an old one, opiates have been used to treat depression since forever.