"i have chronic anxiety and have tried many many serotonin type meds over a 15-year span and have also suffered from depression very bad reaction to the meds.being in hard labor  i worked all my life/concrete-tree removals-underground utility work/water main repair etc...i have had numerous injuries to my back/neck/knees/hands/shoulders..broke many bones (comes with the territory) i was diagnosed with degenerative disk disease and was prescribed ultram 50 mg got up to 400 mg down to 300 now and what a difference not just with pain but my anxiety was reduced by at least 50% and depression was gone.my alertness increased and mood was elevated.will try to stay on medication for life.walmart had the med for $4-$12 if no ins."