Does anyone know or had experience with tramadol and whether or not the intake could trigger a HA?  Last March I had 6 stents inserted and a pacemaker and am having to take Effient (similar to Plavox).  Because of this I cannot take Ibuprofen.  My cardiologist prescribed tramadol for pain.  I have a lot of aches etc. outside of the CH and heretofore I always just relied on Advil for these pains but since I cannot take that I would take the Tramadol but obviously I don't want to stir the Demon any more than I must because I am in a horrible cycle (2 1/2 months now) and not sure when it will end.  Outside of cycle I have had no problems and taking the tramadol (which I did infrequently) did not cause a cycle (I am eposodic). 

Thanks Wishbone.

Your last sentence appears to be the answer--as you could substitute alcohol for Tramadol.

There's no way tramadol is going to to touch a cluster !! I'm taking it to just take the edge off with post surgical pain. It doesn't do anything for some  major neuroPathy that I'm experiencing in my leg so in no way do I believe it to be able to help with CH

Good luck

I thanks for the responses, but maybe my question was posed improperly.  I would not be taking the tramadol to try and mask the pain of the cluster I would be taking for other aches and pains when I am not actually having a HA. I just did not want to take it for say severe joint aches and all of a sudden get hit with the cluster because I had taken same.  As I said nomally I would just take advil but can't because of cardio meds. 

Bob it sounds like you believe the tramadol would cause a HA because during my cycle I don't drink alcohol.

Thanks Again. Wishbone

Hi Wishbone!

Tramadol is an opioid like morphine, hydrocodone, etc.  Where tramadol is different is that it is weak agonist of the the μ-opioid receptor, releases serotonin, and inhibits the reuptake of norepinephrine.

It is much more selective in it's attachment to it's opioid receptor than most of its opioid brethren.  It is still addictive if taken in larger doses and regularly, but generally is considered a safer medication than most of the other opioids. 

Again, it also has the capability as above, of releasing serotonin and norepinephrine which most of the other opioids do not - this effect is helpful for chronic nerve pain such as from neuropathy or even fibromyalgia.

I have not heard of it precipitating a cluster episode.

Lettucehead wrote on Apr 14^th, 2011 at 12:11pm:

It is much more selective in it's attachment to it's opioid receptor than most of its opioid brethren.  It is still addictive if taken in larger doses and regularly, but generally is considered a safer medication than most of the other opioids.

It doesn't need to be taken in large doses or regularly for it to become addictive for some people. I was given fairly small doses for a back problem but realised that within a few days I was getting addicted to it and that was following the dose directed by my GP.

It's one of the reasons why I don't want to touch any opioid again.

Are you on any meds tramadol could interact with? I'm allowed to take it whenever I want (have back/SIJ+CH/TN problems) but have been advised to avoid doing it because it interacts with almost anything else. My clusters vary between classic cluster, classic TN and somewhere in between, but Tramadol actually made my headaches slightly better for a little time the first time.. just a tiny dampening effect. However, any drug has the potential to make your beast worse or better depending how your CNS responds to it - don't listen to people who say "X will/won't can/can't" if they mean "as an absolute thing" - even O2 can make the occasional cluster worse for me, and after 5 years of chronic w/ shadows (and not a day off), i'm now in the first patch where caffeine (espresso-based coffee) is having a bad effect on me sometimes.

the specialists have regularly explained to me that if you can feel yourself needing a drug independently of the effect it has on your symptoms, then it could be addictive for you - if you have an addictive personality this can extend to pharmacology. however, if you're in enough pain to be treated with opiates (which should almost always be a second or third-line treatment) then where the opiates are acting on the source of the pain, addiction is unlikely/rare.

i'm on 100ug fentanyl patch + 70mg oxycontin and 20-60mg oxynorm a day atm, so i'm hoping it'll hold true. when the patches are ready to be changed, withdrawal is a real pig.

having said that - the long and short is that tramadol didn't set off clusters for me, but the pain levels of not being on a cocktail of high strength painkillers can make my CH worse.

best,

John

Answering your questions...

• I wasn't on any other medication at the time that tramadol would interact with.
  
• I was taking it a few years before my first CH.
  
• I never felt the drug acting in any way other than against the pain, if anything I wondered why people abused them as I never felt anything other than a degree of relief from the pain.
  
• The only sign I saw of dependence was anxiety that when I'd only got a few days left of the tablets that I needed to get more of them.
  
• As soon as I wanted to stop I did stop taking them and I've never touched them since
  

Thanks everyone.  Obviously I am not a doctor, but my cardiologist prescribed all the meds I am on except litium and topomax and he was aware of that I was taking those meds.  Actually I was on verapamil also but he took me off of it (after the stents) because I think it would interfere with the effient he precribed.  He prescribed the tramadol when I asked what I could take for pain (I have a lot on old atheletic injuries) since I could no longer take ibuprofin.  I rarely take it but when I have I did not have any feeling that I was getting addicted.

Wishbone.

Hi guys, I'm new here (3year sufferer and counting) and have tried every OTC med I can find to try and help, with little success.... hence why i ended up finding this site.
Whilst I have found that no OTC painkiller will touch a CH in full flow I have found that Tramadol acts as an abortive/delaying agent. If I take tramadol I don't get a CH, pure and simple (but as always it's waiting in the wings). I've also found looking at this site that what works for Peter does not work for Paul and vice versa, it's wrong to dismiss anything that helps if you haven't tried it.
Sorry to make this a long first post - when I found Tramadol was helping I started doing some research and I'm positive it's the seratonin-releasing aspect that gives Tramadol the edge over other opioids in this case.
With that in mind I tried Sumitriptan (Imigran) due to its similar Seratonin releasing behaviour, and sure enough it's the best thing I've found so far. So if you feel Tramadol helps a little bit perhaps this line of meds might work for you. but NEVER mix the two, I'm no doctor but I know that it is fatal to mix tramadol with any other SSRI such as a sumitriptan.

jamesmsv wrote on Apr 27^th, 2011 at 6:32am:

With that in mind I tried Sumitriptan (Imigran) due to its similar Seratonin releasing behaviour, and sure enough it's the best thing I've found so far. So if you feel Tramadol helps a little bit perhaps this line of meds might work for you. but NEVER mix the two, I'm no doctor but I know that it is fatal to mix tramadol with any other SSRI such as a sumitriptan.

Hi James!
Welcome!

Please don't apologize for your post - we're all glad that you are sharing your experiences!

I just wanted to clarify a couple of things -
sumitripan is not an SSRI (selective serotonin reuptake inhibitor).  Sumitripan is in a class of medications known as tripans.  Medications such as zoloft, prozac, celexa, paxil, these are the SSRIs.

And as for it being fatal to take these meds together - there are risks to it.  The concern involves a condition called Serotonin Syndrome - symptoms include nausea, vomiting, sweating, agitation, diarrhea, hallucinations, etc.  It's rare but it does happen - almost always when multiple medications affecting serotonin are use in conjunction. 
It is definitely a risk of the medications that a user needs to be aware of...

From everything I've read one of the biggest dangers that you should be aware of with Tramadol is risk of seizure.  At normal doses I don't think it's that much of a risk, but lots of people will up their dose of opiates once they get tolerance to it, this is a drug where it's not a good idea.

  Check out this from Wikipedia--

"However, there have been several rare cases of people having grand-mal seizures at doses as low as 100–400 mg orally.[25][26][27] An Australian study found that of 97 confirmed new-onset seizures, eight were associated with tramadol, and that in the authors' First Seizure Clinic, "tramadol is the most frequently suspected cause of provoked seizures".[28] There appears to be growing evidence that Tramadol use may have serious risks in some individuals and it is contra-indicated in patients with uncontrolled epilepsy (BNF 59). Seizures caused by tramadol are most often tonic-clonic seizures, more commonly known in the past as grand mal seizures. Also when taken with SSRIs, there is an increased risk of serotonin toxicity, which can be fatal. Fewer than 1% of users have a presumed incident seizure claim after their first tramadol prescription. Risk of seizure claim increases 2- to 6-fold among users adjusted for selected comorbidities and concomitant drugs"

On another note, My wife always laughs when I say "Grand Mal" seizure, because in spanish it means "Big Bad"   :)  (I can tell ya from experience, that's about as descriptive as it gets)

Hi Wishbone, I'm not a doctor so anything I say should be considered only my opinion.  I have been doing a lot of reading and I did find that CH can be triggered by too much serotonin.  I also learned that tramadol acts on the serotonin levels in the brain.  I am nearing the end of my cycle (Oct - May)   I did notice when I could get by without taking tramadol, my nightly CH attacks were not as severe.  BUT this could be because the cycle is winding down anyway.  I would use caution with it though.  Best of Luck to you.