I went off tramadol for a week and switched to a NSAID.  I had mild shadows but no waking at night and nothing during the day over a 5 KIP.  Yesterday, just on a hunch, I started back on the tramadol for shadows.  They continued to worsen through the day and I was awakened 3 times during the night with 7 to 9 KIP...  Then I started doing some reading on this board... I found a post by Flash... 1999

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I also googled "serotonin headaches" (without the quotes) and I came up with more information about the connection between the two. 

I just wanted to share this information and get in on the record in case anyone else might suspect the connection between excess serotonin and cluster headaches!  It is definitely there for me.

Linda

Your experience with tamadol is one of the reasons we advise against using pain meds for Cluster. The general rule is that using a pain med 3-5/days a week can set you up for rebound attacks. The actual  # of days and dosing is subject to much individual variation--but this is a well recognized relationship.