Can Tramadol Cause Rebound Headaches?

Analgesics taken for a long time causes rebound headache. There are various mechanisms involved in causing this condition. Tramadol, if taken for long, may cause rebound headache.

Can Tramadol Cause Rebound Headaches?

Can Tramadol Cause Rebound Headaches?

Tramadol is the drug used to treat moderate to severe pain. The active metabolite of the tramadol that performs the function of pain management is desmetramadol. The common side effects of the drug include indigestion, vomiting, constipation, abdominal pain, drowsiness and headache. One of the side effects of tramadol is rebound headache. It is due to its mechanism of action which changes the perception of brain towards the pain receptors as well as neurotransmitters. Tramadol functions through inhibiting the serotonin reuptake. In the temporary phase or in the small doses, the serotonin increases in the system contributing to happiness and a feeling of well-being. However, when the tramadol is frequently taken for a long period, the levels of serotonin are increased to such a level that body does not able to handle high levels and resulting in the rebound headache. Further, the cortical spreading depression is increased with excess administration of tramadol.

Rebound Headaches

First described by Dr. Lee Kudrow, rebound headache is caused by the medications used to relive headache. The condition is also known as Medication Overuse Headache. The condition is painful and is the reason for daily and frequent headaches. It develops when the medicines for removing the pain due to headache or migraine are taken frequently. It is seen that the rebound headache is caused when the patient uses the medicine for the treatment of headache. However, if the pain killer is used to cure the pain other than headache, rebound headache is not observed. The life of the patient is completely out of track due to the constant, dull rebound headache and the patient experiences the symptoms of depression and may also develop fatigue, cognitive dysfunction, irritability, insomnia, and body weakness. Generally, the treatment is to stop the medications of pain and using them only when required.


The rebound headache is the dull, chronic, daily and dull-tension type headache which makes the patient irritated. The patient experiences a variety of symptoms such as:

Fatigue: The person with constant dull headache feels low in energy and the person develop fatigue and tiredness. Further, a lot of energy is directed towards the management of rebound headache.

Insomnia: The important prerequisite of a sound sleep is quite and relaxed mind. Rebound headache causes chronic and constant pain and the person does not feel relaxed. Sometimes the pain is severe, and the patient does not able to sleep.

Cognitive Dysfunction: The person with constant pain in the head have lost the ability for thinking and taking logical decisions as the functioning of mind is always interrupted by the headache. This may lead to cognitive dysfunction.

Unilateral Headache: The symptom of the rebound headache is unilateral headache i.e. the headache occurs only on single side of the head. The rebound headache may also cause localized pain.

Chronic Headache: Due to the change in the perception of brain for pain signals, the patient of rebound headache almost always experiences the pain which is constant and dull. Chronic headache interferes with the normal life of the patient.

Frequent Migraine Without The Involvement Of Tension Headache: Generally, the patients, who are constantly on the analgesics for the management of the migraine pain, suffers from rebound headache. Rebound headache in such patients are like migraine pain but without the existence of tension headache.

Nausea: Like migraine, the rebound headache also causes nausea and vomiting due to constant and dull headache.

Depression: As the life of the patient is totally out of track due to the present of two headaches i.e. one is the original headache and the other is the rebound headache which is caused by frequent administration of analgesics for treating original headache. Due to this, the patient may experience depression.


Tramadol is the drug used for mild to moderate pain. If taken frequently, tramadol may cause rebound headache due to increase in concentration of serotonin.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:February 12, 2020

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