Duregesic Patch

[baby72006]

Well folks I come back to you all.  I am sooooo grateful you are here.  It truly helps me!  Bless all of you.
I am at a crossroad.  I will have to decided in a little less than a month whether or not I will ask to be taken off the Duregisic Patch and switched into something else.  Since I last came here, I discussed with my PCP the possibility of doing this.  I was told that the procedure would be to switch me out suddenly.  By that I mean they would stop the duregisic patch and switch me to Mscontin without any weaning of the duregisic.  I know now that I have to do SOMETHING because this duregesic is not good for me anymore, however this sudden switching is scaring the heck out of me!!!!  All I know is that they will use a conversion chart to do that transition.  I asked the PCP what to expect, and she said that I would feel some discomfort for the first couple of weeks but that it wouldn't be bad.  She really wasn't convincing though.  I have been on 75mcg/q48hrs for 4 years.  I am sure that I am very dependent on this stuff.  Why all the fear you may ask??  As I spoke in my previous posts stated, I suffer from severe depression, medication resistant, no insurance, no savings, my PCP is 2 1/2 hours away and should I have any problems with the switch, I won't be able to get to them.  Plus....it has been my experience that the laws that have been placed on these type of medications have gotten so strict that it has become very difficult for those of us who suffer.
I guess what I am looking for here is some feedback from those who have transitioned from duragesic into oral meds.  See, I am alone and doing all of this alone is a scary road.  Thank you folks...any questions, please feel free.

[JadedSweetheart]

I switched off Fentanyl 100mcg to MSContin although I was only on the fentanyl for a couple of months.  I had some minor withdrawl-ish feelings for a few days.  I have an anxiety disorder and was on medication for it at the time.  I was slightly more emotional, the pain was a little stronger, and I was very sleepy.  After a week I was adjusted to it although I adjust to meds quickly.
I have also experienced "Seratonin Sydrome" while on Ultram and an anti-depressant so I understand your fear there.  I did not experience any Seratonin Sydrome with fentanyl or MSContin.  I found it worked pretty well for me but at the time my insurance wouldn't cover the patch.
From what I have read, the way they are switching your meds is typical.  No matter what you will have more pain when you reduce or stop the fentanyl.  The MSContin should help with the pain and any other symtoms of dependence while switching.  It's really good that they are using a conversion chart as some doctors simply "wing it" and "winging it" isn't a good way to do a switch.
You said your PMP doesn't do multiple narcotics, I assume you mean he doesn't prescribe more than one med.  That's somewhat unusual as most doctors prescribe one long-acting med and a short-acting med for break-thru pain.  I think that would be helpful with your switch as you could start a BT med before the switch and that way you'd have some form of constant med for the extra pain of the switch.  Although I had a doctor who didn't always allow for a BT med or only allowed one a day, so I do understand how that goes.
I know life is very hard when dealing with depression/anxiety and chronic pain, especially when you live alone and family and friends don't understand.  Please know that you are not alone in dealing with depression and CP, though.  We are here for you to talk about any of it with.  Many of us have no one else but eachother to talk to about the stresses of CP and it helps the depression and anxiety a lot to know there are other people out there just trying to keep the pain under control like we are.  
Hang in there!  I hope the med switch goes well for you so you can get your life back.

[baby72006]

Everyone reacts differently to medications.  I have been on fentynal for just about 4 years and most of that time it has been 75mcg/q48hrs.  When it was necessary to switch to the brand name Duragesic, it truly set me on a tail spin with depression.  I ended up seeking a Psych to help me deal with it as it was severe.  After trying numerous anti-depressants with no results and in some cases severe side effects he started talking about me being resistant to anti-depressants due to taking opiods. There is also a huge risk of "serotonin uptake syndrome" which is fatal if not recognized and treated.  Mellie4, you stated that you just started using the duragesic patch....I have been on it for approximately 4 years.  
My PMP does not do multiple narcotics.  It is one or another.  They all have different opinions and methods of treatment.  When I discussed my problem with the PMP, I was told they would use the conversion chart and that when I removed the last patch I would then switch into MS.  You ask why I would stop using the duragesic patch...this depression is crippling me.  However, depending on who you talk to...switching could be worse.  I am at lose here Mellie, I honestly do not know what to do.  Being totally alone doesn't help.  Thank you for posting your response!  I  hope for the best for you.

[mellie4]

I'm wondering why you feel the Duragesic is bad for you?  I just started the Fentanyl patch, 75 mcg every 48 hours plus oxycodone for breaththrough pain along with a few other meds  I specifically witched over to the Duragesic brand a month or two ago, and that one work bet for me in many way.(It doesn't fall off or leave a glue residue on my kin or clothes.)

I have talked to my pain clinic about coming off it in case there comes a time I need to or want to and they have assured me it will be done with a VERY slow taper, and I would have no withdrawals.

I just personally don't think a fast taper benefits no one.