Duragesic Patch

[baby72006]

I have been on the Duragesic Patch 74 mcg for about 3 1/2 years.  During the last 6 months, I have become extremely depressed.  I notice that it is worse after the second day any given patch is on.  I have been treated for the depression with different antidepressants and so far have not found one that works.  I am so desperate for help as the depression has taken over my life.  Has anyone out there experienced this?  Any input would be appreciated.  I feel as though I am running out of time.

[mdmstellar]

Hello. I was on the Duragesic patch for 8 months back in 2006. Though it eased my pain tremendously for the first 2 days it was applied, at the end of day 2, I would begin to feel terribly bad, as if i had the flu, as well as depressed. Upon relating this to my doctor, he would up the dose, till I eventually was on the 75 mcg. This began a nightmare for me, as I would go into extreme withdrawals after the 2nd day, even so bad that I lost 30 lbs in 2 months, and would have cold sweats, tremors, and even experience hallucinations.

Seems by body was absorbing the medication too quickly. Doctors didn't understand or realize this at the time, and I was accused of abusing the medication. Luckily, after extended discussions (or I should say arguments, my doctor threw me out twice and even refused to any longer be my doctor) he came to his senses and realized the patch was only lasting 2 days. I then decided enough was enough, and withdrew myself from the patch, with my doctor's help, by lowering the dosage slowly over a period of 2 months. Still, withdraw was very painful, though not as painful as going through withdrawal ever 3rd day.

Don't know if this helps, but it can't hurt right? Possibly the patch simply is not lasting you 3 days.

[baby72006]

Hi....first I must thank all who took the time to try and help me.
Tuckamore, you are a total stranger to me but have taken a moment to reach out to me.  For this I was blessed.  Thank you and God Bless you and your plight.
I am a 53 year old female who had lived a very productful life up until a year ago.  The company I worked for eliminated numerous positions and mine was one of them.  I am only telling this so that you have a better understanding of my position in regards to my physical health and my limitations to get the help I so desperately need.  I am without health insurance and have no funds.  The  state I live in does not have any social medical programs.  I see a PMP once a month and pay him out of pocket.  I recently applied and was accepted in a Patient Assitantance Program for the Duragesic Patch.  I see a Nurse Practioner in a county run program for the Psych medication.  Tuesday I started talk therapy at a local university.  It is free and the therapist is a senior in their counseling dept. who  is getting her clinical time in.  This is what is available to me at this time.  
I have been suspecting that some or a great portion of this horrid depression is in some way connected to the patch.  I guess I have a decision to make before my next appointment next week.  I fear any changes as I don't want to be thrown into a tail spin in any way.  I am alone and have no one to help me.  I live 2 1/2  hours away from my PMP and no insurance to get to a hospital if needed.  I am not asking for pity here just trying to hold on.  Thank you

[Tuckamore]

Hi Baby,

Welcome to the Pain Management Forum. I am glad that you found us and took the time to post. However I am very sorry to hear that you are struggling with depression.

Depression often goes hand in hand with chronic pain. It can be aggravated by opiates and/or it can be from the numerous challenges and daily struggles that accompanies our fatigue inducing journey through chronic pain.

Certainly the Duragesic (Fentanyl) Patch being an opiate can be responsible for your depression but to what degree is always the question. Opiates affect each of our systems differently.

Please don't feel as though you are running out of time. You just need to bring this to the attention of you PMP or your PCP swiftly. Let him/her help you however they can. Request a consult to a good pain management therapist for an evaluation of your depression. It's important to know if you have a chemical or situational depression.

I don't respond well to antidepressants either. I've tried multiple families of them and have not tolerated the side effects. I was able to take one for close to four weeks a few years ago that honestly seemed to help me in that short period of time. I think it was enough to just break the cycle.

So what ever is the cause of your depression it should not be ignored. Talk to your physician so you can begin to feel better....rather that may be through talk therapy, medication changes or both. No one today has to struggle through depression without assistance.

My heart goes out to you. Please feel free to ask additional questions and by all means please let us know how you are doing. I will look forward to hearing from you. We are always here to offer our support.

Take Good Care,
~Tuck

[skmedlin27703]

I experienced the patches not working any longer... they changed the way they make them and they don't work as well. The doctor had to change me to MsContin.  Do you think it could be that you are hurting more and it is causing you to feel this way?

[Ashelen]

I'm sorry that you're going through this!

I do not use the patch, but my dad does. he says that he starts to feel depressed the night before it's time to change his patch because as the medicine begins to wear off he goes through a mental withdrawal. The medicine is still in his system because of the patch so he's not withdrawing physically, but the dosage does become slightly lower as you get closer to the time to change the patch as I understand it because certain environmental and physical things affect the patch itself. If you've been using the patch for 6 months there's a chance that you're starting to become tolerant which means that the effects would wear off slightly sooner for you and may account for this depression.

As I said, I do NOT take the patch so I'm speculating based on what my dad's told me about his experience. I hope someone who does use the patch can come and tell you their experience and give you a hand.

Good luck I hope you find an answer!