I am in that process of trying to figure out my baseline meds. I am starting school again in August, so the goal with all of this is to come up with a med with minimal sedation/cognitive impairment. After trying several meds over the years I'm just not sure which will be *best* since they all have their pros and cons. My next PM appointment will involve making a decision on this, so any feedback is appreciated (and yes, I know I over think these things)
1) Nucynta: Great pain relief and minimal sedation, but it is supposed to last 6 hours and I only get about 3 hours relief out of it. It is also new and expensive.
2) Hydrocodone: Great pain relief, but more sedating than the Nucynta and randomly causes nausea.
3) Tramadol IR: Moderate pain relief (not as good as the other 2), but I like the idea of a non-narcotic.
4) Tramadol ER: I haven't tried this, but my pharmacist recommended that I ask my PM doc about it- My concern is how sedated/druggy I'll feel around the clock being on an ER drug, but the pharmacist thought it could perhaps cause less cognitive impairment than the IR drugs b/c of tolerance (yes, I've had a few post debating the IR vs. ER approach). Does anyone know how long it takes to "test" a drug like this (as in, how long to develop enough tolerance to really know how you'll feel on it long-term?)
I never knew how hard it would be to figure out the best drug. I know none are perfect, so I'm not sure how to pick among these since they are so different in their effectiveness and side effects...