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Help please - Fentanyl withdrawal

Hi. ... Apologies in advance - this is a long post.

Two days ago I was released from a rehab hospital following a 10 day Ketamine infusion and an intensive physical rehab program. Prior to going in I was on 25mcg Fentanyl patch (changed every 2nd day) plus a 200mcg Fentanyl lollipop for daily breakthrough episodes. (I had been on this dose for over 2 years). The purpose of the Ketamine was to reset the opiate receptors because the Fentanyl was no longer doing its job and, due to a pesky metabolic disorder, the dose couldn't be increased without risking overdose. I hate being on Fentanyl because it makes my head fuzzy and so asked if I could get off it.

PM was okay with that and changed me to Palexia (50mg twice a day with up to 2 extras per day for breakthrough).

For 10 days I was on a constant infusion of 200mg Ketamine plus 75mg Clonodine every 24 hours. The 25mcg Fentanyl patch was removed on day 2 and replaced with 50mg Palexia twice a day plus the extra 2 tabs for breakthrough. There was no tapering. By day 3 the withdrawals started with anxiety and muscle spasms. Day 4 saw the addition of severe restless legs and seizure type spasms. First couple of days symptoms were treated with Vallium and then PM added 5mg Midazolam to the infusion driver. It helped, but not enough. So Clonozapam was added for a couple of days and Vallium was ceased leaving me nothing for severe episodes that the meds didn't cover. After another 2 days, Clonozapam was ceased and Vallium added back as needed. By about day 8, I appeared to be over the worst and so only had the Ketamine, Clonodine and Midazolam in the infusion driver. At the end of day 10 the infusion was stopped and the next morning I was released from hospital with just the Palexia and some Vallium. That was last Friday morning.

I was ok during the day but by the afternoon started to feel the anxiety coming on. By that night the muscle spasms and extreme restless legs started again. Obviously the Clonodine and Midazolam that were in the infusion driver had been holding the symptoms at bay leaving me with a false sense of security. It got so bad in the night that I spent at least an hour sitting on the edge of the bed in tears and rocking back and forth like a demented person just wishing I would die. It took quite a bit of Vallium to get through the night. Yesterday (Saturday), I suffered high levels of anxiety all day and last night had another night like Friday night.

It's now Sunday morning and it's been 13 days since the Fentanyl was stopped. In the hospital the withdrawals, while severe, were being medically managed. Now I am out here on my own and I'm not sure how much more I can cope with. To make matters worse, the Palexia, which seemed to manage my pain levels while I was in the hospital, is now no longer doing it so I am hitting almost a constant level of breakthrough.

I still have some Fentanyl left and I know that it would ease both the pain and the withdrawal but I have come this far and I refuse to take a backward step. I can't face having to start the whole process again.

Can anyone shed any light as to how much longer the withdrawal symptoms are likely to last? I just need something to hang on to ... Some light at the end of this tunnel.



  • n2bravesnn2braves Posts: 68
    edited 10/31/2015 - 8:03 PM
    Went thru them several times over the years when taking drug holidays. I would think that you should be feeling better any day now.

    When I tried the patch it was only for a few days and I just had terrible anxiety when using it so went right back to the long acting drug I had been on. Because of the long half life of Fentanyl, it probably takes a little longer to clear out of your system then other delivery systems.

    You deserve a pat on the back! You have come along way and I can certainly understand why you don't want to take a backward step.

    I just added you to my prayer list and I will ask that this be over for you ASAP!

    Hopefully the Palexia will kick in and start working. That is not a drug I am familiar with.

    Is there something else you can try if the Palexia doesn't work for you?

    I like to have a backup plan because so many meds just aren't effective for me.

    When I do drug holidays, it always seems like just when I get to that point where I am not sure I will make it, things calm down and I feel better.

    Please keep us updated.

  • [Deleted User][[Deleted User] Posts: 0
    edited 11/01/2015 - 3:36 AM
    The user and all related content has been deleted.
  • SavageSavage United StatesPosts: 5,427
    Curious why you still have fentanyl in your house? When discontinued, should be destroyed.
    And also the temptation would be removed.

    Since, if I reading correctly, you're working with PM doctor.....You don't want to ruin the trust he has in you by taking a medication that he is no longer prescribing for you.
    That could become a whole new world of possibly being dismissed from pain management.
    It would be in my case anyway.

    I agree with above, please contact your doctor about the horrendously difficult time you are having....being at constant high levels of pain.
    Personally, I would call the office, weekend or holiday, or whatever if I'm suffering so.
    They have answering services for that reason.

    Our pain doesn't have banker's hours and if anyone would understand what you're going through, it's your pain management
    And it's combined with the withdrawal. You don't need to do it alone!
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • Thank you for your prayers and words of encouragement. Even though I have the support of a wonderful husband, this journey is a lonely road. Only those who have been there can have any insight into how hard it is.

    Had a slightly better night last night. Actually slept for 5 solid hours. Hopefully this is starting to come to an end. Even though I know that going back on Fentanyl would end my current torture, it was my choice to stop it and I don't regret that choice. I'm not even tempted to go back on it because I don't ever want to go through this again.

    Why do I still have it in the house? Because I was still on it when I went into hospital and so there was about 2 weeks supply in the safe at home. My PM wasn't actually planning on taking me off it but I pleaded with him and he agreed to give it a go. I spent the last two weeks in the hospital and only got out on Friday and have not yet had the opportunity to have it disposed of. I am in Australia and we don't yet have the problems with our pain management doctors that you do in America. We don't have to sign contracts etc. I guess it might be different for patients suspected of abusing the meds but it's not something I've ever come across.

    I have an appointment with my GP this afternoon and hopefully she can suggest something more appropriate than the Vallium for the spasms / seizures. I don't like having to take so much of it.

    Palexia is Tapentadol. It is a slow release synthetic opioid that apparently has a slight antidepressant effect as well as a pain killer. I'm hoping that this new med will work out for me. So far so good - there are very few meds I can tolerate and, apart from the fact that the dosage is not quite right yet, I am not suffering any major reactions. The only down side is that it wears off too quickly and so the pain comes back several times a day - then it takes about 30 minutes or so after taking a pill for it to ease back down again.

    At least I can say that I am one day closer to being free of Fentanyl ...
    Day by day, hour by hour, minute by minute. I will get there!
  • It's so good to hear that you got some sleep! That's always a good thing.

    Tapentadol! Ok, I took Nucyenta about 5 years ago. I think I stayed on it for the better part of a month but it just didn't work well for me.

    I know it works well for alot of people though, so I will be praying that it works for you.

    So glad you are going in to see your GP.

    Please let us know how that goes.

    Hopefully this is the end of the misery for you.

    Bless your heart, what an accomplishment!

  • CherylCCCherylC Posts: 185
    edited 11/02/2015 - 8:28 AM
    Saw my GP yesterday and she is happy for me to stay on the Vallium as needed for the next few days. Also managed to get an appointment with my PM doctor for next Monday. Happy to say the seizures have stopped. Still having some problems with anxiety but that too will settle soon. Am through the worst of it thankfully.

    Not sure that the Palexia is going to work - already taking the maximum dose I have been prescribed. Will see what my PM doc says next week.
  • Thank you for your support while I struggled through the change from Fentanyl to Palexia. I now believe I am through it. No more anxiety attacks, muscle spasms or seizures thankfully!

    My only difficulty now is that the Palexia is no longer covering the pain. I am taking the maximum I am aloud to have and I'm back to severe pain in my lumbar spine, legs and feet. I see my PM doc on Monday - don't know what else he can offer me. I can't take Lyrica, Gabapentin, morphine, OxyContin, endone, tramadol. I don't want to start back on Fentanyl again.

    My head feels much clearer that it was before but my pain levels are bouncing between 6 - 8 out of 10. I just need to find some happy medium!
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