Nucynta (tapentadol)

[Thisismyusername]

I'm in pain management and I was prescribed Nucynta 50mg immediate release. It is a new opiate with also effects serotonin levels. I have to say, it really really helps with the pain, but I feel uncomfortable using it because it has some strange effects on me.

My experience so far: After about an hour I start noticing a pleasant feeling and mild pain relief. It affects my brain but I don't know how to describe it. It has a slight stimulant effect and makes me feel kind of focused and spaced out at the same time. I don't know how to describe it. Over the next 2 hours the feeling intensifies. By the 3 hour mark it creates a euphoric feeling through my body and I feel very strong pain relief - like the pain is brought down to a 1 out of 10 (0 being pain free). The pleasant feeling fades after 4 or 5 hours total. The pain relief is mild after 1 hour, moderate after 2, and strong from hours 3 to 6 or 7. The effect on my brain does not feel extreme - it is more subtle, but given that I'm trying to get a PhD in math I am concerned about how well I can function on it.

I honestly don't like how it makes me feel really good because it seems dangerous - like it could be psychologically addicting. And of course it is also causes physical dependency being an opiate.

The other thing is that one time after it wore off the pain came back worse than ever. It was really bad for at least a few hours in a row. I think it probably had to to with the medication.

I actually tried 25 mg by cutting the pill in half and it also seemed to provide good pain relief so I think I will stick with this dosage for now. I have not been taking it every day. I'm not sure how much I'll use it.
I don't like using pills for pain because of the side effects and addiction potential, but I'm suffering so much that I'm desperate enough to at least give it a try.

I wish I could have my old pain free life back and I wish I could have sex again without pain, but it seems like this pain isn't going away any time soon (or ever?? kill me now).

I also scheduled an appointment with a pelvic pain physical therapist for next week. This is my biggest hope right now.

[webslave]

This drug is definitely addictive so be careful. Do not use it long term. In your shoes, I'd treat it as a last resort to overcome pain in circumstances when that is required.

http://en.wikipedia.org/wiki/Tapentadol

[Thisismyusername]

Since I've started this drug I've had long periods of very low pain, where I almost feel like my old self. And then I have long moments of excruciating pain where I feel worse than before. Right now I have a very intense burning in my perineum which is driving me insane. I decided not to take the drug today or tomorrow because I have a test and I want to have mental clarity while studying and taking the test. But the burning hurts so bad! I miss my old life.

[Thisismyusername]

I decided to discontinue use because when the medication wore off my pain was worse than ever. This effect disappeared within 24 hours of discontinuation. However my brain still feels weird from the medicine and I keep making mental errors that I wouldn't normally make. Hoping (expecting?) that this disappears over time as well.

[webslave]

As I report here, opioids (like Nucynta) affect mast cells and can make the pain worse, ironically.

[Mike Kavo]

Bad news! Stop this path now. Opioids really make this worse. My advice is to discontinue from stressful life and try Wise-Anderson Protocol - take 1-2 years out you are young and do this NOW. You will "fully" recover if you do I suspect. Get out the rat race and let your body recover. CPPS is directly kicked off by stress (believe me you don't know you are stressed in the same way mentally ill people don't know they are mentally ill; usually it just becomes normal to you). You will destroy your body using opioids and make CPPS last MUCH, MUCH longer.

Opioids have left me in a mess; my mast cells are a shot. They kicked off Dermatographic Urticaria. I now cannot use my hands or even walk properly anymore. I am completely disabled. This is not just skin writing it causes immune attacks all over the skin and will eventually lead to more problems down the line. You really want to risk this kind of crap for a non fatal disease? This is just one of many diseases opioids can trigger - opioid use IS NOT FREE. Don't even get me started on addiction and how that destroys your very being as you morph into a medicated educated junkie (the worst kind).

I started opioids at 24 stopped 32 and was disabled by them more than CPPS. Since stopping opioids low and behold my CPPS has literally gone but not the immune/nervous system problems — they probably never will go away now. You are TOO young and CPPS will not kill you, so you need to find a way to manage this without pain meds until it ebbs off - good low (NOT NO) carb diet + Wise-Anderson Protocol and only ejac at "night directly before sleep" and that will control it until it ebbs off (AND IT WILL!).

CPPS will on its own ebb off in young people in a couple years or so - it may never fully resolve but ebb below the need for opioids GOD YES OF COURSE IT WILL IF YOU LOOK AFTER YOURSELF. You're 28 by 33-35 you won't notice it much by 40 it will be of minor concern. The gift of CPPS young is prognosis is MUCH BETTER! You are risking all in pain management to buy yourself 3 or 4 years of pan relief.

I never got my PhD in computing not because of CPPS but the damage opioids did to me. I can't even think straight anymore because of meds to control my immune system. All via pain pills! I can not solve a linear equation now let alone a differential. ^^ You want that? You are too young! Lifestyle changes until you improve not medication in the answer!

What is even more a risk is CPPS MIGHT have a mast cell component anyway - and opioids really make them go haywire. They will continually stimulate them and nerves (feedback loops of spasms) and never allow it to ebb away.

YOU ARE WARNED! IF I COULD GO BACK I WOULD NEVER USED THESE MEDS THEY ARE FOR DYING PEOPLE ONLY! BTW NSAIDS ALSO MESS UP MAST CELLS ALL PAIN MEDS ARE BAD FOR CPPS VIA MAST CELLS & THE NERVOUS SYSTEM!!!! THIS DISEASE IS NOT TREATABLE WITH MEDICATION!!!

[Caedar]

YOU ARE WARNED! IF I COULD GO BACK I WOULD NEVER USED THESE MEDS THEY ARE FOR DYING PEOPLE ONLY! BTW NSAIDS ALSO MESS UP MAST CELLS ALL PAIN MEDS ARE BAD FOR CPPS VIA MAST CELLS & THE NERVOUS SYSTEM!!!! THIS DISEASE IS NOT TREATABLE WITH MEDICATION!!!

I agree with everything else you said regarding opoids and their dangers, but this statement is a little much. There are many medications that can help CPPS, including alpha blockers, antihistamines (to help with the mast cell angle), tricyclic antidepressants, etc. Not to say that these are the solution, but they can help the process along.

[webslave]

Opioids have left me in a mess; my mast cells are a shot. They kicked off Dermatographic Urticaria.

This study seems to confirm (Note: codeine is an opioid).

J Allergy Clin Immunol. 1986 Jun;77(6):802-7.
Discrimination between urticaria-prone and other allergic patients by intradermal skin testing with codeine.

Cohen RW, Rosenstreich DL.

To study the ability of cutaneous mast cells to degranulate in urticaria-prone patients, subjects were skin tested with the known mast cell degranulator, codeine sulfate. Sensitivity to codeine as determined by the concentrations of codeine necessary to cause a net wheal of 5 mm was compared between urticaria-prone subjects, allergic subjects, and normal control subjects. Urticaria-prone subjects were more sensitive to codeine at every concentration tested and exhibited a mean reactivity to codeine that was almost 100 times that of the other allergic individuals and normal control subjects. This difference could not be explained by an increased sensitivity to histamine in 71% of urticaria-prone patients nor by any dermatographic tendencies or increased relative allergic reactivity. These findings suggest that codeine skin testing can be used to identify a distinct population of patients with urticaria.

PMID: 3711548

[Wolfcub]

The gift of CPPS young is prognosis is MUCH BETTER

This is the first time I ever hear such of thing. What is the basis for that?

[webslave]

"The gift of CPPS young is prognosis is MUCH BETTER" - this is the first time I ever hear such of thing. What is the basis for that?

If you are young now, the condition is easier to overcome than if you have had it for 20 years. We have many more treatment options and knowledge now. Multimodal treatment is a new option as well.

Once you've had it for decades, it gets burned into the neural pathways in a way that makes it difficult to cure. Basically, the less time you've had this, the easier it is to beat.

[webslave]

Another note: In one study, Tramadol induced urticaria in 18% of patients!
http://pubmed.ncbi.nlm.nih.gov/12861852

[Wolfcub]

"The gift of CPPS young is prognosis is MUCH BETTER" - this is the first time I ever hear such of thing. What is the basis for that?

If you are young now, the condition is easier to overcome than if you have had it for 20 years. We have many more treatment options and knowledge now. Multimodal treatment is a new option as well.

Once you've had it for decades, it gets burned into the neural pathways in a way that makes it difficult to cure. Basically, the less time you've had this, the easier it is to beat.

One can raise an argument this has the possibility of some kind of a cognitive bias... (yet not conflicting with the possibility of a CNS "hardwiring"/remodeling involvement.

[webslave]

I think you'll find there are studies supporting that

1. Recent-onset cases are more amenable to treatment
2. Multimodal treatment, a recent innovation, is more effective than monotherapy

And of course, quite clearly, there are more treatment options now than, say, 15 years ago.