Fentanyl

Sleuth · Post by **Sleuth** » Thu Apr 02, 2009 5:56 pm

Sorry for starting another topic but I don't know how else to get an answer.

Yesterday I had cataract surgery. I had a little anesthesia. I noticed that I did not have any RLS symptoms for the next 24 hours. That has not happened to me in about a year. Today I called the anesthesiologist to ask her what she gave me. She told me it was a mixture of Versed (similar to Valium) and Fentanyl, which is a narcotic.

I doubt that the Valium had any effect since I take Ativan, which has no effect on the RLS. I bet it was the Fentanyl.

Forgot to mention that I am also very depressed today. From reading the messages, it seems that depression is a side effect of these opiates. Is that correct?

Does this make sense?

Dale

SquirmingSusan · Post by **SquirmingSusan** » Thu Apr 02, 2009 6:03 pm

It was probably Fentanyl, which is a very strong narcotic that's often used for anesthesia. I had a minor surgery about 1-1/2 years ago, and they used a light anesthesia that was a mixture of Fentanyl, Valium, and a barbiturate. I felt great afterward. Fentanyl is what's in the Duragesic patch, I believe.

Sleuth · Post by **Sleuth** » Thu Apr 02, 2009 6:04 pm

You're right. I just called the doctor back. It was Fentanyl. It has left me depressed.

One of the first doctors I went to told me that the medicine that would help RLS would increase my depression. I guess he meant these types of drugs.

Dale

woodsie357 · Post by **woodsie357** » Thu Apr 02, 2009 8:02 pm

very interesting. Thanks for posting. Sorry about the depression

Sleuth · Post by **Sleuth** » Thu Apr 02, 2009 9:15 pm

I guess that means there is no medicine for me. Requip doesn't work and the narcotics make me depressed.

Now I'm really depressed.

Aiken · Post by **Aiken** » Thu Apr 02, 2009 9:24 pm

Fentanyl is an opioid, just like hydrocodone, oxycodone, morphine, etc.

As such, it will give you a certain amount of mood *boost* while in effect, and as with any such modification, you get a rebound effect when it wears off.

However, if you were on some kind of long-term treatment with such a drug, you could use an extended-release or long-duration form that would keep you from ever getting to the point of rebound. You'd eventually adjust and lose the boost itself, but you should simply end up with a mood similar to your original unmedicated mood, while retaining the benefit of treating your RLS.

I wouldn't give up on the idea so easily. Maybe talk to your doctor about oxycontin (continuous-release oxycodone), or maybe a fentanyl patch, or maybe even a low dose of methadone, whose half-life is so long that it might as well be continuous-release medicine. I'm sure there are other options as well. Perhaps even extended-release tramadol, which is a pseudo-opioid with a touch of an SNRI antidepressant in it.

Post by **ViewsAskew** » Fri Apr 03, 2009 12:02 am

Sleuth, while it's certainly not great news, it's very possible that there is SOME combo out there that WILL work.

How's the new doctor? Have you seen him or her yet?

SquirmingSusan · Post by **SquirmingSusan** » Fri Apr 03, 2009 1:21 am

I wouldn't give up just yet. It might not even have been caused by the Fentanyl - Versed is a benzo, and those do cause depression. I can't say that I've noticed any mood depressant effects from methadone. I sure did when I was on Valium for 10 years, though.

Johnny2 · Post by **Johnny2** » Fri Apr 03, 2009 3:39 am

jumping in here late, don't know how many different opiates (pain killers) you have tried my experiance is they will all have a somewhat different effect/after effect so if you have not tried several, i would, you may find one that works.

Sleuth · Post by **Sleuth** » Fri Apr 03, 2009 7:11 am

ViewsAskew wrote:Sleuth, while it's certainly not great news, it's very possible that there is SOME combo out there that WILL work.

How's the new doctor? Have you seen him or her yet?

I saw her on Monday. She seemed terrific at first, but I'm not sure she will do. I think all these doctors affiliated with movement clinics in major hospitals here in NYC follow the same pattern. I don't believe that includes experimenting with anything other than the usual Requip type meds.

Sleuth · Post by **Sleuth** » Fri Apr 03, 2009 7:15 am

Susan,

Isn't Versed in the same family as Ativan. I've been taking that for years now. I know it causes depression, but the depression I felt after the surgery was very intense.

BTW, I never felt a boost. I was too disorientated from the eye surgery to feel anything. The one thing I noticed, though, was no RLS symptoms. The depression I felt the next day was so intense, it negated the thrill of having no RLS symptoms. If I had to choose between the two, I'd have to go with RLS. That's how bad the depression was.

This morning, I feel soooo much better depression-wise.

SquirmingSusan · Post by **SquirmingSusan** » Fri Apr 03, 2009 5:10 pm

I'm glad you're feeling better today. Whatever caused it must have worn off. Versed is a "benzo," like Valium, Ativan, Klonipin, etc. You may react differently to different benzos, who knows. When they give you general anesthesia it's different from taking an Ativan to relax or to help with the RLS - they totally knock you out. It's a lot of drugs in the system all at once.

Sleuth · Post by **Sleuth** » Fri Apr 03, 2009 6:42 pm

The doctor I saw on Monday just called. I emailed her about my experience with the Fentanyl. She was interested to hear it. She said she treats many RLS patients with narcotics. She named a few names that I've seen posted here. Monday I'm going for a blood test. She is going to call my psycholopharmecolist and meet with the psychiatrist who works with her. She thought that between the three of them they could come up with something that would work while controlling the depression.

This sounds very promising.

Post by **ViewsAskew** » Fri Apr 03, 2009 8:25 pm

That sounds awesome, Sleuth.

Neco · Post by **Neco** » Sat Apr 04, 2009 11:01 am

I hope she can help you out man, it seems like she's more interested to know more than the other doctors, and if she treats many RLS patients with narcotics and not the standard you've been slapped in the face with, it suggests she may be able/willing to think outside the box.