could fentanyl patches cause bursts of anger

[rismomma]

I have been on fentanyl patches for the last 9 months after having severe chronic abdominal pain for the last 14 years. My PCP started me off on 50mg every two days and now I am up to 125mcg ever two days but in the last couple of months I have started to  notice that the smallest things have been setting me off and there are even sometimes when it feels like I have absolutely no control over the anger and I just have to wait until the feeling leaves my body. Starting to worry that maybe the fentanyl is starting to mess with my head and I'm just wondering if anyone has felt something like this to the degree it gets to sometimes?

[philnoir]

Anger is not a natural side effect of opiate therapy, however, anger can be a part of the frustration that all chronic pain patients feel. It is a good idea for all chronic pain patients to develop a relationship with a pain psychologist, who helps find solutions to the many problems chronic pain causes. Ask your doctor for a referral, or seek out your own therapist -- they can be found in most university hospital pain management settings.

Only you can tell if you're on "too high of a dose" or opiate analgesics. The trick with using opiates to treat chronic pain is to use the lowest dose needed to attenuate that pain.

However, chronic pain is often treated as if it were acute pain, and many physicians will treat chronic pain with excessive opiate doses, chasing complete analgesia. This never works, but in time leads to opiate tolerance, increased dosing, withdrawal pains, and even exotic conditions of the nervous system like opiate-induced hyperalgesia, where increasing levels of pain medication increase your pain perception.

The best I expect from opiate pain medication is a 1/2 reduction in pain, and I'm usually satisfied with less. Chronic pain people learn to find various ways to mitigate their pain. An experienced pain psychologist can provide both insight and guidance in discovering behavioral techniques to will help you reduce your chronic pain.

Remember that pain reduction is a game that's won through making incremental adjustments. For instance, if you have level 7 pain, and medication reduce your pain by 2 points, and you try icing for 15 minutes that reduces pain by another 2 points, and listening to your favorite music with headphones that reduces it by another 1 point, you have reduced your pain by 5 points, turning a very uncomfortable level 7 pain experience into a tolerable level 2 pain.

Only you and your doctor can decide on an appropriate dose of opiate medications. If you have concerns that you're over medicating for the wrong reasons, talk with your doctor.

best wishes.

[Jinx_777]

I think you may be on too high a dose.  I have severe chronic pain from a broken back, hip and pelvis and I am only on 50 mcg.  I will NEVER go any higher because I notice a huge change in me on the 50.  I cannot imagine being on 125.  for me, it also causes severe fatigue.  I have not hardly been out of bed in 2 months.  It has completely changed my mental state.  reading how bad the withdrawals are scare the bejeezus out of me.  I am considering a different long acting med instead of this patch