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I am a 41 year old woman. I have suffered from generalized anxiety for years, treated with desvenlafaxine 50 mg/day and clonazepam 1 mg/day, very well managed and without panic attacks for years. A year ago, shortly after having cavity, I started having a lot of fatigue. At the end of december 2022, the fatigue was disabling and I began to have paresthesia, a lot of pain, brain fog, and hyperacusis. I had many tests done and finally in february I was diagnosed with post viral chronic fatigue syndrome due to epstein barr or covid and was treated with modafinil 400 mg/day, magnesium 400 mg/day and vitamin d3. Two weeks ago I saw a new neurologist and told him that I was in a lot of pain. He put me on lyrica-pregabalin (i'm on 50 mg/day now but need to increase to 75 mg tomorrow) and 20 mg transdemic buprenorphine patches for a month, a treatment he often prescribes for fibromyalgia pain. He told me to take this new medication without removing any drugs that I was already taking. Everything was going well until 5 days ago I started feeling weird. I have been sleeping very badly for 2 days and I am very worried. I have a hard time falling asleep and in the end I sleep like 4 hours a day waking up a thousand times during the night. Today I looked at the graphs of the apple watch during sleep and I have dropped from an average of 13. 7rpm (breaths per minute) two weeks ago to 9.8rpm now. Tonight I hit 8rpm and 91% saturation. I have never had such low data until I started this medication. Now I read that transdermal buprenorphine can cause serious breathing problems especially if taken with benzodiazepines and lyrica. The doctor says that he sees no problem in the data but if the patches don't help my pain, I can stop them. They help me a lot with the pain, but I am afraid of the side effects. In addition to the issue of sleep, it gave me great difficulty urinating and swallowing. What do you think? Should I suspend the patches?

4Doctors Answered
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