Hi, everybody:

I use Duragesic (fentanyl patches) 125 mcg (one 100 mcg patch and one 25 mcg patch every 72 hours) for intense chronic pain caused by generalized internal chronic RSD and I take MSIR (morphine sulfate immediate release capsules) 30 mg (one capsule once or twice daily as needed) for breakthrough pain.

I have very intense fatigue. No one knows why. My primary care doctor, my only doctor, does not believe me, but there are witnesses at my workplace who have seen me extremely tired, trying to keep my head from falling on my desk from such tiredness. I sleep about 8 hours a day, sometimes less, sometimes more.

I have some leftover dextroamphetamine tablets, which were prescribed for me in the U.S. a long time ago by my wonderful U.S. pain management doctor. I do not have access to new dextroamphetamine tablets anymore because I am not in the U.S. (French doctors look at me as if I am pointing a gun at them when I ask for a dextroamphetamine prescription renewal, even though this medication was already prescribed for me in the past by a U.S. doctor) I take a 5 mg tablet of dextroamphetamine when my fatigue gets sooo extreme I think I cannot take it anymore. I noticed the more tired I am when I take my dextroamphetamine tablet, the more effective it seems to be. I wonder why. If someone has any ideas, feel free to share them with me.

My other questions are:

-Can dextroamphetamine be taken with opiates circulating in the blood?

-Can dextroamphetamine be taken at the same time as MSIR without these two medications cancelling each other's effects? If no, how long do I have to wait, when I took one of these two medications, to take the other one? I am asking these questions because a person can be tired (thus needing dextroamphetamine) and in intense pain (thus needing MSIR) at the SAME time. Then what do I do?

Thanks for sharing your opinions and answers.