"i have numerous chronic conditions but i will speak about my pain. i have been attending the pain clinic for approximately 5 years and have tried every conceivable pain medication that i could get including a ketamine iv , nothing has worked until now. i am on 500 mg of palexia/tapentadol/nucynta and it works. i have nerve damage due to an undiagnosed neurological condition with symptoms copying multiple sclerosis. it has taken about 8 weeks for it to work but it has made a big difference. side effects are no sleep (chronic), dizziness (goes away) and mood swings. i want to stay on it and hopefully my doctor can help with the sleep, so anyone just on it or about to go on it please give it a bit of time."