Sherry, i am also on the patch and have found with all the other meds they have tried me on it helps the most... i have heard from other patch wearers that it is an up and down effect however i have an even flow with this med so it will entirely be an individualistic thing as to how effective it will be for you. I also take breakthrough but have found to need less as i have began the patch/ Be sure to move your spot (not being the same every time you change due to possible irritation... i did not get irritation right away... rather 2 months down the road... i used hydrocortizone cream to clear it up.. good luck to better pain management shawna french