Hello! Thank you for your question on HCM! I appreciate your concern. I think that your symptoms may be related to tolerance to tapentadol. It may also be a chronic daily headache drug induced. This drug can lead to tolerance and addiction when it is taken for a long period. The tolerance means that higher doses are needed to control your pain. The addiction means that your body needs to take this drug and you can not stop it abruptly because of withdrawal syndrome. So I would recommend you to consult with your GP, and try to tapper slowly tapentadol , decreasing very slowly the dose until stopping it. For the chronic pain I would recommend you to start on an antidepressant like sertraline or an antiepilepsy drug like lamotrigine or pregabaline. I would also advise you to monitor your blood glucose and your blood pressure regularly. Hope to have been helpful! Greetings! Dr. Aida