Wow, you know, I never understood why methadone was useful for dependence. Now I see. There's no sudden rush/buzz like you get with the real opioids. It's got the painkilling and the calmness, but it's all very gentle and slow to come on. If I were a doctor, I'd much rather prescribe this than hydrocodone or oxycodone. As a patient, I also think this is better--I find that sudden opioid onset more disconcerting than pleasant most of the time, though I'm probably in the minority on that.
It's only day 1, so I don't have much else to report. I took 5mg and I'm getting about 80% relief after 3 hours. I'll probably take another 2.5mg later, but given what I've read about the body building up some of the drug long-term in fatty tissues, I bet Zach was right that I'll only need 5mg or less most days.
Very encouraging...
One more on Methadone
-
ViewsAskew
- Moderator
- Posts: 16602
- Joined: Thu Oct 28, 2004 6:37 am
- Location: Los Angeles
Yes! I have never liked the feeling of traditional opioids. For me, the first thing they do is make be cranky 
. I get this vague sort of gritting my teeth, suppressed anger at everything. Yuk. Then I get the out of it, detached quietness. Not a good combo for me.
But with this? Nothing except the RLS is gone, darn it. Just plain gone. And, maybe a bit of the calm, but not that artificial out of it.
Glad to hear that there was nothing untoward with it and hope to hear that the RLS is completely controlled soon. And, hopefully, with one dose a day.
. I get this vague sort of gritting my teeth, suppressed anger at everything. Yuk. Then I get the out of it, detached quietness. Not a good combo for me.
But with this? Nothing except the RLS is gone, darn it. Just plain gone. And, maybe a bit of the calm, but not that artificial out of it.
Glad to hear that there was nothing untoward with it and hope to hear that the RLS is completely controlled soon. And, hopefully, with one dose a day.
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Okay, wow, I do have something to report after just one night. There is a significant difference for someone with moderate RLS.
A few hours after thinking I had plateaued and that I needed another half of a pill, I discovered I was very wrong about that. I waited 5 hours to take the extra, but I'd say my system was still absorbing/distributing the original dose in significant quantities up to 8 hours after taking it. I knew from research that it could take a long time, but didn't expect it to be that long.
I developed some very noticeable respiratory depression... probably nowhere near fatal, but enough to concern me. You don't get a do-over if you guess wrong with that. Since methadone is supposed to be very fat-soluble, I ate some fatty tortilla chips to wick up anything that I hadn't yet digested, and that actually did halt the progression. Not good for my reflux, but it's only one night and I won't do it again. Actually, my reflux, and the slow stomach I get as a result of the meds I take for it, may be a factor here.
I'm definitely going to tell my doctor to warn anyone without a hefty tolerance to go very easy at first. I think this might be the main difference between a moderate sufferer like me and those of you who are using this for full-blown refractory RLS. I simply haven't as much tolerance as those who've taken multiple daily doses of other opioids before switching to methadone.
Other than needing to adjust down, though, I'm still very encouraged. I got comfortable and uninterrupted sleep, which I think I haven't had even once since this time last year. It was really nice.
A few hours after thinking I had plateaued and that I needed another half of a pill, I discovered I was very wrong about that. I waited 5 hours to take the extra, but I'd say my system was still absorbing/distributing the original dose in significant quantities up to 8 hours after taking it. I knew from research that it could take a long time, but didn't expect it to be that long.
I developed some very noticeable respiratory depression... probably nowhere near fatal, but enough to concern me. You don't get a do-over if you guess wrong with that. Since methadone is supposed to be very fat-soluble, I ate some fatty tortilla chips to wick up anything that I hadn't yet digested, and that actually did halt the progression. Not good for my reflux, but it's only one night and I won't do it again. Actually, my reflux, and the slow stomach I get as a result of the meds I take for it, may be a factor here.
I'm definitely going to tell my doctor to warn anyone without a hefty tolerance to go very easy at first. I think this might be the main difference between a moderate sufferer like me and those of you who are using this for full-blown refractory RLS. I simply haven't as much tolerance as those who've taken multiple daily doses of other opioids before switching to methadone.
Other than needing to adjust down, though, I'm still very encouraged. I got comfortable and uninterrupted sleep, which I think I haven't had even once since this time last year. It was really nice.
Disclaimer: I often talk about what I do and what works for me, but these are specific to me and you should always consult a healthcare professional before trying these things yourself, lest you endanger your health or life.
-
SquirmingSusan
- Posts: 3028
- Joined: Sun Nov 12, 2006 4:08 am
- Location: Minnesota
- Contact:
Respiratory depression is a huge issue with the methadone. It seems like it's very easy to OD it because of that. Probably one of the reasons it's so tightly controlled. I remember starting out and being frustrated with the docs because they only gave me 5 mg. And they've raised the dosage so slowly. But I guess it's the price to pay for staying alive. 
Susan
Being very opiate tolerant, I guess I lucked out in that dept.. I can take quite a lot and not get any kind of depression going on. I remember back when I very first tried Oxycodone though, I only took two (10mg) and I thought I was doing to DIE the next day because I kept getting paranoid about my breathing, lol.
the dot
A couple of people have commented on the dose of Klonopine I take. I said 5 mg. I forgot that little dot. It's .5 of Klonopine, which I think is standard. I still haven't called the doc, I'm still afraid I guess. Now, I'm going right to sleep but get up about 1 1/2 hours later and the race is on, walking the halls, mopping the floor. I've promised myself I'll e-mail the neurologist on Monday and will let you know what he says.
I did e-mail my doc, he said start by upping it to 15 mg and he would write me another rx for Mirapex, but not to try it for a couple of weeks. So -- I've taken the 15 mg of Methadone 2 nights in a row. I still get up, at least twice, with an RLS episode. But I seem to be calmer and I don't have the feeling that I'm running or nervous the whole time I'm in bed. I am a little more tired the next day.
doety--
I'm finding that both the onset and duration of methadone are very elongated for me. It takes 2-3 hours to hit full strength, and then it seems to be nearly full strength for at least another 6-8 hours. I'm not sure if this is typical, but I've definitely read that it can go on for a long time for some people.
However, as I said, I have a very slow stomach due to my reflux meds suppressing acid production. I'm wondering if maybe you digest things rapidly. Another possibility is that I still have food in my stomach from dinner hours earlier. That food acts like, hmm, I think it's called a buffer. It diffuses any medication I take, causing it to take longer to take effect, and also providing a sort of extended release as the food slowly gets absorbed over the following hours.
You might want to talk to your doctor about the possibility of taking your methadone with a certain type/amount of food to get a similarly-extended dose. I know methadone is fat-soluble and supposedly a lot of it goes into your body's fat store first, and then slowly gets released over time. Maybe your have either too much or too little fat in your body, or perhaps in the food you eat. You might get most of the dose right after taking it and then it quickly tapers off. From what I've read, metabolism can change the half-life by a factor of up to 50x between people.
Obviously, I've only been taking this for a week, so I know very little, and even what I've read is always suspect because I found it on the internet, but your doctor might have some ideas about why your absorption is working differently.
I'm finding that both the onset and duration of methadone are very elongated for me. It takes 2-3 hours to hit full strength, and then it seems to be nearly full strength for at least another 6-8 hours. I'm not sure if this is typical, but I've definitely read that it can go on for a long time for some people.
However, as I said, I have a very slow stomach due to my reflux meds suppressing acid production. I'm wondering if maybe you digest things rapidly. Another possibility is that I still have food in my stomach from dinner hours earlier. That food acts like, hmm, I think it's called a buffer. It diffuses any medication I take, causing it to take longer to take effect, and also providing a sort of extended release as the food slowly gets absorbed over the following hours.
You might want to talk to your doctor about the possibility of taking your methadone with a certain type/amount of food to get a similarly-extended dose. I know methadone is fat-soluble and supposedly a lot of it goes into your body's fat store first, and then slowly gets released over time. Maybe your have either too much or too little fat in your body, or perhaps in the food you eat. You might get most of the dose right after taking it and then it quickly tapers off. From what I've read, metabolism can change the half-life by a factor of up to 50x between people.
Obviously, I've only been taking this for a week, so I know very little, and even what I've read is always suspect because I found it on the internet, but your doctor might have some ideas about why your absorption is working differently.
Disclaimer: I often talk about what I do and what works for me, but these are specific to me and you should always consult a healthcare professional before trying these things yourself, lest you endanger your health or life.
-
SquirmingSusan
- Posts: 3028
- Joined: Sun Nov 12, 2006 4:08 am
- Location: Minnesota
- Contact:
doety wrote:I did e-mail my doc, he said start by upping it to 15 mg and he would write me another rx for Mirapex, but not to try it for a couple of weeks. So -- I've taken the 15 mg of Methadone 2 nights in a row. I still get up, at least twice, with an RLS episode. But I seem to be calmer and I don't have the feeling that I'm running or nervous the whole time I'm in bed. I am a little more tired the next day.
Well, it sounds like maybe you need an even higher dose beat back the RLS monster, especially if you aren't able to take the Mirapex. But it sounds like the doctor is working well for you. Do you think it would help it you split your dose between 2 times - May one 1-2 hours before bed, and another when you wake up the first time?
Of course you're tired the next day. Your sleep is interrupted at least twice. Hopefully you'll get the meds figured out so they'll be working for you again. It's so difficult when things aren't working right.
Susan
Doety- I can't remember in your posts if you mentioned ever trying neurontin or lyrica for your RLS? I'm only saying that because even if I took 100 mg of oxycontin, much of my actual leg movements would still be occuring. I use neurontin in combination with oxycontin and have found that combo to be a godsend.
Josh
I think I'll just have to experiment.
I'm on a very lowfat diet right now and that may cause quicker absorption.
I laughed about the comment "of course you're tired, you got up twice." That's actually so good, compared to what usually happens! I haven't slept through the night since I was a teenager and can't imagine. But I am going for good sleep and think I'm going in the right direction. This morning, I got up at 6 (after twice last night) and thought I was up for good, but lay back down just in case. Then I woke up at 9:30! I think for most of us, those last hours we sleep are the deepest and most rejuvenating. Got up feeling great! Still, I don't want to live like that if I can help it.
Thanks so much for all the comments. Obviously, we're all in uncharted waters and reading about your experiences helps me so much.
I'm on a very lowfat diet right now and that may cause quicker absorption.
I laughed about the comment "of course you're tired, you got up twice." That's actually so good, compared to what usually happens! I haven't slept through the night since I was a teenager and can't imagine. But I am going for good sleep and think I'm going in the right direction. This morning, I got up at 6 (after twice last night) and thought I was up for good, but lay back down just in case. Then I woke up at 9:30! I think for most of us, those last hours we sleep are the deepest and most rejuvenating. Got up feeling great! Still, I don't want to live like that if I can help it.
Thanks so much for all the comments. Obviously, we're all in uncharted waters and reading about your experiences helps me so much.
-
SquirmingSusan
- Posts: 3028
- Joined: Sun Nov 12, 2006 4:08 am
- Location: Minnesota
- Contact:
I've also been taking Neurontin off and on (off because I just get sick of all the pills) and have noticed that when I take it I sleep much more deeply and the sleep is much more restorative. My prescription finally ran out from last winter, and I called in a refill. I think I'm going to keep taking that one. Doety, if kicking is waking you up, you may want to ask about it.
Susan
doety wrote:I think for most of us, those last hours we sleep are the deepest and most rejuvenating.
Oh heck yes. Unfortunately, they're also the ones that we're most likely to have to abandon in order to go to work. Sigh.
Disclaimer: I often talk about what I do and what works for me, but these are specific to me and you should always consult a healthcare professional before trying these things yourself, lest you endanger your health or life.
-
SquirmingSusan
- Posts: 3028
- Joined: Sun Nov 12, 2006 4:08 am
- Location: Minnesota
- Contact:
For me those last few hours are when I dream full-length, feature movies! It's amazing what come's out of my mind when I'm dreaming! Last night I dreamt about running into a mortgage agent who was trying to harass people out of their houses, and I found out about a fundamental civil right called "The right to nest." (What was I in this dream, a bird?) But there in my dream were several quotations from famous people, and all kinds of information backing up this "right." We even went to court and had our accusers thrown out because they were being deceptive and trying to take away out rights.
LOLOLOLOL
No wonder I wake up tired. My brain never misses a beat in my sleep!
LOLOLOLOL
No wonder I wake up tired. My brain never misses a beat in my sleep!
Susan