Methadone and Gabapentin no longer working well

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debbluebird
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Methadone and Gabapentin no longer working well

Post by debbluebird »

I take methadone. It has been since 2010, I think. I only went off one time for a reset. Now, 2.5 mg every 6 hours. Taking it around the clock to handle the insomnia.
Then I added gabapentin several months ago, reluctantly. I have taken it before. I have been taking 600 mg once in the afternoon and the other in the late evening .
This was working. Helping with the insomnia. Now, it is no longer working. It seems that my body wants more. I added a third dose around 2 am, which caused me to sleep most of the day. This is not going to work for me. I cut back last night by 300 mg. Tonight I will go back to the original dose.
There is no point in increasing the doses. I realized that it will just keep going up and up. Max dose is 3600 mg in 24 hours. I might as well stop at 1200 mg in 24 hours.
So, as usual I am stuck. Methadone is not working well enough and now the gabapentin.
My appointment with the new doctor isn't for another 6 weeks.

badnights
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Re: Methadone and Gabapentin no longer working well

Post by badnights »

Gee Deb that really sucks. Just when things seemed to be getting under control. Are you sure you're getting tolerant to the methadone or could it be one of the phases you go through when symptoms get worse?

Same thing happened to me with gabapentin.
Beth - Wishing you a restful sleep tonight
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I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

ViewsAskew
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Re: Methadone and Gabapentin no longer working well

Post by ViewsAskew »

I also was wondering if you are getting tolerant...not fun, but at least you can solve that.
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.

debbluebird
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Joined: Mon May 21, 2012 3:27 pm

Re: Methadone and Gabapentin no longer working well

Post by debbluebird »

Well, I know that the methadone isn't enough, but then the gabapentin isn't enough either.
There is probably a tolerance. It feels like the body wants more, but I like said there is no way I will increase either one.
It also seems to be connected to my activity level. I believe I have said this before. It took a week for my spasms to calm down from the sewing for a few hours. Then today I had some meetings, lots of sitting in a straight chair. Feeling RLS this evening.
So if I sit in my recliner and do nothing, I am better. I get sick of doing nothing.

stjohnh
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Location: Palo Alto, California

Re: Methadone and Gabapentin no longer working well

Post by stjohnh »

Deb, I'm sure you know that many of us with severe RLS take multiple medications to handle our symptoms. Indeed low doses of multiple medications seem to work better and have fewer side effects than higher doses of a single medicine. How about adding a tiny dose of pramipexole?
Blessings,
Holland

debbluebird
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Joined: Mon May 21, 2012 3:27 pm

Re: Methadone and Gabapentin no longer working well

Post by debbluebird »

I can't take it at all. The last time I tried, it didn't help much and gave me insomnia. Redused sleep to 2 hours at night. It was not the only thing I was taking at the time.
Wish it did work. It worked for me for years.

debbluebird
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Joined: Mon May 21, 2012 3:27 pm

Re: Methadone and Gabapentin no longer working well

Post by debbluebird »

It is getting worse. My RLS has been fairly controlled. Today the RLS really kicked in. I broke down and took a half of a mirapex. A very small dose a .125 mg tab, one half. I could feel the calmness come over my body.
Tonight RLS is active again. Didn't have any spasms today or tonight so far. Had a major spasms last night.
I am not looking forward to the days ahead.
I am wondering if I should stop the gabapentin, not abruptly, but warn off? But then it will all get worse. Plus insomnia.
I have a little kratom left. So, I think I will give it a try for tonight.

stjohnh
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Re: Methadone and Gabapentin no longer working well

Post by stjohnh »

Deb, I found that kratom does well with other RLS meds. I'd say continue the gabapentin, pramipexole, methadone, and add kratom. If kratom's main effect for RLS patients is stimulation of the mu-opioid receptor, then it probably won't help since the methadone is doing that. BUT its not known how kratom really works in RLS and has lots of different compounds in the leaves.

I don't remember you trying marijuana. Its legal in Colorado, I think that's where you live.
Blessings,
Holland

debbluebird
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Re: Methadone and Gabapentin no longer working well

Post by debbluebird »

I took the kratom last night and tonight. I am about to go to sleep, but thought I would check in here first.
I had spasms 2 hours after going to sleep last night, and took second dose of kratom. Worked the rest of the night and slept most of the morning.
Didn't take any mirapex last night, today or tonight. I don't have much of it left. Didn't have any RLS today. Will see how tonight goes. Don't have many does left though.
Yes, marijuana is legal in Colorado. I have been wanting to try the oil.

Rustsmith
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Re: Methadone and Gabapentin no longer working well

Post by Rustsmith »

Deb, the pure CBD oils can be rather pricey (I know because my wife uses them). For a first time experiment, you might consider trying a 50/50 THC/CBD edible since they cost much less. The high level of CBD inhibits the intoxicating part of the THC, so most do not feel any sort of high feeling. The thing to remember is that edibles take an hour or two to get into the blood stream, so take an edible about a half hour before going to bed. If you stick with the oil, it kicks in pretty much immediately.

Also, most of us tend to benefit from the THC rather than the CBD when it comes to sleep. My suggestion if you go that route is still to stick with the edibles, but start with a small dose (say 2.5 to 5mg) rather than the single sized 10mg edibles sold in the recreational stores. And do it a night before you don't have anything scheduled the next day just in case you wake up a bit spacey in the morning. For this, I suggest trying one of the gummy candies rather than the chocolates. My experience with the chocolate was that they tended to be very brittle and difficult to split. My first experiment was with 10mg chocolates. They guy at the dispensary said 10mg was the normal amount to try the first time. I woke for a bathroom break during the middle of the night and barely got there and back because I was so drunk. But the next morning, I felt great and that was the best night's sleep that I had had in a year (because I was deep into augmentation at the time). I cut the chocolate in half the next night and did fine.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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.

stjohnh
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Location: Palo Alto, California

Re: Methadone and Gabapentin no longer working well

Post by stjohnh »

My experience with marijuana is similar to Steve's. The party line for the dispensaries generally is that Indica strains are more sedating than sativa strains. I did not find that the case for me.

I also tried a various ratios of extracts including high-cbd extracts and Edibles. I didn't find that they help my sleep much. When I started paying attention just to the number of milligrams of THC I got much better results. I use 15 mg edible THC approximately 7:30 and another 5mg several hours later. My experience is that if the amount of THC doesn't make me feel at least a little bit stoned that it's not going to help my sleep.
Blessings,
Holland

debbluebird
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Joined: Mon May 21, 2012 3:27 pm

Re: Methadone and Gabapentin no longer working well

Post by debbluebird »

Thank you for all of the information. It will be awhile before I try the marijuana products. The kratom is helping for now.
I only have a couple more doses of kratom left. After that I will just have to indur until I can purchase what I want to try or get more kratom.
Money was tight before, but since we hit that elk last October, we can't seem to get caught up.
Thank you for all of your support.

debbluebird
Posts: 2385
Joined: Mon May 21, 2012 3:27 pm

Re: Methadone and Gabapentin no longer working well

Post by debbluebird »

The kratom has been working, but now I have to stop it for 2 or 3 weeks. Got labs done because of increasing thyroid med. Thyroid is fine now, but kidneys are now worse. Doctor wants me to stop kratom and then recheck labs to see if that caused the problem. Before kidneys were only had mild issues, now lab readings show stage 4.
I am screwed either way. If the kratom caused the problem, the I can no longer take it. If it didn't cause the problem, then I am in trouble.
I just can't seem to win.

Polar Bear
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Re: Methadone and Gabapentin no longer working well

Post by Polar Bear »

deb - aaaagghhh..... want to scream on your behalf.
I really hope that when your tests are done there is a more positive outcome that you expect.
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

ViewsAskew
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Re: Methadone and Gabapentin no longer working well

Post by ViewsAskew »

Oh, Deb. That just sucks.
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.

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