Oxycontin vs Methadone

[brossman]

I am currently taking 5-7.5 mg of oxycodone around 5 pm and 10 mg oxycontin at bedtime. No matter what time I take my bedtime dose (it is usually around 9:30-10 PM) I wake around 2-3 hours later with RLS. I thought by going on oxycontin vs the immediate release at bedtime, it would get rid of that, but it hasn't. I have taken an extra 5 mg oxycodone at bedtime as a booster too and that has not made a difference. I can get rid of the symptoms by vaping CBD/THC, but I don't like to do that every night. I've tried tinctures, but nothing works as well as vaping for me. My doctor has suggested switching to methadone. However, I am somewhat concerned about side effects. I have never had a major depressive disorder, but while taking Lyrica (300 mg/day), I was profoundly depressed and gained a significant amount of weight. I do not want either of those things to happen again. I was a very unhappy person during that period. I have since lost the majority of the weight and do not want to put it back on. I would rather continue to vape every night as it does work for me. I augmented on pramipexole and Neupro, have also tried gabapentin (did nothing for me) and clonazepam. What experiences have people had on methadone?

[stjohnh]

What's the problem with vaping THC every night?

[Rustsmith]

I appear to be very susceptible to side effects for a number of medications, including methadone. I didn't experience depression with methadone, I experienced severe apathy. The apathy didn't happen immediately but probably started growing about a year or more after I started. With apathy, I wasn't depressed, i.e. sad, I just had no feelings at all other than my feelings toward my wife. Things that normally bring me pleasure left me flat.

So, I switched from methadone to Tramadol ER, which also caused unwanted side effects after about a year. I am back on methadone and my doctor has agreed that the best way to manage both my RLS and the side effects will be to switch between the meds every six to nine months so that I can control my RLS and avoid the unwanted side effects.

[brossman]

I guess vaping got such bad press for a while. I get medical marijuana so I can be assured (I hope) of the quality. I will probably just stick with vaping every night because it is a good combination for me without too many unwanted side effects. Thanks Steve and Holland.

[badnights]

I agree it's better to keep your opioid dose low by supplementing with vaping. You're lucky it works for you.

If you didn't want to vape, you would probably need to up your dose of oxycontin or, as your doctor suggested, switch to a different opioid. Methadone is less likely to cause suicidal depression than Lyrica, which actually comes with a warning about it (all the anticonvulsants can cause suicidal depression) . However, "less likely" refers to statistics; for you as an individual, there is no way to predict how it will affect you. You have to act according to your knowledge of the statistical risk and your personal balancing of potential risks and benefits.

[QyX]

Most likely Oxycontin would be able to cover your RLS symptoms without vaping but as Beth already said, you would have to increase your dose significantly which most likely will accelerate tolerance issues.

Vaping marijuana for RLS in combination with potent opioids are one of the most effective treatment strategies available for RLS. As long as it works for you and you can tolerate the psychoactive effects of marijuana, I would simply continue down this path.

[debbluebird]

I've been taking methadone since 2010. I've stopped it once because one of my Doctors was afraid of it and that was about 3 or 4 years ago. The substitution was horrible, so I restarted it. I sometimes take oxy as a back up, but I don't like to take it on a regular basis. It only lasts 4 hours. Then if I take it several days in a row, I find my body wanting more by making my RLS worse. So then I stop, get through a few bad nights and get back to my normal.
I haven't had trouble with weight gain. Weight gain came with antidepressants and gabapentin. I had nausea the first couple of months, but it finally ended. I've tried over 20 different meds and methadone is the only thing that works for me.