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Re: Second opinion w Dr Buchfuhrer

Posted: Mon Jun 01, 2020 8:58 pm
by ViewsAskew
lhoff12085 wrote:
Mon Jun 01, 2020 5:45 pm

I've never heard of the drug you mentioned. I can mention it to my doctor and see if he chokes me. ;) Thanks for helping. Laura
Carbamazepine is an anti-convulsant. Several options in this class have been tried. I don't have the RLS book in front of me (it is the best book on all the potential treatments and the research related to them - meant for primary care docs, many of us use it to review options). They are not considered first options - either because of side effects or that they simply don't work for a high enough percentage of people, so they are often tried when other things fail.

I do know that over the years, some people swear by some of these medications.

Re: Second opinion w Dr Buchfuhrer

Posted: Tue Jun 02, 2020 1:30 am
by QyX
lhoff12085 wrote:
Mon Jun 01, 2020 6:10 pm
Qyx, One thing I'm sure you could help me with is I'm trying to find out when Horizant and methadone are at their max in my system. Is that the T-max? I haven't found any graphs or data on that and I know Dr B was trying to maximize their effectiveness in the afternoon for the first dose. Maybe I'm searching on the wrong thing but it seems tough to find. If you can figure this out, I'd appreciate it! Laura
I think what you mean is C-max: https://en.wikipedia.org/wiki/Cmax_(pharmacology)

With many drugs there is not often a real correlation between peak serum concentration and peak effectiveness.

Finding the correct dose is in most scenarios a simple trial & error process. You try different things based on established guidelines and experience and it either works or doesn't. And just in general, Horizant is not that effective for RLS, at least compared to opioids but it sometimes can treat certain pain related symptoms or insomnia while supporting the analgesic properties of opioids. Sometimes things sadly just don't work.

I think I would consider taking iron tablets again as long as you don't have any medical reasons for not taking them. For us it doesn't really matter if we have normal Ferritin serum levels. All that matters is the iron concentration in our brain / central nervous system and meassuring Ferritin / iron in the blood doesn't tell us how much iron really is in our brain.

That's why it makes sense to get iron infusions or take iron tablets even when you have completely normal / healthy levels.

My own Ferritin values have always been absolutely normal, however I still experienced a vast improvement of my pain related RLS symptoms after several weeks of taking iron tablets.