I've been on Oxycodone for almost 10 years now, with 20mg a day over 3 doses per day (ER), most recently 5mg in the late morning, 5mg in the late afternoon and 10mg in the evening. There are stretches where I have to go up to 25 or even 30mg a day for a few weeks.
I noticed that the dose I take in the late morning appears to be more important than the ones later -- in the rare cases where I forget to take it or when I take it too late, I'll always have a very bad night even if I take it later. Recently when I had a stretch with ramped up symptoms I realized that increasing the dosis in the evening or afternoon wouldn't help, but increasing the dosis in the morning to 10m did, significantly. All this even though I don't have symptoms during the day (unless I try to sleep).
Did someone else observe these patterns, and are there any ideas why this would be the case?
Now this is somewhat puzzling. It doesn't align with the theory "the higher the dose, the better the treatment" -- if I get a lot of breakthrough symptoms, I get better results by increasing the dose in the morning than by increasing the dose in the evening, where the symptoms occur. And at least in my case (perhaps I'm very unusual?) it raises some severe questions if the "one dose per day" approach, that used to be the norm with dopamine agonists, is optimal...
And I doubt that the Oxycodone stays in my system for a very long time. Often my worst symptoms are in the morning, after maybe 5-6 hours of sleep, a I'm seeing the same during the daytime: If I shift the morning dose forward to, say, 10am and the afternoon dose at 6pm, I can nap in the morning but will see symptoms if I nap after 4pm or so.