Daytime breakthrough

[IzzyKoshi]

Dar Members:

I am currently taking 20mg Methadone (10mg in morning and 10mg at night). I can sleep with this regimen. The BIG problem now is very significant daytime RLS, typically every day and most often for the entire day. Legs are flying even as I type this message! Any ideas or suggestions will be greatly appreciated. Thank you.

[Rustsmith]

Talk with your doctor about the possibility of combining other RLS meds with the methadone. I take 7.5mg of methadone along with 900mg of gabapentin and 0.125mg pramipexole. I was completely off of the pramipexole for a while, but found that I needed to increase my methadone one more level. So, my doctor agreed that it was easier on everyone if I took the minimal (half tablet) of pramipexole rather than increasing the methadone to 10mg (which is where I start to feel a bit drugged by it.

[IzzyKoshi]

Oops. Forgot to mention that I also take 900mg Horizant.

[Bridgercan]

Have you asked your doctor about upping Horizant? I take 1200 mg once per day in evening. I believe max dose is 1800 mg. A shot in the dark, but worthy of a discussion with your doc, especially if the drug’s cost isn’t huge. Or, if you’ve not augmented before on DAs, 1 or 2mg Neupro patch for daytime for small-dosage extended release? Checking your ferritin levels is always a good idea.

[IzzyKoshi]

Thank you all for your suggestions. I increased my Horizant from 900mg to 1200mg and that has significantly decreased my daytime RLS.

[Polar Bear]

Great to hear that this increase of your Horizant has been a success.