Methadone fatigue?
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emmettdigger
- Posts: 12
- Joined: Thu Dec 11, 2008 4:55 pm
- Location: Portland OR
Methadone fatigue?
I started methadone about 6 months ago, found a comfortable dose (12.5 mg) that worked for me. I initially had poor appetite, low sex drive, fatigue - all of which have subsided but the fatigue. I AM EXHAUSTED all the time. I have sleep apnea too but recently had a sleep study and my pressure is adequate and I use my cpap diligently. When I don't work, I sleep til about 10 and take a 2 hour nap. When I work, I'm drowsy when I get home and feel like I'm sleep walking through my evening. The methadone has made my RLS disappear but the fatigue is SO frustrating. Any suggestions on the fatigue? Is there a less-fatiguing but effective alternative to methadone? Thanks!
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ViewsAskew
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- Location: Los Angeles
It does that to some of us; many are just fine. Drugs are weird; RLS is weirder. 
I could try switching to another opioid. The opioids do work differently regarding those things. You might find that another opioid works much better for you. Other people have switched and are happy.
I could try switching to another opioid. The opioids do work differently regarding those things. You might find that another opioid works much better for you. Other people have switched and are happy.
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.
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.
Aiken posted the following. June 14 "Has anyone given up on daytime meds?":
"If I … just took methadone, I'd need to take a big dose of methadone to cover my evening peaks. …..you can see why I got drowsy during the day, because I've got about twice as much methadone on board while I'm at work from noon 'til 8pm."
Aiken, you seem to have worked out a pretty good way to handle drowsiness, but I’m a little confused as to how. (The chart from June 14 was pretty descriptive, but I don’t quite get it…
).
Would you be able to share your solution of combining hydrocodone and methadone? Do you think your plan could be adjusted for someone who – say – needs to get up at 6:30 – 7:00 am? How much do you take and how divided?
My life time preference has been for early bedtime, early rise (9 p.m. – 5 a.m.). With methadone I’m more awake in the late evening – up to 11:00. My doctor suggested I take my methadone (10 – 12.5mg) all at once before I go to bed. He thought that would result in less daytime drowsiness, but it hasn’t.
I'm with emmettdigger, but for me it's more drowsiness than fatique. I can move around once I get started, but sitting - my eyelids slam shut!.
Having a similar problem with daytime drowsiness on Neurontin. I'm hoping it will pass as I only recently starting taking it. It's working great, so I don't want to give up on it.
Like you, if I'm active I'm OK, but if I just sit down to relax, I'll feel drowsy and ready to take a nap within minutes (can't do that at work) so, I've started drinking something with caffeine in it (like coffee or a coke) in the mid-afternoon to wake me up a bit for the drive home.
I've been considering something like those energy drinks, but I don't want to get so completely wired up that I can't get to sleep at night, and lately I've been sleeping really well. Never had an energy drink before and don't know how that would effect me.
Like you, if I'm active I'm OK, but if I just sit down to relax, I'll feel drowsy and ready to take a nap within minutes (can't do that at work) so, I've started drinking something with caffeine in it (like coffee or a coke) in the mid-afternoon to wake me up a bit for the drive home.
I've been considering something like those energy drinks, but I don't want to get so completely wired up that I can't get to sleep at night, and lately I've been sleeping really well. Never had an energy drink before and don't know how that would effect me.
Maria--
Well, my solution requires that you have a peak and valley in your symptoms every day. I have a wide valley in the daytime and then about a 4-6 hour peak in the evenings.
Basically, what you want to do is take only as much methadone as is required to cover the valley's symptoms, and then supplement it with something like hydrocodone or oxycodone during the peak. This works better than taking methadone for the peak, because methadone has a very long half-life, a day or more, and you'll still have a lot of it in your system during the next day's valley, when you don't need it anymore. All it's doing then is making you drowsy. Hydro and oxy tend to have half-lives of more like 3-6 hours and will largely be out of your system by the next day, leaving just the lower dose of methadone.
Note, though, that methdone locks pretty tightly to your opioid receptors, keeping other opioids out, so you might need more hydro or oxy than you'd expect.
Really, it's a lot of experimentation, and it might or might not work, especially if your valley isn't very deep.
Well, my solution requires that you have a peak and valley in your symptoms every day. I have a wide valley in the daytime and then about a 4-6 hour peak in the evenings.
Basically, what you want to do is take only as much methadone as is required to cover the valley's symptoms, and then supplement it with something like hydrocodone or oxycodone during the peak. This works better than taking methadone for the peak, because methadone has a very long half-life, a day or more, and you'll still have a lot of it in your system during the next day's valley, when you don't need it anymore. All it's doing then is making you drowsy. Hydro and oxy tend to have half-lives of more like 3-6 hours and will largely be out of your system by the next day, leaving just the lower dose of methadone.
Note, though, that methdone locks pretty tightly to your opioid receptors, keeping other opioids out, so you might need more hydro or oxy than you'd expect.
Really, it's a lot of experimentation, and it might or might not work, especially if your valley isn't very deep.
Disclaimer: I often talk about what I do and what works for me, but these are specific to me and you should always consult a healthcare professional before trying these things yourself, lest you endanger your health or life.
Thanks, Aiken. I think I get it now. And the caveat about the opioid receptors is good info to have, too. I’ll do some experimenting when my schedule looks flat. (No matter how poorly one’s plan is working, at least it’s familiar and one knows where the bumps in the road will be. So sometimes it’s easier to settle for interrupted sleep and drowsiness than to cast routine to the winds and try an unknown regimen that might work better.)
Congratulations to all of us for getting a day’s work done whenever we do it! And special comfort to everyone who finds hot weather brings on the heebie-jeebies!
Congratulations to all of us for getting a day’s work done whenever we do it! And special comfort to everyone who finds hot weather brings on the heebie-jeebies!