can opioids keep you awake?

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badnights
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can opioids keep you awake?

Postby badnights » Sat Feb 13, 2010 10:49 pm

Is it possible that codeine or oxycodone can have an alerting effect? i.e. remove the RLS but activate your mind somehow and keep you awake? anyone have this happen? It sounds backwards to what they're supposed to do - the side effects I find listed on various sites include sleepiness and fatigue but not insomnia.

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SquirmingSusan
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Postby SquirmingSusan » Sat Feb 13, 2010 11:17 pm

Yes, definitely. Many of us have had that experience with certain opioids after the first few days of use.
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Postby Betty/WV » Sat Feb 13, 2010 11:18 pm

Hi Bethf: After I had surgery and was taking percocet (opiate) along with my RLS meds., I think the percocet helped me to sleep better. But it could affect someone else different.

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Postby Polar Bear » Sat Feb 13, 2010 11:26 pm

I take tramadol and ropinerole for rls symtoms. The tramadol helps a great deal with relief but although my symptoms may be at ease, sleep is very poor, even with the use of zopiclone.

I don't know if it is the tramadol and it may be coincidental, but it is not the first time I have heard this comment regarding opiates.
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Postby Neco » Sun Feb 14, 2010 3:08 am

A lot of drugs can have paradoxical effects, and it can be a somewhat common side effect for most people, but usually it only shows up when taking chronic doses, or chronically high doses.

Usually it starts out with opiates knocking you out, but then as your tolerance builds, even via normal prescribed use, some people start to experience insomnia for some reason.

I do pretty OK on 15 - 20mg of Methadone, but if I start taking 30mg or more, I will get insomnia no matter how tired I actually am.

I've had similar experiences in the past, when I was self medicating beyond any amount of reason, be it Vicodin, or Oxycodone in particular, and sometimes Tramadol. Taking higher doses than you are used to, or redosing to boost / maintain euphoric effects can cause this to some degree as well.

It's a matter of finding a balance I suppose. Just like some people can barely take any Methadone at all, or they'll fall asleep in the middle of the day at work, no matter how hard they try to stay awake.


There were times in the past where I would end up having been up for 2 or 3 days straight, with maybe 5 hours of poor, broken sleep, scattered across the whole span. Never more than 15 or 30 minute catnaps too I think.

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Postby badnights » Sun Feb 14, 2010 3:50 am

sh.t

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Postby badnights » Sun Feb 14, 2010 4:26 am

excuse my previous post.

When I was taking gabapentin and codeine, I used to do my best scientific reading right when I was supposed to be going to bed. I suspected the codeine, but it happened once without the codeine so I figured that wasn't it. Now I'm not so sure. I've already had a few experiences of not being able to sleep after 10 mg oxy, though it kills the RLS beautifully.

Good to know I'm not the only one this happens to. I'll try 7.5 oxy. Maybe I'll dare 11.25 mg zopiclone. I tried adding clonazepam instead of zopiclone once, but both it and pramipexole are zombie drugs for me, so the combination made me truly the drooling dead.

Betty, I too remember sleeping oooohhh soooo well on oxycondone after a knee operation. So I certainly wasn't expecting what seems to be happening....

Do we all experiment like this on our own, or do some people get to run things by a physician? one who can actually provide advice? Or, if not provide advice, at least learn, eg. that opioids can be alerting?

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Postby Polar Bear » Sun Feb 14, 2010 5:21 am

My zoplicone is 7.5mg. I do not wish to take more than prescribed and last night to try and extend the length of time I sleep, I split the pill. So at midnight I took half a pill, and it is now 5am and I have just taken the second half of the zopiclone together with my 'during the night' ropinerole. That 5 hour stretch of sleep is good in itself. We will see how long I get when/if I get back to sleep. It is of course possible that tonight's sleep has been encouraged cos its been so poor recently.

Just as an aside, be aware that the metallic and bitter tast of Lunesta is truely intensified when the pill is split.
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Postby Betty/WV » Sun Feb 14, 2010 11:54 am

Polar Bear: Is zoplicone the generic for Lunesta? I to have insomnia but tried Ambien with disasterous results, only took it one night and that was enough. Never heard of zoplicone before.

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Postby Polar Bear » Sun Feb 14, 2010 12:55 pm

Yes Betty,

I believe that Lunesta and Zopiclone are the same drug, but.... and I am not absolutely certain on the facts/percentages on this....... I think that 7.5mg zoplicone and 7.5mg lunesta would not be the same strength. i.e.

Yes, I found an email from Dr B in which he explains this: here is quote:

"""Lunesta only comes in 1, 2 and 3 mg tablets. The Lunesta 3 mg is similar to zopiclone 7.5 mg (more or less). This drug has a half-life of 6 hours compared to the 2.5 hour half-life of Ambien which is why it gives you longer sleep times."""

I moved from Ambien/zolpidem to Lunesta/zoplicone cos I didn't get a long enough sleep with Ambien.
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Postby SquirmingSusan » Sun Feb 14, 2010 7:04 pm

Technically (remember I have a degree in chemistry so this kind of makes sense to me, lol) I believe that eszopiclone is the generic of Lunesta. Most drugs come in a mix of active and inactive "enantiomers" which are mirror images of each other. Zopiclone is a mixture of both active and inactive chemicals. I think that the generic zopiclone is about half active enantiomer, so 7.5mg of zopiclone would be equal to 3.75 mg Lunesta/eszopiclone. So the generic would be a bit stronger.

But, there is no generic available in the US. When I took Lunesta I took 2 - 2mg. tablets an hour or two apart. Then I could sleep well most nights. My doctor was ok with that, but insurance gets really weird when you take more than the FDA approved dose. Now I take zolpidem, but I usually have to take a Sleep MD or melatonin or something with it to sleep through the night. I should probably talk to Dr. B about that, but I email him so much already...

Beth, I think a lot of us DO play with our meds, but that doesn't mean it's a good thing. Ideally we would all have doctors who would get back to us right away when we have questions, but Dr. B is the first doctor I've EVER had who got back to me quickly, before I did something stupid on my own. 8)

Especially with drugs that suppress breathing, like opioids and sleeping pills, it's best to check with your doctor. There are still lots of other options for meds that can help you sleep.

(edited to make sense, maybe)
Last edited by SquirmingSusan on Sun Feb 14, 2010 11:52 pm, edited 1 time in total.
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Postby Neco » Sun Feb 14, 2010 7:54 pm

Lunesta / Ambien are hypnotics though, they shouldn't act as a CNS depressant ??

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Postby ViewsAskew » Sun Feb 14, 2010 7:59 pm

Just wanted to add that opioids have always acted paradoxically on me. My best function in any day is from 9 PM until 4 AM....the time I should be sleeping. Fortunately, the RLS is mildest from 5 or 6 AM until 1 or 2 PM so I still sleep. BUT.

I really dislike it. I just want to sleep like most people do and be awake when most people are. Somethings just don't happen the way you want.
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Postby Polar Bear » Sun Feb 14, 2010 8:04 pm

Susan, thank you for clarification.

Betty, in my last post I was not clear.
I did not mean to infer that zopiclone was the generic for Lunesta.
What I meant was that they were similar.
Sorry for any confusion.

On a positive note, I posted this morning at around 5am to say that at midnight I had taken half of a zopiclone 7.5 mg and had gotten 5 hours sleep. I then took the other half of the pill, stayed up for a half hour, went back to bed and slept until 10 am. What bliss !!!! Only got up at that time cos hubby said breakfast was ready :)
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Postby Neco » Sun Feb 14, 2010 8:05 pm

I'm thankful for every night I can get into bed and just zonk out like a normal person.

I'm rarely up past 8, or 9pm if I'm stretching it. But I usually try to be in bed by 7:30 or 8pm. I'm convinced the Methadone has something to do with it, and I hope it doesn't stop working.

My whole life I would go to bed and just lay there for 2 or 3 hours trying to fall asleep. The past year and a half has been awesome.. Sometimes I'll wake up to snack or go to the bathroom and its only an hour or two later and I am always surprised I was able to get to sleep that fast.


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