Methadone

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skn0412
Posts: 51
Joined: Thu Sep 18, 2008 10:27 pm
Location: Seneca, South Carolina

Methadone

Post by skn0412 »

Hi Ladies and Gents,

Well.......you haven't heard from me in awhile; I've been doing pretty good; not great. Today I am starting to taper off the Gabapentin and Dr. Earley is starting me on Methadone .25 mg to start.

I'm ready and willing to hear everyone's input regarding the effectiveness. I've heard great things about it...... I'm looking forward to great things, gosh I hope, and some better sleep!!

its good to be back on here .... I haven't posted, but I have been reading ALOT the past several days !!
Sue

ViewsAskew
Moderator
Posts: 16571
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Methadone

Post by ViewsAskew »

Hope the methadone works for you. It is effective, but not without drawbacks. For the first 6-8 months, I was sure it was a miracle. After I had tolerance and had to keep increasing it, it wasn't as much of a miracle. Do keep an eye on it. Once you find a stable dose, do keep an eye on it and let Earley know if you find any breakthrough or other signs that your dose isn't enough.

It does cause nasty constipation - ramp up your hydration and fiber! I actually find that magnesium helps a lot to loosen the stools.

Could it be that he prescribed 2.5 mg methadone? I don't think that it comes in a .25 mg dose.
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.

skn0412
Posts: 51
Joined: Thu Sep 18, 2008 10:27 pm
Location: Seneca, South Carolina

Re: Methadone

Post by skn0412 »

ViewsAskew wrote:Hope the methadone works for you. It is effective, but not without drawbacks. For the first 6-8 months, I was sure it was a miracle. After I had tolerance and had to keep increasing it, it wasn't as much of a miracle. Do keep an eye on it. Once you find a stable dose, do keep an eye on it and let Earley know if you find any breakthrough or other signs that your dose isn't enough.

It does cause nasty constipation - ramp up your hydration and fiber! I actually find that magnesium helps a lot to loosen the stools.

Could it be that he prescribed 2.5 mg methadone? I don't think that it comes in a .25 mg dose.


Yes !! That's exactly the dose !!! I'm a little sleepy .. the Gabapentin, once I increased the dose to 1200mg, I'm like a walking zombie. "drunk in the morning" as Dr. Earley described it !! And it takes everything I have to get myself moving, I don't feel like doing anything !!! Anyway.....I plan on loading up with the Miralex to help with constipation, I certainly don't need that; us women have enough trouble pooping as it is!!! LOL Question: What is your dose? And how long did it take you to get to that dose? He said to increase by 1/2mg every 7 days if needed. He said I can take up to 2mg...eeeeek!! Did it help you sleep? He wants me to take my dose at 6pm. My gabapentin I would take 300mg at around 4pm, sometimes earlier. Will the methadone work around the clock, like help in my afternoon flare-ups?

This is the best place to ask questions and get answers from real time folks that have taken and experienced these medications!!! Its kinda scary knowing that I am at the level at Methodone!! But I just hope and pray that this works for me!!!
Sue

ViewsAskew
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Posts: 16571
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Methadone

Post by ViewsAskew »

I started at 5 mg - I was dealing with augmentation. It wasn't enough, so it was moved to 10 mg in a few days. it was like a miracle for me - truly. I had been augmented for 18 months and it has been so bad for the last few months that I hadn't slept more than 15-20 minutes at a time in a long time. So, this was bliss. I was a bit tired the next day, but I was so happy to by symptoms free. I could even nap during the afternoons - something I'd never been able to do. Truly, at that time, methadone was perfect.

That worked for about 4 months - then I needed more - the doc gave me 15 mg, saying that it was likely the original 10 wasn't quite enough. But I only took 12.5 because I was starting to wonder about tolerance - so when I needed another increase in about a year, I went to 15 and by that time, was sure it was tolerance. I stayed there at that dose for about a year, then needed another increase to 20. When that wasn't enough, I sucked it up for about a year - dealing with the breakthrough because I didn't want to increase to 25. When I really couldn't stand it anymore, I freaked out. The highest dose is 30 mg and I was having more side effects the more I took.

So, I went to see Dr B and we tried a lot of other opioids - none worked - and another trial of gabapentin (I was up to 1800 and had the drugged effects as well as it not covering all my symptoms, so I made a suggestion to Dr B - could I take methadone for a couple days, then alternate with pramipexole for a couple days and avoid tolerance and augmentation. Since it takes me 1-2 weeks to augment, I felt I'd be safe taking it just two days. He thought it was a good idea and since then, except for trying gabepentin encarbil and a brief trial of rotigotine, I've alternated pramiepxole and methadone. I've not needed to increase my dose of either since I started doing this a few years ago - maybe 5 years?

It can be really tough to stop - I didn't have trouble the first two times, but I can tell I am dependent now. The two days I would be off of it was always hard - but now I have headaches and some early signs of withdrawal. So, I've been taking just a half dose of methadone - 12.5 mg - for five days along with a half dose of pramipexole, then two days at a full dose of methadone. I'm currently thinking of how I could stop it for a week or two - since I've had two infusions and my ferritin is about 170 now, I'm hoping I won't augment in 2-3 weeks. With some gabapentin, lately I've been able to take pramipexole for 12 days and reduce the methadone to 2.5 mg without any issue. It's that last 2.5 that I think will be tough. But, if I can at least have the pramipexole cover the RLS while I go through withdrawal and not worry about augmentation, then I'd be able to get most of it out of my system and maybe go back to alternating and not build up tolerance again.

Long story you likely weren't expecting!
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.

QyX

Re: Methadone

Post by QyX »

Methadone is a nasty drug! I read a lot about patients on methadone for opioid dependency.

There are only two days of reducing methadone dose: doing it very slowly over a long perioid of time or switch to an alternative (Morphine, Oxycodone, Hydromorphone, Oxymorphone) and then reducing the dose.

I don't know if it is only a tolerance effect. Some say RLS get's more severe when you get older. At least for me that is true when I look back the last 15 years. So it doesn't sureprise me when I have to increase the dose every year a bit.

There are patients on methadone for opioid dependency who take several hundred mg of methadone per day. So your dose is still very low but the more you take side effects will develop. Patients who take high doses of methadone suffer from exzessive sweating, weight gain, insomnia, sedation, ...

debbluebird
Posts: 2386
Joined: Mon May 21, 2012 3:27 pm

Re: Methadone

Post by debbluebird »

I have been taking 10 to 15 mg each night for over four years. I have 5 mg tabs. I take one at 5 pm the next one anywhere from 11 pm to 2 am, depending on how my legs are. About half the time I need the third tab around 3 or 4 am. Again, depending on when I took the second one. At first I had extreem nausea for a couple of months. I continued anyway. I was coming off of five other drugs. I had augmented on Mirapex too. I never take more than 15 mg total. Otherwise, I will start itching. For me it is better than oxycodone. I start itching with oxycodone if taken more than two days. I have taken gabapentin, Valium, ativan, muscle relaxants and a few others I can't remember. I gained weight with the other drugs. I feel that the other drugs were much worse.
Good luck.

ViewsAskew
Moderator
Posts: 16571
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Methadone

Post by ViewsAskew »

I don't think methadone is a nasty drug for RLS/WED if used smartly. It can be nasty. But, so can pramipexole. Ask any of us who have had augmentation. It has several advantages for us that shorter acting opioids do not have. Tolerance is an issue - but it is with all opioids. To manage it, the RLS experts say that a small level of breakthrough is a good thing when taking it - complete coverage may not be.

The experts have said for a long time that normal increases in symptoms usually take 2 or more years to show up - that is how they identify augmentation with DAs. I'd think the same would apply here to tolerance. If you need more and it hasn't been about 2 years, it's likely tolerance (or something else interfering).

As QyX noted, stopping it can be hard, however, even at our low doses. There are two ways around that. One is to take regular drug holidays - the other, as noted, is to switch to an alternative, then reduce it and stop it. Both are manageable.
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.

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