Switching from pramipexole to an opiate - What to expect

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Rustsmith
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Re: Switching from pramipexole to an opiate - What to expect

Postby Rustsmith » Sat Apr 02, 2016 8:39 am

My honeymoon with methadone is over.

After a week of 5mg methadone and 0.5mg pramipexole, I moved to the next stage of the transition, which was 10mg methadone and 0.25 mg pramipexole. On Thursday, I realized that the increased methadone was causing side effects in the form of dizziness, nausea and foggy thinking. Since the point of the exercise is to get off of pramipexole and control my RLS, I have temporarily halted the methadone and marijuana and went back to 0.375 mg pramipexole. It has now been two days off of methadone and I am just now starting to come out of the fogginess and still no RLS.

My going forward plan is to see how things are doing this afternoon before I decide whether to take another methadone today, tomorrow or maybe even the next day. I have a charity function to attend tonight at the local fine arts museum (honoring the artist who took the small wooden and clay models that Michelangelo used to produce a number of his most famous marbles and converted these small models into bronze castings). As a metallurgist, I am looking forward to the chance to talk with the modern artist about the process that he used to produce the bonzes. So I will need to have my the most serious parts of my RLS controlled, one way or the other but without re-entering the fog.

I am hoping that I will be able to continue to process of reducing the pramipexole dose but with only 5mg methadone. Whether that ends up being 5mg every day or every other day is something that remains to be seen.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

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.

ViewsAskew
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Re: Switching from pramipexole to an opiate - What to expect

Postby ViewsAskew » Sat Apr 02, 2016 6:04 pm

have fun at the charity event. Sounds fascinating.

Don't give up on it yet - though it doesn't sound as if you are.

Thinking about all the people who used it here, most only used between 5 and 10 mg total during the DA withdrawal (and withdrawing cold turkey). You might be able to just stop the DA at this point and try 5 to 7.5 total mg (I often use 2.5 mg increments to benefit).
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.

Rustsmith
Moderator
Posts: 3173
Joined: Sat Sep 28, 2013 9:31 pm
Location: Pueblo, Colorado

Re: Switching from pramipexole to an opiate - What to expect

Postby Rustsmith » Sat Apr 02, 2016 7:48 pm

Thanks Ann

I am pretty sure that my doctor was just as, if not more, concerned about the 3.5 to 4 hrs of sleep that I had been getting prior to the introduction of bedtime marijuana a few months ago. She was therefore quite explicit that I am to try to get at least 7.5 hrs of sleep each night and that I should remain on 0.25mg pramipexole, 900 mg gabapentin and 5 mg of THC candy each night before bedtime. At this point I am pretty sure that she will schedule me for a sleep study when I go back in June.

Your note got me to thinking and I realized that because methadone is a lipid soluble drug and because I have a low BMI with very little body fat, the "normal" high range dose of 10mg is probably too much for me. I sent her a note and fully expect to get revised instructions to remain on 5mg and 0.25mg pramipexole for now just so long as the combination controls my RLS. I also expect that either following the possible sleep study or else the June appointment that the pramipexole will be dropped.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

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.

ViewsAskew
Moderator
Posts: 15210
Joined: Thu Oct 28, 2004 6:37 am
Location: Chicago

Re: Switching from pramipexole to an opiate - What to expect

Postby ViewsAskew » Sat Apr 02, 2016 8:33 pm

I seem to remember at least two people who used only 2.5 mg methadone during DA withdrawal. You really might be taking way more than you need. Wonder if you would still get great sleep at 2.5 mg?
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.

debbluebird
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Re: Switching from pramipexole to an opiate - What to expect

Postby debbluebird » Sat Apr 02, 2016 9:18 pm

I had nausea for about two months when I first started Methadone. I was getting off of several drugs at the time. I think I increased the Methadone too fast. I went back down to a lower dose. Nausea finally went away. Later I was able to increase it again. I now take 15 mg, divided into three times at night.


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