OxyContin, oxycodone and severe anxiety

[Rlstader]

Can anyone help me with their experience? After augmenting from Mirapex I have severe RLS almost all day. Dr put me on Percocet. Worked for a while but everyday was so stressful trying to go as long as possible into the afternoon before taking one so that I did not need to take more than 4 each day. Every night I'd wake up 3 1/2 to 4 hours after going to bed needing another Percocet to settle my legs down. Every morning woke up with mild anxiety which would gradually go away as I got busy - but it was hard work every day. Then it would go away and start to come back around noon or two when my RLS would kick in. Then get better, more than likely due to the Percocet back in my system.

So Dr put me on one 10 mg OxyContin twice/day as we thought if we leveled the dose I'd sleep more which would help anxiety too. Worked for a few weeks but then I started getting SEVERE anxiety. The kind where you can't take your head out of your pillow. Realized it was probably the long-acting OxyContin and went back to Percocet. Anxiety got a little better but still way too high.

Scared to death. I can't live like this. Dr has mentioned methadone and I'm afraid of that because I know it's the end of the road and if that makes me anxious I don't think there are other alternatives. Can anyone tell me if it's common to have anxiety with Percocet and OxyContin? How about methadone. Any suggestions would be greatly appreciated.

PS I also take Gabapentin 600 mg 3 times/day. My PCP just this week put me on buspiron 15 mg for anxiety but it's not working great either. Any suggestions welcome. Thanks so much!

[Rustsmith]

Although anxiety is not listed as a common side effect of oxycontin, anxiety does appear on the list of side effects that occurs between 1 and 5% of patients. So, it is entirely possible that the oxy was causing your issues.

As for methadone being the end of the road, that is most definitely not the case. First off, many of our members have used low dose methadone successfully for many years without requiring an increase or change. For those members who eventually did need to change (often due to side effects) there are a number of other alternative medications. A number of us also either go to combined therapies where an opiate is combined with another drug or else we go onto a rotation where we take something like methadone for a few days, then a dopamine agonist for a few, and then back. This helps avoid the side effect issues with the opiates and also problems with augmentation with the dopamine.

If you live in a state where medical marijuana is available, you might want to consider trying a product that is high in CBD. CBD can be very effective for the treatment of anxiety. The CBD products are not intoxicating. Also, you do not necessarily need to smoke it. Most dispensaries have extracts that you place under your tongue or some form of edible, like brownies, chocolates or gummy bears).

[debbluebird]

I have been taking Methadone since 2010. I take 5mg, once around 5 pm and the second around midnight or 1 am. I had side affects from oxycodone. I prefer the Methadone. When I first started it I had the side affect of nausea, but it went away after a couple of months. Now, once in awhile I will be very awake in the middle of the night, but not very often. I've tried many other meds, I like the methadone the best.
Good luck

[legsbestill]

I took 30 mg of Oxycontin per day for about 6 weeks and I did notice some anxiety when I was coming towards the end of the slow release period (ie after about 6/8 hours of taking it). Nothing like as dramatic as you describe however but bad enough that I didn't want to continue with the drug or take it more regularly. When I stopped taking it I experienced very unpleasant withdrawal symptoms which might be described as anxiety but maybe were closer to panic attacks and felt more physical than psychological - by which I mean there was a sort of restricting band across my chest which felt like a physical manifestation of claustrophobia. But that was only after I stopped taking it, not while I was on it - it seemed to last for ages, maybe 3 weeks after the last dose of OxyContin. I also found that gabapentin (which I took before I started OxyContin - not at the same time) made me feel depressed and irritable. I have no pharmaceutical knowledge whatsoever so don't know if there is a possibility the two drugs could exacerbate each others side effects.

As to Methadone, I wish I could find someone to prescribe it if only to see whether it worked for me. Have come to the conclusion that with this condition once augmentation has set in it really is a question of 'suck it and see' and quite a challenge to find a treatment or combination of treatments that works.

[Rustsmith]

legsbestill, it shouldn't be necessary to "suck it and see" once you have augmented on DAs. Although methadone might be the first opiate choice for the treatment of RLS, everything from tramadol to methadone and suboxone have been used when side effects rule one or more of them out. In his video, Dr. Earley says that if you have problems with the side effects of one opiate, then try another because the side effects can vary from one drug to another.

As for finding a doctor who will prescribe methadone, that is simply a matter of leg work on your part. Call all of the doctors in your area. If that doesn't work (it didn't for me), then expand your horizons and try doctors in towns close enough to drive to. Try the medical schools in your state since they are often provided with more freedom (and experience) than local doctors. And if all else fails, contact the nearest RLS Foundation Quality Care Center since one of the conditions of their designation as a QCC is that they must consider all modes of treatment, including methadone.

In my case, I travel 100 miles each way to the state medical school in order to see a doctor who can prescribe methadone. By doing that, I also managed to get assigned to a doctor who is actually conducting RLS research, so she is using the latest knowledge on RLS. I am also very fortunate in that she is also willing to discuss my treatment and actually listens to my input rather than the "I know better than you" attitude of many doctors.

[Madmom02]

I was on buspirone (Buspar) this summer and it made my RLS worse. Also, are you sure what you are experiencing is anxiety and not a racing heart? I was on an antidepressant that caused me to have really high blood pressure and a really fast heart rate. My psychiatrist originally thought it was anxiety, thus the buspirone. I ended up going off both meds.

I'm sorry you augmented on Mirapex. I did, too. How long have you been off the Mirapex?

[Rlstader]

Madmom02, the symptoms I am referring to as anxiety was an awful feeling in my entire body that is hard to describe. Kind of like all my blood was ice chunks and it caused goosebumps and just a very weird and extremely unpleasant feeling. I just wanted to fall asleep forever. I did not have a racing heart or sweating palms.

I went to my doc and we stopped the long acting OxyContin and started buspar. I feel much better. I am taking 3 to 4 five mg oxycodone and 15 mg of buspar 3 times a day.

I am thankful to all for their input. I guess it's really important to remember what works for one may not work for another and unfortunately for many of us the treatment will have to change overtime. Mirapex worked for me for about 8 years.

[legsbestill]

I am nearly 6 months into my post-mirapex-augmentation journey and finding it difficult to achieve a regime that copes with my rls and has tolerable side effects. I may have used the wrong phrase - by suck-it-and-see I meant that, at least for some, it seems to be necessary to try many options/combinations of options ('suck them') to 'see' how they work - and keep going until an acceptible compromise is achieved.

At present, I continue to struggle with something that seems like anxiety - it is difficult to describe but, in addition to being present throughout the day, it is keeping me awake in nearly equal parts with rls. I am not sure if it is some weird new presentation of rls, a withdrawal from OxyContin (as I originally thought but it is now over a month since I took the last OxyC and the 'anxiety' is as powerful as ever) or possibly a side effect of the neupro patches. I am trying to eliminate possible causes while at the same time finding some means of controlling the legs at least at night time.

I am taking ages to type this as got no sleep last night because I reduced from 2mg of neupro to 1mg intending to eliminate it in next day or so to see if anxiety improves. Hope it is making sense and also that I am not making trouble by posting in the wrong place as I now think my anxiety may not be related to OxyContin.

It is so important to try to keep hopeful but also realistic. I have not exhausted all the options other than methadone yet. I would admit I find it daunting to ask for it - my php told me he would see if he could organise a pain consultant to prescribe it but he keeps forgetting. I suspect he is actually hoping I will forget. I am grateful for your suggestions, Steve, you have given me some good ideas.

Rlstader, I'm really glad you are feeling better. I hope the new regime continues to provide relief. Mirapex worked for me for nearly 10 years also - though in in ever increasing quantities! I really miss the simplicity of the mirapexin days.

[Madmom02]

Rlstader and legsbestill, my sympathies on the anxiety thing.

I'm glad you're feeling better, Rlstader. Buspar can work wonders for anxiety. I know people who've had a great response to it. I don't think it always increases RLS. Wellbutrin supposedly is one of the few antidepressants that doesn't cause or worsen RLS but it did for me. People do respond differently to the same meds. I should have said that and been clearer in my initial response.

legsbestill, I'm hoping things get better for you. One of the things I've learned from this board is that, like with chronic pain, perfect relief may not be possible. We can't give up in finding the right combo that offers some relief. Maybe that combo is going to have to include things like opiates, methadone, dietary changes, sleep time changes, more or less exercise, etc..We'll find it eventually. Others have. Hope is good, right?

[Rlstader]

Thanks madmom02!

[badnights]

One of the things I've learned from this board is that, like with chronic pain, perfect relief may not be possible. We can't give up in finding the right combo that offers some relief. Maybe that combo is going to have to include things like opiates, methadone, dietary changes, sleep time changes, more or less exercise, etc..We'll find it eventually. Others have. Hope is good, right?

Hope is essential! I wish it was as easy to find as saying that. When I have hope, I can endure the most insane things.

legsbestill, did the anxiety creep up on you, or can you pinpoint its start to a particular time? Anxiety is common with WED/RLS, but no one understands why. For what it's worth, I noticed one day that I no longer felt the low-grade depression and anxiety that was a constant in my life for years, and looking back at what had changed, I feel it coincided with when I began to eat unpasteurized fermented foods. I did that to address issues of SIBO (small intestinal bacterial overgrowth) that apparently I had, and that other treatments didn't seem to do anything for. My guts are happier, and as an unexpected bonus, I almost never feel depression or anxiety now. I used to come home from work every day and feel like I should be doing something but I didn't know what, even though there was actually nothing that needed doing.

It's not as crazy as it sounds at first; microbes in our guts release metabolites that make their way into our bloodstream and can have far-field effects on bodily systems, including mood. Replacing nasty microbes with the "good" ones in raw fermented food can change what gets into your blood. At least, that's my primitive understanding of it.

This is not relevant (or not as relevant) if you can trace your anxiety to a time when you started a certain medication or other substance, like rlstader has. Keep trying to find the cause.

And I quoted madmon for another reason - she's right that we shouldn't seek full relief. The symptoms tend to ramp up if they're fully addressed, until they're annoying again, whereas if we let them be present to an annoying but not debilitating degree, they don't ramp up. Seems that way with most of us, anyway.