recent change from d.a. drugs to methadone

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cloverdr
Posts: 6
Joined: Sat Dec 10, 2016 5:17 pm

recent change from d.a. drugs to methadone

Post by cloverdr »

Discovering that I was having augmentation from Mirapex after being on it for approx. 4 years. I saw a RLS specialist in Los Angeles
about a month ago. He took me off both the mirapex and gabapentin, switching me to methadone. The first 2 weeks were tough, both
going thru withdrawals and dealing with the new side effects of methadone. I initially took 15 mg per day of methadone but have decreased my dosage to 10 mg a few days ago. Currently I do get the RLS tremors at night for about a hour then I fall asleep. I am hoping to get down
to 5 mg a day, maybe with the help of reintroducing the gabapentin. The side effects of methadone are not pleasing to me, dizziness ,nausea,
tired feeling. It also seems to have effected my sense of smell, and if I try to have a glass of wine or a beer with dinner the nausea gets worse.
If anyone out there has changed to methadone and would be willing to share some thoughts with me, I would be greatly appreciative.

Thanks

Rustsmith
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Location: Colorado Springs, Colorado

Re: recent change from d.a. drugs to methadone

Post by Rustsmith »

I switched from pramipexole/Neupro to methadone last March and it has been the best thing for my RLS since that very first pramipexole pill. I also was, and still do, take gabapentin.

My experience with methadone was that my doctor started me at 5mg with instructions to go to 7.5 after a week and then to 10mg. My RLS was mostly under control from just a few minutes after my first 5mg pill. Since I had been in severe augmentation for almost a year (long story, not my doctor's fault), it was a great relief to finally feel somewhat "normal". Things went well until about 3 days into the 7.5mg step. I woke up one morning and realized that I was in a mental fog. It was also very obvious that this was due to the methadone because I simply felt drugged. I couldn't think clearly, my stomach was uneasy and I just felt out of sorts. So I dropped the dose back to 5mg and informed my doctor of my decision.

As for the gabapentin, I take it for 2 reasons. I have migraines and gabapentin is the best drug I have found for preventing these headaches. Gabapentin is also the only medication that I have found that allows me to fall asleep normally. A "side effect" of methadone is something that we often refer to as alerting. For me, alterting occurs just as I want to try to sleep. My mind suddenly goes into hyperdrive, racing from subject to subject with the thinking process racing along much faster than normal. Sleep is simply not going to happen until my mind starts to slow down. Gabapentin somehow prevents this from happening and allows me to fall asleep like a "normal" person. Even sleeping pills like Ambien, Lunesta and Sonata cannot do that.

Finally, I hope that you read the information that came with your methadone that warned you about combining methadone and alcohol. That glass of wine or beer with dinner can be dangerous. Both methadone and alcohol are respiratory depressants. Combining them is the classic suicide mixture of narcotics and alcohol. The cause you to fall asleep and never wake up because you go into respiratory arrest while asleep. I do not know enough about your specifics, but the nausea could be a warning sign that the mixture of your current dose of methadone and that beer or wine is nearing the danger point. In my case, I haven't had a drink of any form of alcohol since I started the methadone, which was really tough during my last vacation at an all-inclusive resort where everyone else was enjoying umbrella drinks on the beach during the afternoon and several glasses of wine at dinner. But no matter how attractive it looked, the thought of waking up the next morning was FAR more attractive.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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.

cloverdr
Posts: 6
Joined: Sat Dec 10, 2016 5:17 pm

Re: recent change from d.a. drugs to methadone

Post by cloverdr »

Thanks for the response. I don't think the the nausea is from the alcohol since Ive been on methadone for a month now and I tried to drink
a beer about 2 weeks ago and it made me kinda sick. I haven't had any alcohol since then. It is a challenging life change thou, especially when
your enjoying a nice meal with friend and nice bottle of wine. I guess those days are over. What dosage of gabapentin are you on? When you dropped back to the 5 milligrams of methadone did your symptoms of being drugged improve?

Rustsmith
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Joined: Sat Sep 28, 2013 9:31 pm
Location: Colorado Springs, Colorado

Re: recent change from d.a. drugs to methadone

Post by Rustsmith »

I currently take 900mg of gabapentin. Some people have side effects from it, but I guess since I need it for two unrelated conditions then maybe my body is soaking it up.

As for dropping my methadone from 7.5 to 5 mg, the drugged feeling was gone the following morning. Now, the only thing that I notice is the RLS when I forget to take it on schedule. It isn't that my RLS kicks in when I forget (that would be too easy). My problem is that I normally take it at noon and if I forget until 3 to 5 PM, then I can plan on having RLS problems when I go to bed. I don't know why, that is just the way that it is.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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.

cloverdr
Posts: 6
Joined: Sat Dec 10, 2016 5:17 pm

Re: recent change from d.a. drugs to methadone

Post by cloverdr »

Since changing to methadone my night time leg movements have improved but they are not gone. My leg movements are not as dramatic,
its more of muscle twitching than full blown muscle contractions, and it lasts for about 1 hour than goes away. I may be getting some "alerting"
that you mentioned earlier. My mind seems to flip thru different scences very quickly when Im in that hour of twitching. It starts about 30 minutes after I lay down to sleep. Im going to try your method and take the methadone earlier in the day, also Im going to talk to my Dr. about
adding gabapentin. Ive dropped the dosage of methadone down to 10mg from 15 mg. and my drugged feeling is better during the day. My goal
is to get it down to 5mg but I think I should wait till I get the gabapentin. What do you think?

Rustsmith
Moderator
Posts: 6476
Joined: Sat Sep 28, 2013 9:31 pm
Location: Colorado Springs, Colorado

Re: recent change from d.a. drugs to methadone

Post by Rustsmith »

You will see comments throughout this discussion board that "everyone is different". However, that said, it never hurts to limit yourself to one change at a time so that you know which ones help and which ones don't.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
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: recent change from d.a. drugs to methadone

Post by QyX »

Dizziness and nausea are common side effects of opioids and they will go away after a couple of weeks but may reoccurence when you raise the dose.

Mixing opioids and alcohol can be very dangerous. Same goes for mixing opioids with Benzodiazepines and Z-drugs. There are cells in the central nervous system who are sensitive to CO2. If a certain concentration is reached the body breathes automatically. Opioids (and alcohol) reduce the sensitivity of this cells to CO2 and if the sensitivity is reduced too much ... you will forget to breath. However if you are conscious which is in many cases if acute intoxication unfortunately isn't the case you can tell yourself to breathe. But this somehow very dangerous if not an other person is around.

Long term these cells adjust to the effects of opioids and so it is somehow safe to consume a little bit of alcohol together with opioids when you are on stable a dose. However this is still not advisable and recommended.

In the end it is all about tolerance. The brain adjusts to daily opioid intake quickly and after 4 weeks you already have quite a tolerance RELATIVE to your dose.

Keep in mind: even with tolerance opioids will likely increase the negative effects of alcohol like feeling tired or maybe even depressed.

Everybody is different and nobody really can predict how you will feel when you mix alcohol and opioids. You have to understand that seen from a medical point of view it is as problematic as mixing Heroine with Cocaine just in this scenario you may die from heart failure instead of respiratory depression.

Personally I do have 2, 3 days a year where I consume alcohol but not much. A maximum of 0,5 liter beer or 1/4 bottle of wine is my maximum. Not because of the opioids but alcohol worsens my RLS.

Persons who normally die from respiratory depression consume like one bottle of vodka and then shoot up opioids after their tolerance was reduced because they were not able to get any Heroine or any other opioid. They underestimate how much their tolerance was reduced and that's just it. You don't even need alcohol for this kind of accidents.

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

Re: recent change from d.a. drugs to methadone

Post by ViewsAskew »

cloverdr, I found that I was able to have wine again after starting opioids, but in the following ways. The nausea often decreases for people over time. Not always, but often. And, there are antinausea drugs if you need them. Given that it decreases, then that problem is gone. For me, I have no nausea, but I have itching - intense itching. It goes away slowly - maybe over a month after I start an opioid. When I stop and restart, it comes back every time.

I found that after a couple months, I could have a glass of wine with dinner as long as I have the wine early enough. For me, bedtime isn't usually until 1-3 AM. If I have a glass of wine at 7-9 PM, it's plenty of time for it to get out of my system and before I take the majority of my opioid (methadone).

Not saying it will work for you....just that it might.

The tired feeling - that wasn't a good thing for me. either. I managed, but I never did get rid of it. Some people do, though, so hopefully you will. One thing that did help me in that regard was to use a green/yellow/white kratom in the morning. Kratom isn't enough alone for me to stop my meds (not close), but it DOES help me manage mood, slightly reduce meds, and almost completely resolves withdrawal when I stop methadone.
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.

cloverdr
Posts: 6
Joined: Sat Dec 10, 2016 5:17 pm

Re: recent change from d.a. drugs to methadone

Post by cloverdr »

Thanks to all of you for the helpful tips. I just found out about the RLS foundation about 2 months ago and finally feel I have other people
out there who can relate to RLS I have been dealing with for the last 10 years.

cloverdr
Posts: 6
Joined: Sat Dec 10, 2016 5:17 pm

Re: recent change from d.a. drugs to methadone

Post by cloverdr »

Dear ViewsAskew,

In your last response you mentioned that you were taking Kratom, I just placed a order on line and should be receiving it soon.
How much do you take to start with daily. Im currently on 10 mg of methadone a day and would like to get down to 5 mg a day,
thus hope the kratom will be the answer. Also you stated that you stopped methadone, what meds are you on now?

stjohnh
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Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: recent change from d.a. drugs to methadone

Post by stjohnh »

Cloverdr, I use kratom as well, and my experience is similar to Ann's (ViewsAskew). Starting dose is 1/4-1/2 tap. It is very bitter. I out it into empty size 00 gelatin capsules. I used to mix it university cold grapefruit juice to help mask the bitterness. Don't expect miracles, but it definitely helps.
Blessings,
Holland

ViewsAskew
Moderator
Posts: 16570
Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: recent change from d.a. drugs to methadone

Post by ViewsAskew »

cloverdr, I do not use kratom for my RLS, but to help me sleep OR to help me when I go through opioid withdrawal. I need much more than Holland does. But, I also need 25 to 30 mg methadone if that is all I am using.

I am currently going through withdrawal and using kratom for that as well as med marijuana and a DA. I augment quickly, but the iron infusions allow me to take it longer. I rotate drugs to try and prevent tolerance and withdraw occasionally to break dependence.
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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