I'm currently on methadone and gabapentin. The combination is controlling my RLS symptoms pretty well. I've found that splitting the methadone dose and trying different times of day makes a big difference. However, I don't seem to have worked out the best timing.
I'd love to hear from others taking methadone to find out what time(s) of day work best for you, and whether you split your dose. Thanks!
Two to three hours before bed. Methadone has a half-life of up to sixty hours, so splitting the dose is not necessary, you should be well covered for 24 to 28 hours.
I believe you used to split your methadone dose, no? Did you conclude it wasn't any better for you than taking a single dose?
Also, are you still not taking any other medications for your RLS? Always good to hear your reports.
Optimist, no, I split the dose only on the first day that I took it prophylactically, when I was flying by the seat of my pants after an horrendous daytime attack. I was so terrified I could have glugged the entire bottle. Kidding.
Now I take it in one dose, any time between 6 and 8 in the evening. The half-life is so long that it does not seem to matter. There are no side-effects and no symptoms.
I took methadone alone for 18 weeks, with huge success, then hit a wobbly when I started falling about with exhaustion. So I added a fragment of pramipexole for a while. I assumed it MUST be the methadone for some reason I had not yet come across.
Long story short, it is a blood pressure problem allied to a thyroid glitch. So I can ditch the DA.
I think it was you who spoke of the 'alerting' effect of an opioid, being relaxed and calm but entirely sleepless? I was the same when I used methadone purely as a backup in the small-hours of the night. But methadone alone does not do that, not for me.
I take 5mg just before bed. I also take cbd oil.
I would drop the gabapentin unless absolutely necessary.
I hear you! I tolerate the gabapentin reasonably well, but I'd prefer to elimintate it. Unfortunately, for now, if I don't take it, I have to increase the methadone to a level I'm not comfortable with. I'm continuing to see how far down I can push the gabapentin. So it's a balancing act.
By the way, ar you sure the CBD oil is doing anything for you? Have you tried the same methadone dose with and without that? I ask because most people on this forum who have tried CBD oil say it has done nothing for them. Whereas other marijuana products with more TCH seem to be mroe effctive.
Hi rls optimist,
When I was happily on my methadone dose of 10 mg, which I never changed over 13 years, I took it at about 6-6:30 each evening giving it enough time to cover any early RLS development and it worked like a charm through into the next day. There were even a couple of times I forgot to take it until bedtime 9-9:30 and still had no problems whatsoever. I’m now on my much hated journey back through DAs and augmentation and sleep studies and all that but I did finally find a doctor who is going to put me back on methadone and actually apologized for all I had been put through. I only ever had to take the methadone, which I loved just one medication. Much less chance of things becoming harmful when taken together. Hope all continues well for you with the methadone. It was truly a lifesaver for me and having had to give it up made life very unbearable for sometime.
Sus
I'm sorry to hear that you had to go through all that, I've certainly been through that, all the DAs, the augmentation, the hellish withdrawals. I'm very glad you have found a sympathetic new doctor who will put you back on methadone. Indeed, it is a lifesaver drug. I'm finally free of the DAs, and now I'm hoping to reduce or eliminate the gabapentin, too.
Thanks. Now I’m going to be still on DAs a little longer as my cpap titration study had to be canceled because I’ve got a sinus infection and can’t breath well out of my nose which is not going to work. Poop. I really want to get this done and start weaning off these Requip. I’m on Requip ER and regular Requip and I’m wondering if that’s going to double my misery when I wean off of them???? A little apprehensive to tell you the truth.
I want to wish you well and it sure would be nice to be on just one med for your restless legs. I’m taking it you must be in the US since I don’t think they allow it in the UK at least as I’ve been told??? Sorry I don’t know where you’re from, still trying to get to know everyone 🙂.
Sus
Yes, I'm in the USA, Boston area.
I'm wondering how and why you ended up on both ER and regular Requip? Why not just one or the other? Good luck.
I’m so, so sorry I didn’t answer you back right away. Been fighting a sinus infection and then there is just life in general. I do know I need to get off this Requip asap. Early this morning I had to get up for an hour because my legs were so bad. I unfortunately had to put off my cpap titration study that was supposed to be Friday night because my nose is still so stuffed up so Dr. Goldstein told me to cancel. I want to do things right but I also want to get off these DAs.
You asked why I’m on both Requip XL and regular Requip well long story short is because my old sleep clinic are a bunch of jerks so that left my poor primary care physician to try to figure out someone who has refractory RLS and has augmented on every DA. I tried the Neupro patch and had weird side effects. I have not tried the Horizant because at one point my PCP said she had done all she felt comfortable doing without causing harm. As for the two Requips. I started on Requip XL (same as ER) and even the 4 mg max dose would not cover them so somehow I ended up on regular Requip too 3 mg. I’m clearly augmenting and my new doctor at the University of Michigan knows this too and we are trying to rush things along but I have to be able to breath. I’m extremely nervous about getting off of two DAs with one at max dose and the other almost there. I don’t like how this medication makes me feel and I’m sure you’re not supposed to be on both. My PCP is treating me because my previous sleep clinic discharged me from their practice because I was having a really hard time with some anxiety because a lot of troubling things were going on and I just wanted to wait to do the sleep study they wanted me to do for a month so I could get things back in control. No could do. I talked to the practice manager and I said it was a mental health issue but they were calling me noncompliant. I told her I wasn’t that I just needed a little time and she said maybe it was my mental illness was what made me noncompliant. Wow! I couldn’t believe it. So much for destigmatizing mental health. To top things off they only gave me enough medication for 30 days. I asked the ever helpful practice manager if they could prescribe something to get me to an appointment with a sleep specialist. I wasn’t even asking for methadone. She said they weren’t going to do anything else for me that that was what my primary care physician was for!!! Really?! She had never treated anyone as bad as me and they should know that. Why else would I end up at a sleep disorder clinic. When she reached out to them for help one of the doctors that I have never even seen told her they thought it could be a somatic disorder and this had been noted in my chart a number of times. She lied. The first doctor I saw there was so no nonsense and told it like it was would have told me that. I’d like to meet her in a dark alley someday 🤨.
Now I have the right doctor but she can’t prescribe the methadone until I do my titration study. I’m barely mildly apneic and if I hadn’t regained weight (15-20 pounds), which has been very painful because I worked so hard to get it off, on the stupid Requip I wouldn’t be at all and I’d be on the methadone now.
Whoops, sorry for the lengthy message 😇. I’m from Michigan by the way. Boston is on my want to visit places for sure! My husband and I and my brother and sister and their families usually go on a long camping trip every June but every one of us has been hit with some significant financial issues. Anyway I best end this. Apologies again for not answering sooner.
Sus
Well, you certainly have been through the ringer with the various doctors. I'm sorry they treated you like that. They really are displaying their ignorance. I'm glad you seem to have found a doctor now who listens to you better, and seems to have more understanding.
What is this "titration study", and why can't your doctor prescribe methadone until that's over?
Apparently I have mild sleep apnea which probably wouldn’t be a big deal but it’s happening during my REM stages preventing good solid sleep. So until I can lose the weight I gained on this stupid Requip then I need a cpap because methadone (like all opiates) is a respiratory depressant and she’s worried about the combination I guess. The cpap titration study is done to see how much oxygen you need to keep your airway open so it’s not obstructed. I had to put the last two studies off because of my having a sinus infection and not able to breath out my nose very well. I have to say I’m not crazy about this at all. I’m a teeth grinder when I’m stressed so I tried a mouth guard. Didn’t work. I always woke up with it out of my mouth. Also during a sleep study 13 years ago I was mildly apneic so they tried cpap on me and I did not tolerate it well at all. I get claustrophobic and don’t want something covering my nose or my mouth and nose so I’m not sure how well this is going to work. I did some research on methadone and it takes 30 mg in someone whose never had an opioid to be a respiratory depressant. I was only on 10 mg. I’m so pissed I’m even in this position. If I’d never taken the Requip I wouldn’t have gained weight and the sleep study wouldn’t have shown apnea. Now I have to do the cpap to get back on methadone and then once again lose weight I gained back plus the additional I want to lose. It’s like taking steps backwards. I’m angry at myself but this compulsive need to eat food seems like a whole different thing then I’ve ever dealt with before. It’s like I don’t realize I’m doing it until it’s done. I want my life back. I’m scared as hell to drive on the Requip because I had two car accidents on Mirapex and at the time I was 100% alert and awake but my last accident happened less then a mile from our house. The last thing I remember was leaving the stop sign on our road and then waking up/coming to in the wreckage of our Jeep. When we went to retrieve some things out of it I couldn’t believe I came out of that with barely a scratch on me. I got an ambulance ride after being administered a breathalyzer. Fun way to start the morning. I was on the way to a meeting with my boss. So now my whole life is in a holding pattern because I need to do physical therapy on a surgical ankle and my very low back. My husband has to drive me to my doctor appointments but it would be impossible for him to take time off twice a week until I’m done. I’m trapped in my own house. We looked into Uber but we just can’t afford it right now on just one salary.
Needless to say after I totaled our Jeep I found another doctor to treat me and after forever he had read something about methadone so we gave it a try. Worked like a charm and for 13 years I never looked back even though I endured a lot of judgement from other doctors. It used to bother me but I’m not a number they can pin some label on. I’m a real person with a very, very bad disease. I told the PA that I last saw that I wish I had some type of machine that I could put him in so he could see exactly what it feels like and why I was so scared to lose methadone as a treatment. And so here I am exactly where I was terrified to be. But at least finally with hope now. Sorry, I think that was a lot more of an answer then you were going for 🤓.
Sus
I'm taking the same as you, if you switched the word "kratom" for "gabapentin." I'm doing well under this regime and would recommend it to others, even if only on a trial basis. As for your question about timing, I have been usually splitting my two 5 mg doses, (i.e. 10 mg per day) but think I'm being convinced by your other responders that a half-life of several days means that there would be no real reason for continuing to do so. I have been taking a methadone tablet along with an 8-gram dose of kratom in a milkshake, twice a day at (very roughly) 12-hour intervals. I am habituated to the kratom, however, and would recommend that novices to the (powdered) leaf, start with only 4-gram doses.
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