Neupro causing Augmentation

[Poppip]

Could I please ask anyone who has experience of using opioids what is the preferred choice and minimum dose that is effective? In the recent warm weather due to physical work outdoors I have not been able to keep the patch on . The symptoms were 10 times worse than before I started. My GP has often suggested Opoid treatment but I have never been comfortable with that. Now I feel I must give it a try. Any advise welcome please. Thank you.

[1234kids]

I was prescribed oxycodone three years ago due to failed back surgery and nerve damage and chronic pain. I’ve also have severe restless legs. I’ve been to a neurosurgeon at Johns Hopkins and she treated me. nothing seem to work.! the only thing that works 100% is 5 mg of oxycodone which I take around five or 6 PM and later on in the night if I need it. It bothered me that I was taking it and share with my spine doctor about my apprehensions. She did call my fears by asking me if I had heart problems would I hesitate or feel so bad about taking medication for that, and of course I answered no. Even my GP doctor said she wished that there was not such negative press about oxycodone. yes it can be addictive and yes you need to be regulated and kept track of by A doctor. Hope this helps.

[Poppip in reply to 1234kids]

Thank you

[Madlegs1]

You are so lucky to have an amenable Dr.

In order of desirability, the opioids of choice seem to be as follows.

Buprenorphin- in various forms.

Methodone- if offered in your part of the world

Hydrocodone/ oxycodone in various forms,- Oxycontin is supposed to last 12 hours, but for many people, it simply does not, and has to be supplemented. Oxycodone is shorter lasting (6hrs) but useful if required for overnight relief.

Tramadol is a weaker form (Ultram)

Codeine is weaker again, but imho has a great propensity for getting addicted to.

I think that covers it. Others may have differing views.

All opioids have initial concerns of insomnia, itching, constipation and addiction/ tolerance and so on, but all can be managed or endured for the few weeks necessary.

Opioids at a low dose- under 30 mg pd should not cause concern for addiction, especially for RLS.

Availability and cost need to be taken into account.

Good luck.

[Poppip in reply to Madlegs1]

Thank you

[Joolsg]

How brilliant that you have a sensible, knowledgeable doctor.

In the USA the preferred opioids amongst the RLS experts are Methadone and Buprenorphine. However, very difficult to get these in the UK.

That leaves tramadol, codeine, oxycodone and oramorph.

Opioids are not addictive if used at low dose for RLS and there is no history of abuse.

I'm on 25mg Oxycontin spread over 24 hours to avoid rebound RLS from mini opioid withdrawal symptoms. I also take a small evening dose of pregabalin because I developed panic attacks when I started oxycontin ( rare but I seem to get the rare side effects to meds).

There is a long term opioid study being undertaken currently in the USA and a few of us from this forum are taking part in it. It shows the different type of opioids being used. Link below.

mcusercontent.com/068feaf31...

[TheDoDahMan]

I tried the prescription meds (dopamine agonists, alpha ligands). I tried a slew of creams, sprays, herbs, vitamins, and minerals. I tried weighted blankets and grounded sheets. Hot showers and vibrating platforms. All to no avail. Then I was allowed to take 2 tablets (5 mg each) per day, as needed, of methadone. BOOM: it was all over-- i could sleep again, my depression was lifted, I got my life back.

I live in the US; because of the moral panic regarding opioids, it's a real hassle to get this prescription here -- I had to go out of state to find a doctor.

[hausbauer]

Neupro did not help me (extreme dizziness when walking).

I have been taking an opioid (Buprenorphin) for nearly one month now, very low dose. Great success until now and - which is important IMO - no constipation. Dr. B. wrote in his answers that Bupr. should not cause constipation, though in a few cases it may.

I have written about it in this forum. But Buprenorphin seems to be very difficult to get in some countries.

[Parminter]

Doctor Buchfuhrer, who has a long history with opioids for RLS, now prescribes a 75mcg (microgram) buccal patch of buprenorphine.

He has moved on to that after prescribing methadone for many years, low dose up to 10mg per day. As little as will do the job, obviously.

Read what he has to say to other patients at rlshelp.org

These two atypical opioids are structurally unrelated to the usual opioids (all related to morphine) and are considered safer.

In the UK you will probably not get either of the former, but may well be able to get one of the latter, such as oxycodone.

[Rolo18]

Just like 1234 kids, I too am reliant on Oxycodone and have been for the past 11 years. I too have spinal nerve damage and am always in chronic pain and the only way I can live a relatively normal life is significant amounts of Oxycodone and Oxynorm which is a liquid version. I take 50mg a day and 1800mg of Gabapentin and am out of it a lot of the time. I lose track of time, forget things, get awfully confused but I know if I come off this then I would never walk again. I am an addict and have secreted a few bottles of Oxynorm just incase I have a problem with getting my slow release tablets. Have been on disability a long time and get quite annoyed that a simple surgical procedure could possible have had me moving around better, but the CCG will not agree to funding, so I just take the sweeties and keep quiet...