Methadone withdrawal without Rx

[WelbyB]

I take 15mg of Methadone two hours before my bedtime of 11pm. It is not a great cure by itself for me. I also take 1mg Nepro patch. Together it helps about 70-80%. Methadone seems like it reduces the intensity of the RLS symptoms but not the frequency. I think of it as palliative rather than therapeutic. Methadone doesn't make me feel much different except a little sleepy. I suspect it is very addictive. I understand very well the tapering process off Pramapexole which was hell.

Last week I forgot my meds while travelling. It was horrible for three days. I was able to secure some Sinemet 10mg (DA) but it didn't seem to help. I then tried some Kratom and Pot because they are legal in Colorado otc. It helped about 30%. I can only speculate that the some of the high intensity and frequent RLS symptoms (10 hours straight) were from sudden withdrawal. I welcome any comments about coping with withdrawal of Methadone and/or Neupro patch.

[GuillaumeL]

I'd recommend that you can get your drugstore or clinic to transfer your Methadone prescription to a local drugstore.

As for recommendation for withdrawal. Methadone and Neupro are two distinct class of medication. As you will see if you look at posts about dopamine agonist (DA) augmentation and/or DA withdrawal, everyone who has been through this suffers hell. Most people suffer from DA augmentation (worsening of symptoms and loss of efficacy leading to higher dose leading to worsening of symptoms...) and eventually decide to quit. Tapering off DAs is a long and arduous process well documented on this forum. That being said, if it works for you and if you don't need to increase your dose regularly, there's no reason you should stop taking it.

As for Methadone and other opioids, you become dependent over time. That's why the medical community only resorts to opioids as a last resort. I understand that in your case this was not planned withdrawal, but if you indeed want to stop an opioid, you must tapper very slowly with medical supervision.

I went from 12mg Methadone to 5mg reducing from 1mg every three days. I'm stable and sleeping better than ever at 5mg without noticeable side effects. Going from 15 to 0 is indeed very intense. Any medication stopped in such a drastic manner will result in severe withdrawal symptoms.

[Joolsg]

The only comment I would make is that you were on an incredibly high dose of Pramipexole for a very long time and suffered terrible increase in severity of RLS (augmentation). You are now on another dopamine agonist which will most definitely be causing augmentationof your RLS as your D1 opioid receptors have never been given time to settle.The methadone will be helping and masking a lot of the augmentation symptoms.

If you want better coverage, I would suggest you slowly reduce the patch. You will experience withdrawals with every reduction but then about 4 weeks after you have completely stopped the Neupro patch, you should find the methadone gives nearly 100% cover.

Stay away from all dopaminergic drugs like sinemet because you will only worsen the augmentation and damage the D1 receptors further.

[WelbyB in reply to Joolsg]

Thanks for your interest in my case. I have to assume you also saw my earlier post about the large amount and duration of Pramipexole. Over 20 years I increased the dose to 2.25mg HS for one year. For a few weeks I upped it to 3mg then learned about augmentation. Tapering off took a few years. Then I spent a full year on no DA. Lyrica for a year did not help RLS and also caused bad side effects. Methadone alone maybe helped 30%. It was a miserable year for sleep.

Dr. Buchfuhrer warned me about augmentation, although less likely with Neupro 1mg as well as Synamed used sparingly. You seem adamant about not using any DA. Why is that? What if nothing else works and the torture is unbearable?

[Joolsg in reply to WelbyB]

I didn't realise methadone alone had not helped. The only reason I am against using another DA after augmentation on high dose Pramipexole or Ropinirole is that very, very few people manage to escape augmentation once again and the thought of them having to go through withdrawal again makes me send out warnings.I realise Neupro has a lower rate of augmentation and now you say Methadone alone didn't help, can understand why you are on the Patch.

Dr Buchfuhrer is one of the best neurologists and if you're under his care, any future augmentation will be handled very well.

And, perhaps Ecopipam will be available and modified to help.