Weight gain on methadone?

I finally found a doctor in Sarasota who prescribes methadone. The plan is to stop Tramadol and switch to methadone. Will I gain weight - does it slow metabolism? I've been reading that some people have problems and I tend to gain weight easily. Anyone have experience? Thanks for your comments.

[Joolsg]

Hopefully someone will respond shortly. As this is a UK based help site, you may not get many replies as Methadone isn't prescribed in the UK for RLS.The US RLS foundation may have some information on Methadone.

[dickJones in reply to Joolsg]

Hi Joolz. Re Methadone. Do you mean that it would be unusual for it to be prescribed in the UK or that it's actually barred from prescription? For someone struggling with Buprenorphine patches (some nights okay, some nights awful) and pretty much at the end of the medication trail, no access to an opiate available elsewhere would be a real problem.

[TheDoDahMan in reply to dickJones]

Though I'm in the US, your question resonates with me. I've read that many UK patients are turned down when requesting methadone, but I, too, don't know whether there's an actual prohibition against it. The opioid panic in most of the English-speaking world has caused much unnecessary pain and I'm not sure when it will ever end. The Mayo Clinic studies point to methadone as being the preferred opioid for refractory RLS. I've been prescribed it for 4 years and am extremely pleased with the results. Have not experienced any weight gain.

[Joolsg in reply to dickJones]

I only know of one person who has been prescribed methadone for RLS in the UK and he was in prison. Methadone is the only drug available in prison as all other RLS treatment would be used as prison 'currency'.It's difficult enough to get Buprenorphine in the UK.

NHS and NICE guidance mention codeine for RLS treatment where other treatments have failed and where pain is involved. Shows how behind they are. Most RLS patients don't suffer pain but the opioids work on receptors that stop the unbearable sensations.

Hopefully we can get the NHS and NICE guidelines updated to reflect best practice in the Mayo algorithm and maybe then, methadone would be accepted as a very effective RLS treatment.

[Cedarish]

To reassure you, I lost rather than gained weight on methadone. I am female, Canadian, age 79, familial RLS since childhood, but managed without prescription meds until my 50s (magnesium & regular exercise were helpful). When my RLS increased in frequency to daily, my very supportive GP prescribed gabapentin. This was successful for several years, but then stopped working.  I tried DAs for a few nights years ago - was warned about augmentation even then.  DAs stopped the RLS but I felt very jittery and absolutely couldn’t sleep anyway! Considered benzodiazepines also but was scared off by the side effects & withdrawal problem. Started methadone at 6 ml per night, went up very gradually over ~10 years to current 6ml @3 pm and 4 ml @ bedtime, plus magnesium 200-400 mg daily and multivits/minerals incl vits D and K2, with yogurt/kefir for calcium. I have been enrolled in Mass General-Harvard Medical-Dr. John Winkelman’s telephone/internet study of opioids for RLS, for years now. Gained ~15 lb gradually on gabapentin but lost it all, equally gradually, on methadone. Tried Suboxone, it certainly worked, but I found it too constipating, reduced my appetite too much, and made me sleepy in the day, so I went back to methadone. I do get breakthrough RLS if I don’t take it early enough in the day or omit the magnesium.  My RLS comes on regularly mid- to late-afternoon and I have to take methadone by 3 pm latest or can end up really suffering for a couple of hours while waiting for it to “kick in”. All in all, though, I’m grateful and feel  my life is pretty normal thanks to methadone. I feel alert all evening, comfortably read, write, do crafts, watch TV, go out to movies, concerts, dinners, etc. I hope my experience is helpful to others. RLS is a true bane until you find what works for you - this forum is so helpful for that - thank you to all contributors.

[Merny5]

I have been on methadone for about 6 months. I have had no weight gain. In fact, I have been losing weight. I suspect it is due to the fact that I have been sleeping better.

[TeddiJ]

Hi. I wouldn't worry at all about gaining weight on methadone. You will most likely end up losing weight. I have lost at least 25 lbs since getting off of the ROP and PRAM. I have been taking either methadone, oxycodone, suboxone, or kratom this past year. I continue to lose weight and I assume it is no longer from getting off the DA's but now due to less of an appetite. You don't realize it but you get full easily or you feel like you just don't want to eat much-which was not the case for me ever before. And when I was on the DA's-I couldn't lose weight at all, no matter WHAT I did. I never knew they were the cause or I would have dumped them far, far sooner. In turn, I would not be in the hell I am in now. On the bright side, I have my old body back-yay.

Best of luck with it!

[Poe7]

I switched from tramadol to methadone almost 2 years ago. I have gained about 10 pounds. My Dr said that methadone can cause weight gain, especially after about 6 months of continually taking it. It's not the medicine that causes it but it can make you really hungry. And for me personally that means I get sugar cravings late at night.

I have lost about 5 pounds since starting to do intermittent fasting. I think it works out so well for me because when I'm doing it it means I cannot eat late at night which was my issue.

I also have a lot of gastrointestinal issues and the IF helps that tremendously so that's a bonus.

So I said all of that to say that if you are concious of what you're eating you can avoid gaining weight.

Oh also another thing that helps is if I get a food craving and I know I've had plenty to eat I'll drink a bottle/full glass of water and make myself wait 10 minutes. 99% of the time by the time that 10 minutes has passed so has the craving. So I know that if I still want to eat it's because I'm actually hungry.

Hope this helps 😊