palpitations and Buprenorphine

[Navy20]

Hi, I have been having palpitations for a while that last for a long time. I was wondering whether it was because of the patches. Has anyone else experienced it?

[Joolsg]

Yes. I started to take non sedating anti histamines and a small dose of pregabalin & it does reduce them. They happen 2 or 3 times a day and spike at around 120.I really notice the increase because my resting HR is very low- so anything above 60 and it is scary.

Dr. Glen Brookes in NY was very helpful and replied to emails after Shumbah put me in touch. He said they would settle and shouldn't cause any real problems. As Buprenorphine stopped all my RLS overnight, I decided to stay on it. To have zero RLS and to sleep every night is too blissful to give up.

I've had heart tests in the last few months- ECG, 24 hr halter and ultrasound and all came back fine.

So, if your RLS is totally controlled, consider staying on Buprenorphine, but do ask your Doctor for an ECG to check everything is fine.

[Shumbah in reply to Joolsg]

hey Joolsg

Did Buprenorphine raise your blood pressure or just heart rate ?

[Joolsg in reply to Shumbah]

Just heart rate. BP stays low. Resting HR is 53, so I really notice anything above 65/70.

[Shumbah in reply to Joolsg]

Thanks Lovely

[PoorRichard in reply to Joolsg]

I'm curious about your resting heart rate because mine is very low, too (~48). I'm 72 and my bradycardia developed post 70, as far as I know. Was yours late onset as well?

[Joolsg in reply to PoorRichard]

No, in my case it's genetic. My whole family has a low resting HR and low blood pressure ( often too low!).

[Hidden in reply to Joolsg]

Hi Jools, my resting heart rate is 55 -give or take. And like you, I really notice when above 65/70. My cardiologist said elite athletes’ resting heart rate can be in 40s. I’m far from an elite athlete. There’s only so much we can worry about. So far now my heart rate is not one of them. Hope you’re doing well?

[Joolsg in reply to Hidden]

Very well thanks. Buprenorphine is still controlling RLS 24/7 & I'm sleeping at least 8 hours every night. The palpitations are helped by 25mg pregabalin at night, which I take to counter opioid induced panic attacks.How about you?

[Hidden in reply to Joolsg]

Hooyah!!! Long time coming. I know how to tame the RLS beast, as you know, but I still like experimenting with it. I was having palpitations, aka, supraventricular tachycardia, as well. Metoprolol helped with that and did not seem to bother my RLS. After about 18 months I stopped the Metoprolol and the palpitations are still at bay. At this point, I’d like more energy and lower cholesterol so that’s my focus. No matter what, life is better when you can fade to black for 8 hours. 🌒

[Nanpat in reply to Joolsg]

Hi, are you on tabs or the patch? Have you had to increase dosage at all?

My patch was miraculous for 3 months but I fear I’ve become used to it as now not working, same thing happened with Targin???

I thought augmentation wasn’t supposed to happen with these drugs? 😞 so very disappointing

[Joolsg in reply to Nanpat]

Im on sublingual pills and never had to increase from 0.4mg.

Targinact didn't work for me either, probably because it only lasts 5 hours max, instead of the supposed 12 hours. I suspect it then causes mini opioid withdrawals, which cause RLS symptoms.

Augmentation means increase in severity of the actual disease. The RLS becomes more intense, starts earlier and moves to other body parts. Tolerance is when the usual dose of the drug is no longer effective and you need to increase the dose. Augmentation doesn't happen with targinact but 'mini withdrawals' do. Augmentation also doesn't happen with Buprenorphine and tolerance is rare, but an upwards adjustment is often needed in the first year according to the Massachussetts General Opioid study for RLS.

However, often, the Buprenorphine patch is ineffective for some RLS patients because it gives a steady dose over 24 hours, rather than a bigger dose when most needed between 9pm and 9am - and it seems to only last 3 or 4 days instead of the 5 or 7 noted on the prescription.

Quite a few people have reported that the patch does not last for the 5 or 7 days it is supposed to last. They then go into opioid withdrawal and the main symptom is RLS.

You may like to ask your GP to switch you over to sublingual pills instead.

The average dose of Buprenorphine pills is 0.5- 2mg and the max dose is 6mg.

If you switch to an equivalent dose, you may find the pill works better than the patch. So if you're on 5mcg patch ask your GP to give you the equivalent daily dose in pill form and take in the evening. Make an appointment with your GP to discuss in detail.

I do hope you can try pills to see if they work for you.

Take care.

[DogBella in reply to Joolsg]

When you say sublingual pills is this the same as the sublingual film?

[Joolsg in reply to DogBella]

No. Here in the UK we have sublingual pills. They are hard tablets that you place under the tongue and they dissolve in about 1 to 2 minutes. You can cut them in half using a pill cutter if necessary.

[Inkosikazi]

I’ve been taking buprenorphine 2mg sublingual tablet once at night for about six months and can report zero palpitations. I also take a beta blocker, so…???

[Joolsg in reply to Inkosikazi]

Interesting as beta blocker is used for palpitations. Which one are you taking? Propranolol? That has been suggested but I know some beta blockers can worsen RLS for some patients.

[Navy20]

Hi, That is interesting. Thank you for your response. The increase is quite noticeable. I take it for pain management and it has reduced significantly. I’ll have a word with my GP.

[Whymelord]

Hi Navy20,I have been to the emergency dept.in my local hospital because of palpitations which are really scary,I got some tests which showed nothing to be concerned about,hospital put it down to stress.this last week I have a pulse in my ears and palpitations when I'm in bed so I'm at a loss as to what to do now as I'm sure if I ring my gp he will refer me back to the hospital, I feel I'm going round in circles.Hospital said that the RLS meds I'm on shouldn't cause palpitations,I wish you well.

[Navy20 in reply to Whymelord]

Hi, Thank you for replying. I also have them in the middle of the night. It is quite alarming. I find that stress is the dr’s go to when they don’t know. I’ll see what the dr says. Take care.

[Nanpat]

I’m on 10mg patch and have no problems……is your patch perhaps too strong?

[Typicallygaslit]

I also get palpitations at night quite often these days and have linked it to increase in serotonin. It’s typically coupled with increased RLS. I’m having a hard time tolerating any opioids as they all seem to increase serotonin just enough for me to have problems with them. So I guess this is a possibility. I’m not sure Buprenorphine is causing it for me though. It’s other things such as food, anti histamines, other opioids, any drug or supplement that increases serotonin which is most of them.