Drug Holidays

[Nikos64]

I’m among the relatively fortunately RLS sufferers that along with gabapentin can get decent relief from a 5mg dose of oxycodone immediate release.

However, I am very concerned about limiting my dependence to this drug due to its power and am determined to avoid having this dosage increased.

I believe like most of these medications we take for dealing with this affliction, they will gradually stop working.

So based on these two premises i am considering taking a “drug holiday” should the oxycodone stop working.

Has anyone tried this technique? Does it work ?

I hear a lot about it on RLS forums.

thanks in advance for any comments ?

[bumblebee_tuna]

Why do you think you’ll need a dose increase? RLS patients can go years without a change in opioid dose.

[Nikos64 in reply to bumblebee_tuna]

The reason I say this is because in the past, I was on ropinirole, then pramipexole and finally Tramadol. Every single one of these initially worked well and eventually stopped working and had to have the dose increased. So, this is my biggest worry. Oxycodone is a powerful narcotic and I fear being on higher doses due to the severity of the side effects

Thanks for your reply !

[Joolsg in reply to Nikos64]

Ropinirole, Pramipexole and tramadol all cause a drug induced worsening of RLS. That's why you needed to increase the dose. Tramadol is the ONLY opioid to do this.So, in my view, you don't need to take a drug holiday.

Have a look at Dr Winkelman's opioid registry. His study is proving that RLS patients are still on the same low dose of opioids for years. No tolerance, no increase in dose.

massgeneral.org/rls-registry

[Nanpat in reply to Nikos64]

I agree with you Nikos, every opioid I’ve tried has worked wonderfully in the beginning then slowly stopped and I’ve had to change meds or increase, so can understand your concerns. You may suffer some withdrawal symptoms.

Good luck

[SueJohnson]

Neither the oxycodone nor the gabapentin will stop working and I wouldn't worry about dependence on the oxycodone as you are just taking a starting dose and so what if you are dependent if it takes away your symptoms. Stopping the oxycodone can lead to withdrawal symptoms. On the gabapentin you may need to increase the dose but that will be after many years.

[Nikos64 in reply to SueJohnson]

Thank you for the reassurances!

Everything I was on in the past initially worked well and eventually stopped working and had to have the dosage increased. (Ropinirole, pramipexole, Tramadol)

Getting off them and switching over to the next drug was hell and I don’t want to go thru that again.

Also, (in the U.S.) there have been shortages of oxycodone thanks to actions of the DEA and if I cannot get it, at least getting off a small dose should have less of a withdrawal hell. This is another reason why I’ve decided this is the end of the road for me as far as drug and dosage. I just refuse to go thru withdrawals again and would prefer to live with my RLS rather than live with more intense RLS and withdrawal symptoms.

However I am encouraged with your comments about the dose staying the same !

So, thank you!!

[Munroist in reply to Nikos64]

I understand your point about not wanting to take higher doses of drugs and based on what others have said that’s unlikely with oxycodone and gabapentin. These are different from dopamine agonists like Ropinirole which are known to gradually lose efficacy and cause augmentation when taken in higher doses AND cause awful withdrawal when you come of them. It’s so bad it has a name i.e. DAWS. That simply shouldn’t happen with pregabalin and oxycodone. I was on 300mg of pregabalin for a year and came off it slowly because I don’t like drugs and I didn’t like the slight “cognitive fog” but there were no withdrawal issues. I can’t comment on oxycodone. So if you have a working regime you are comfortable with and is unlikely to change I can’t see why you’d stop. At the same time I can’t see any harm in stopping medication other than you may not sleep as well and you then know what your options feel like.

[Nikos64 in reply to Munroist]

Thank you for your comment !

I guess it is also partly because oxycodone has such a bad reputation of being a super dangerous drug that has killed many. This is why I set a hard limit that I will never exceed 5mg in my treatment. Fortunately, it appears it appears that unlike everything else, oxycodone retains its effectiveness.

I’ve experienced both DAWS and went thru a lengthy withdrawal process with Tramadol. Not only that I too experienced the brain fog, weight gain and extreme sleepiness of pregabalin !

I don’t plan on stopping my current treatment. But it is the end of the road in terms of dosage amounts and drugs I will take to control this vile condition.

Best regards!

[SueJohnson in reply to Nikos64]

Yes it has a bad reputation but that is at much much higher doses and sometimes because it was laced with fentanyl.

[Jumpey]

I haven't tried Oxycodone. But have experienced tolerance on Codeine, Tramadol and Morphine. Drug holidays of a month have definitely helped keep dosage low.

[DNoda]

I understand your concern Nikos64 . I became tolerant to pregabaline, pramipexole, cannabis oil and now also oxycodone. So it is very much possible.