oxycodone and anxiety

[Covenant1962]

Ui everyone. I have been taking 25 mg oxycodone per day for at least 2 years which controls my RLS symptoms. I have just started having anxiety attacks when I first wake up in the morning. Anyone have any suggestions?

[SueJohnson]

Buspar (Buspirone) takes 2 to 4 weeks to work. Trazodone also helps anxiety.

[Covenant1962 in reply to SueJohnson]

Thanks Sue

[Joolsg]

It's unusual for that particular side effect to happen 2 years after you started Oxycodone, it normally kicks in after one or two months.I always develop opioid induced panic attacks anxiety, usually around 4 weeks after starting the opioid.

I was advised by Dr Buchfuhrer to add a small, nighttime dose of pregabalin as it is sedating and helps with RLS and sleep. He was right, it helped within 2 days. Keep to the lowest dose.

Has anything else triggered it? Have you started any other new meds, including OTC meds/supplements?

[Covenant1962 in reply to Joolsg]

Many thanks Jools. The only thing I’ve started recently is magnesium citrate and cod liver oil

[Joolsg in reply to Covenant1962]

I suggest you make an appointment with your GP and ask for an additional med to counter the waking anxiety. You may just need a small, occasional dose of diazepam or a small night time dose of pregabalin.

[Covenant1962 in reply to Joolsg]

Thanks Jools, I will talk to my GP soon.

[ziggypiggy]

It could be a symptom of withdrawl finally kicking in depending on when you take your nightly dose. Even though its been two years anxiety free something may have changed. You could test this theory by taking a dose in the middle of the night several hours before you normally wake up and see how the anxiety is with a decent level of medication in your system by morning.

[Covenant1962 in reply to ziggypiggy]

Many thanks for the suggestion, I will give it a go

[Joolsg in reply to ziggypiggy]

Your comment has made me rethink my response. It could be mini opioid withdrawals causing the anxiety, because of the short 5 hour half life.

[Joolsg]

Another thought, it could be mini opioid withdrawals from the Oxycontin itself. Opioid withdrawals cause anxiety.Oxycontin is supposed to last 12 hours, but that was a marketing lie, never proved in trials. Oxycontin actually only lasts 4 or 5 hours, so ideally should be taken every 4 hours throughout the day, particularly by people who metabolise Oxycontin more quickly.

ziggypiggy comment made me think of that. It would be unusual, because it would normally show up sooner.

So maybe try taking the Oxycontin at different times, spread more evenly over 24 hours.

I wasted 5 years on Oxycontin because the mini opioid withdrawals caused RLS in my case.

Switching to a long half life opioid solved everything.

[Covenant1962 in reply to Joolsg]

Thanks again Jools. Actually I've been taking Oxynorm not Oxycontin but same issue potentially in terms of potential withdrawals so I will give the suggestion a try.

Longer term I'm working on my GP to get her to support a move to Buprenorphine.

[Joolsg in reply to Covenant1962]

Oxynorm has an even shorter half life.I hope changing the timing and frequency makes a positive change or that your GP agrees to Buprenorphine.

But, be aware Buprenorphine caused me severe opioid induced anxiety after 4 or 5 weeks. A small dose (25mg) of pregabalin completely resolved it.

[Covenant1962 in reply to Joolsg]

Thanks Jools, when did you take the pregabalin?

[Joolsg in reply to Covenant1962]

I still take 12.5mg every night. I first had opioid induced anxiety/panic attacks when I started Oxycontin. At around 5 weeks, I developed a really,really weird feeling and my husband recognised it as a panic attack. I'd never had anything like that. I was in email correspondence with Dr Buchfuhrer at the time, as he was advising me what to do after Ropinirole. He is a top US expert who kindly responds to all enails for free.He suggested adding pregabalin as it is sedating and counteracts the Opioid.

It worked within 2 days.

I stopped taking it after 4 years on Oxycontin, reducing very, very slowly.

When I switched to Buprenorphine, I was expecting the anxiety/panic attacks and sure enough, they happened around 4 weeks in.

This time, I took 25 mg.

Now I'm slowly reducing pregabalin to see what happens as I get near to zero mg.

My body may have adjusted.

If not, I'll stay on low dose pregabalin as it helps with sleep.