methadone no longer helping

[wairoa36]

I am 87 and live in Australia I have had RLS for at least 4 decades. Only slept when on morale’s. Finally got methadone and had a heavenly 5 hours sleep for 4 years now. I had multiple pulmonary embolisms last year. No source found I needed increase of Methadone to 10 mg twice daily due to anticoagulants and Blood pressure pills. Sleep was poor. Then 2 months ago I fractured a vertebra due to osteoporosis . It was agony. I was on palexia for pain with little relief. I was told due to methadone. I am up most of night now, every night. No pain now but no sleep. I see neurologist in October . Gp is helpful.

What to do? Help please , from all you experts.

Thank you, Picol

[Joolsg]

I am so sorry to hear this.Methadone is linked to Osteoporosis.

You say you have no pain but you are up most of the night. Is that because you now have RLS symptoms? Or is it insomnia?

If it's increased RLS, it will be because of all the other pills, BUT you need to take those.

This is an area outside my knowledge and suggestions.

The fractured vertebra will be worsening the RLS and, as it heals, the RLS may diminish.

I am currently looking for articles on Buprenorphine. To see if that also causes Osteoporosis. If so, there's no point switching to it.

What do your medical team say?

[SueJohnson]

What is morale’s?

[wairoa36 in reply to SueJohnson]

Morales was a correction. Should read DAs

[SueJohnson]

Many blood pressure medicines make RLS worse. Which one are you on?

Some medicines that are safe for high blood pressure are propranolol (Inderal, Hemangeol, InnoPran) a beta blocker that may help RLS, Isosorbide Mononitrate (Monoket, Imdur) which is not a beta blocker nor calcium channel blocker. Other possibilities are: Clonidine (Catapres) an Alpha-2-Agonist used to treat high blood pressure which may help RLS and which also treats insomnia, tenex (Guanfacine, Intuniv), prazosin (Minipress) an alpha-adrenergic blocker that is also useful in managing sleep-related problems caused by PTSD and Tadalafil a vasodilator that in one study completely eliminated RLS. Discuss these with your doctor. And then there is reducing salt by 1 teaspoon a day nih.gov/news-events/nih-res....

If it is just insomnia, I suggest lunesta.

Joolsg is right that as your fractured vertebra heals, your RLS should get better.

[wairoa36 in reply to SueJohnson]

Thank you very much for your help here. I am very grateful, and for your speed in replying. You are wonderful, as I have said every time I need your help.

First I am on Spironolactone 12.5 mg daily for BP. I already eat low salt, no processed foods for many years.

I think my vertebra is healed as the acute pain is gone now for about 2 weeks. I have some heaviness, and dragging feeling in my lower back at times.

I don’t understand why the Methadone is no longer working on the RLS,

I go to bed , sleep about an hour , then I am wide awake and frantic with RLS. I have to get up and move most of the night.x Finally I sleep again with luck about 5 am.

Many thx again. I see the neurologist in October.

Thank you, Waroa36/Picol