Methadone - How Long to Take Effect?

[2islandboy]

Hi all, I'm on day 5 of 2.5mg Methadone (6PM). RL improved slightly, but still having low-level breakthroughs. I continue with 2400mg Gabapentin 600mg @ 4,6,8 and 10:00, plus iron, C and magnesium(mid-day) tabs. Two iron infusions 10 weeks ago. Off Mirapex 4 years ago (thank you Blog/Sue!!). Not taking any drugs that might contribute to RL (per Sue's advice). How long does it take for the Methadone to become effective? Should I increase to 5mg. I'm under the care of one of Dr. John Winkleman's Neurologists (Christopher Abel Cano, MD, Faulkner Hospital, MGH Boston). PS: Dr. Winkleman is "retiring" and no longer taking patients. His wonderful Harvard/MGH Division of Sleep Medicine is a great resource and he will continue with research, etc. Happy Easter!

[Madlegs1]

The general dose of methadone would be in the 10 to 30 mg range. So you have a way to go.

[SueJohnson]

According to the Mayo Algorithm the usual effective dose is 5 mg to 20 mg so as Madlegs says you have aways to go. If the 2.5 mg hasn't helped yet it won't so you do need to increase it.

Thank you for letting us know that Dr Winkleman will no longer taking patients and giving me the name of your doctor.

[Clamire]

Hi Island, did the infusion from 10 weeks ago make any difference to your symptoms?

[2islandboy]

sadly no. I had two infusions in 2023 and they made quite a positive difference