I need help with Methadone dosage

[Bubo]

Hi,

I'm new to Methadone but not new to pain. I have Fibromyalgia and was stable for some time on a low dose of Vicodin. I got an inplant last fall for pain in the occipital region of my brain. A "Occipital Neuromodulation" stimulator. It helped initially but as with a lot of treatments the pain relief gradually subsided. I went to my PCP and told him the two vicodin a day were not helping anymore so he suggested Methadone for long term pain management. I was a little put off because of the negative image Methadone has. He explained it would be better for my liver as it does not have tylenol in it. I started on 10 mg 3x a day. After a week I called and they increased it to 20 mg. 3x a day. Still no real pain relief and sometimes I feel sleepy. I was just wondering if Methadone doesn't work with some people? I was really hoping when he raised the dosage I would suddenly be pain free, well I can dream! I was reading an old study done at Brigham and Womens hospital that a drug called Kadian ER helped fibro pain. I have not read any message boards where it was mentioned?

My question is do you think if the Methadone gets raised I will eventually get some relief on it? My pain is so bad that I feel like throwing myself in front of a bus. I won't... but that is how I feel. I have never been a person that did drugs and I have never gotten high on pills and don't want to. I want to be functional and just have some moments without being in pain. I hope the Methadone eventually works and if it doesn't what else is there without Tylenol in it? Anyone get any good results from a certain drug that doesn't make you a zombie or overly tired?

Thanks

[Bubo]

Gemini Girl, Inga Girl and Mellie, Thanks so much for the great advice. I wasn't expecting much being new to this board and came home from my my side job and it was so nice to see replies! I only worked 2 hours instead of 3 because I am in a flare and just useless. I drive and elderly woman to appointments and shopping etc. I'm disabled but this helps me to have enough for copays and bills. She is 89 and I feel older then her some days! For some reason my Fibro and Chronic Fatigue have just gotten progressively worse the last couple years.

Gemini, Thanks for letting me know that Methadone didn't work for you. I was reading a lot of feedback that it was great for pain and was like what the heck? I also didn't respond to any of the Fibril type drugs like Lyric, it made my ankles swell, Neuron tin, Sadella, Cymbals, muscle relaxers, Mobil and Trimodal. They didn't do a thing for my pain. I only had luck with Coding. Many pain pills which I was given post op made me sick to my stomach.

Inga, I'm not going to throw myself under the bus- I promise-  but feel like it some days. I am afraid of the pain and wonder if it is going to get unbearable. I have a high threshold for pain but when it is unremitting I get worn out. It's good to know that you responded well to a lower dose of Methadone. It is probably just me.

Mellie, I think your correct, that stress from an accident can bring on a flare. I had a couple bad stresses recently and my fibril got a lot worse. I have never done stress well even before fibril. Thanks for the Oxymoron advice. I really want to keep tylenol out of my pills if possible. I don't understand why they put that much Tylenol in the pills to begin with? It's not like a high dose of Tylenol is going to make the pain any better!

I'm going to call and let my primary care doctor know that we should try something else. I will do a slow taper and hopefully the Dot's won't be to bad. There has to be something out there that will relieve my pain to where I can still have a life. I'll let you know how it goes.

Take care, Bubo

[mellie4]

I, too, have fibromyalgia.  I was diagnosed about 10 years ago.  Initially I used Vicodin along with Ambien at night for sleep and it helped a bit.  I also have other chronic pain issues, particularly severe osteoarthritis.  I had tried Lyrica  a few years ago for the fibro and at the time I got a little relief from it.  

Then I had some hand surgery and was on different meds for that, which also, at the time, helped with the fibro.  Back in April I was in a bad car accident and my fibro seems to be flaring up pretty bad.  Tried Neurontin and Lyrica and couldn't take them.  As we were adjusting my medications for my hand, I thought we'd hit on something that would cover the fibro as well.  So far, no luck.

For me, the fibro has been on the back burner as my hand has been so bad, especially since I developed RSD after one of the surgeries.

I was offered methadone as a choice at one point but I stayed away from it. Hearing about the withdrawals from it sort of made me afraid. Right now I take the Fentanyl patch 75 mcg every 48 hours along with 30 to 45 mg. oxycodone every four hours for breakthrough pain.  I also use a special compounding lotion and I have lidoderm patches.  In addition, I take Naprosyn or Advil as well as some vitamins.  This combination seems to work the best for me, though I am still having some serious fibro pain.  I really feel my car accident brought this flare-up on and it just seems to take forever to clear up.

There are lots of medications without Tylenol in it.  I switched from Percocet to oxycodone because I didn't like taking something with Tylenol in it several times a day.

I hope you're able to find some relief.

[inga511]

Hi Bubo-everyone's system responds differently to pain medications. Work with your Doctor by to see what works with you but by no means "throw yourself in front of a bus." If the vicodin worked for your, I would say to try and stay with something in that class, I have heard from others that the patch works well but that may be a too huge a jump from two vicodin a day. You may want to get a second opinion becasue the amount of methadone your Doc has you on seems high to me-but I am no Doc. I am on 10 mg in the morning 10 mg of methadone ot night for fybromyalgia and DDD. I am awaiting spine surgery. Methadone is very difficult to come off of, one must wean extrememly slowly or suffer terrible withdrawls. I would not take it unless it was the only thing that I have found that diminishes my pain. Vicodin does nothing for me. But again be very carefule with this drug if you decide to come of it, it is very strong and make sure you are taking all your supplements as it depletes your bodies resources. I would go back to your Doctor and seek an alternative medicationfor your pain (the patch, oxy)that your body responds well to and wean SLOWLY from the methadone. Thats my input.Good luck, and I hope that you find a Doctor that really listens to you and cares.

[geminigirl1963]

I'm sorry you're having so much pain.  I also have fibro and can definitely relate to the severe pain.  I do also have other chronic pain issues.

I was on methadone at one point for a short time.  I also did not get ANY pain relief from it, only severe side effects - hence, the reason I am not on it any longer.  Methadone is like any other medication - it can work differently for different people - some people get great pain relief from it and others get nothing.  That can happen with any medication.

Kadian is an extended release form of morphine sulfate.

Have you ever tried either Cymbalta or Savella?  Both have been shown to help some fibro patients with their pain.  Unfortunately, I'm not able to take either one, but I've heard many people say that one or the other has helped them.  Have you tried Lyrica?  That also is a medication that is used to treat fibro pain and other symptoms.  I did take Lyrica for about a year and a half and it did help me at first.  Then it stopped helping at the dose I was on and when my doc increased my dose, it not only didn't help any, but I also began experiencing severe side effects.  So my doc and I made the edecision to wean me off the Lyrica since it didn't appear to be helping me any longer and at the higher dose all I was getting was the side effects.

If you're not geting the pain relief from the methadone that you feel you should be getting, please discuss this with your doctor and ask if there is anything else that they could try.  There are other pain meds out there that do not contain acetaminophen (tylenol) - and other meds to treat fibro.

Please know you are not alone - anytime you'd like to talk, just send me a PM.

Best of luck!