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Suggest Treatment For Irritability And Increased Restlessness In Legs When Treating MS
Question: Hello, my husband has been on a Fentanyl patch for a number of years, currently 75 mg. He has his last patch 7 days ago. Other than irritability, increased restlessness in his legs and general discomfort he has being doing okay. He made this decision himself and quit cold turkey. He has taken l mg. of ativan 2 x per day for anxiety. Are things going to get worse? He has MS.
Brief Answer:
cannot predict the future
Detailed Answer:
but in general the peak of withdrawal from fentanyl, although delayed compared to short acting pills, would have occured by now. The withdrawal symptoms decline and are often present for 1-2 weeks but of considerably diminished amount after about 7 days (often less). AND 75 mg fentanyl patch by itself is not a huge dose and the withdrawal from it is also not huge. Often people don't have it.
In summary, no, it is doubtful that things on the drug withdrawal will get worse.
On the other hand, I cannot predict about the MS! The course of it is quite variable. Ihave two patients in which it somewhat "just got better". oFten there is a single or a few problems and these remain, but no more symptoms ever add up. But sometimes people have progression of thdisease which can get quite debilitatitng. There are increasing numbers of (safe) medicines that can damp down the progression.
cannot predict the future
Detailed Answer:
but in general the peak of withdrawal from fentanyl, although delayed compared to short acting pills, would have occured by now. The withdrawal symptoms decline and are often present for 1-2 weeks but of considerably diminished amount after about 7 days (often less). AND 75 mg fentanyl patch by itself is not a huge dose and the withdrawal from it is also not huge. Often people don't have it.
In summary, no, it is doubtful that things on the drug withdrawal will get worse.
On the other hand, I cannot predict about the MS! The course of it is quite variable. Ihave two patients in which it somewhat "just got better". oFten there is a single or a few problems and these remain, but no more symptoms ever add up. But sometimes people have progression of thdisease which can get quite debilitatitng. There are increasing numbers of (safe) medicines that can damp down the progression.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
One more question, my husband regularly takes Imovane at night to sleep. Is this a problem during the withdrawal period. It certainly does help him sleep.
Brief Answer:
It is considered addictive
Detailed Answer:
"Evidence of drug abuse and dependency was found in case reports and small patient series. Dependency symptoms of severe rebound, severe anxiety, tremor, palpitations, tachycardia, and seizures were observed in some patients after withdrawal. Abuse occurred more commonly among patients with previous drug abuse or psychiatric illnesses. Many clinical trials have found evidence of rebound insomnia after recommended dosages were stopped, albeit for a minority of patients"
This is probably less of a worry in the withdrawal period because the interaction between narcotics and the Innovane won't be an issue if there are no narcotics on board. One might worry about dependence (only sleeping if one has the drug) in this context but often, the entire issue would be not addressed until after the patient is off of the narcotic.
That being said, there is not a huge amount of experience in the literature with Innovane BUT it seems like it probably is less of a problem than valium/ativan/ lorazepan or other full strength benzodiazepines.
It is considered addictive
Detailed Answer:
"Evidence of drug abuse and dependency was found in case reports and small patient series. Dependency symptoms of severe rebound, severe anxiety, tremor, palpitations, tachycardia, and seizures were observed in some patients after withdrawal. Abuse occurred more commonly among patients with previous drug abuse or psychiatric illnesses. Many clinical trials have found evidence of rebound insomnia after recommended dosages were stopped, albeit for a minority of patients"
This is probably less of a worry in the withdrawal period because the interaction between narcotics and the Innovane won't be an issue if there are no narcotics on board. One might worry about dependence (only sleeping if one has the drug) in this context but often, the entire issue would be not addressed until after the patient is off of the narcotic.
That being said, there is not a huge amount of experience in the literature with Innovane BUT it seems like it probably is less of a problem than valium/ativan/ lorazepan or other full strength benzodiazepines.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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