Posted by MIKE L (216.160.236.91) on August 14, 2000 at 18:47:54:
One of the drawbacks of my methadone treatment for clusters and Migrainesis that after 9-10 months of slowly increasing dosage I grow resistant to the meds. When this happens I slowly taper of the methadone 4-5 weeks while substituting MSContin. At this point I am starting to get 2 -3 attacks per day. My Aqtic (fetanyl) is still effective for the breakthroughs relief in 15-20 min.. My migraines usually start up lasting 3-6 weeks with little or no remission. If I could use Imitrex I would'nt have this problem. Imitrex will abort a full blown migraine in about 15 min. During the switch The intensity of the clusters are increased. I usually am down for 4-5 weeks. This time as we started the switch I felt a lot better so didn't decrease the methadone for a while (summer is our busiest time at work) I lasted a couple weeks then I got worse fast. Now I have been down for 7 weeks and am 2/3 done with the switch/methadone holiday and am back to work it will take a few more weeks to be back to my best about (75%). Next time I'll just miss work and not wait so long. Hind sight is always good. I am glad to be back at work and got in 65 hours before my 1st attack and may or may not have a second. When I go back on the methadone I will be able to use 1/2 the previous final dosage and get 9-10 months of decent relief. If anybody uses daily long term opiates ask your Dr. about trying Actiq. It is used for acute cancer breakthrough and for me gives quick relief and allows me back to work in an hour. My Dr. does a lot of cancer patients and doesn't feel that a cluster is less of a reason to use this drug as he thinks the attacks are close or equal to cancer pain Thanks MIKE L