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Nuvigil / Methadone

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Comments Submitted Says:
 
My husband has Narcolepsy and has started taking Nuvigil. He has been on Methadone for almost two months now.H e complains that he feels bad by evening time. Is it one of the drugs or mixing them? He also takes Vivactil and Ritalin. He feels jittery, tired and nausated. Please help.

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anon Says:
 
Speaking from personal experience... Ritalin and Provigil didn't mix for me. Granted that was Provigil.

I've recently started Nuvigil, and can not tell if I am having holiday anxiety or a reaction to my Nuvigil. My feeling is slight pressurized headache, tightness in chest, mild vision blur, very pressurized feeling in chest and sides of throat and anxiety. Checked my BP and is 180/80. Norm for me is around 130/85 w/bistolic. He may want to monitor his BP if he's feeling tired and nauseous

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2
Abhay Singh Says:
 
meth is not long acting opiate,bad mood in d evening is bcos of d meth high goin down...brk meth into two dosages,take 2 times a day,it shud help d mood disorder...tho m nt sure abt d addiction risk,waise if he is on it for 1 month,it shdnt matter

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Clarince Says:
 
methadone is even in low dosages a drug that has a very long half-life, hence I do not agree. What I will say having narcolepsy and having taking Nuvigil(had to stop when started low dose methadone for pain because of the interaction) is that there are both indirect and direct ones. Directly Nuvigil induces one of methadones multiple enzymatic pathways, hence quickly eliminating METHADONE from the system faster. It also indirectly has an impact aside from elimination in that it counteracts therapeutic effects of methadone such as pain relief and analgesis. While methadone has compared to other pain killers(semi and pure opiates) much less analgesic effects, especially when used for chronic pain, it still possess some. Nuvigil is not like Adderall or other stimulants. it does not release dopamine, but rather it seems(albeit can't find any proof since pharm company that makes it will never give this information out, which is quite disturbing) The reality is it eliminates methadone from body faster, and therefore can negatively impact by increasing pain being unmasked and even precipitating withdrawals if on even low dose methadone for some people even a month!! Therefore, Nuvigil or Provigil block many of the therapeutic value of such a pain killer like methadone. Methadone is not instand release, it has very long activity but that is why it could be useful for chronic pain sufferers. Any medication that acts in releasing histamine only negatively synergizes with pain killers histaminergic activity, causing itchiness. Anti-histamines not histaminergic drugs like Nuvigil or Provigl could be used with analgesics. it's why these so called "awakening agents" are very bad and yet poorly emphasized and elaborated in the mainstream which is hurting patients like the one discussed. I feel badly for your husband and hope he finds a doctor who does understand the mechanisms behind the interactions with these drugs and can compassionately help him!

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