I really would love to try some levorphanol. I'm currently on 10mg methadone TID, and it works well for what its scripted for, however I've become annoyed with some of the side-effects (the excessive sweating for one... I live in TX atm, summer is going to be hell on methadone. The weight gain sucks a dick too). Levorphanol and methadone are seen in the relatively limited scope of articles on RLS (alot of the same info if you google RLS the opioids), but are seen to have the best response for individuals with refractory RLS (daily, severe RLS that starts in the early afternoon - so majority of the day). Of course I'd like to switch from methadone to levorphanol, and yeah, some of it is just wanting to try a new opioid (to me), but having long acting opioids with NMDA-antagonism, some SNRI activity, high oral BA1, and powerful analgesic activity really is important for daily sleep. Both methadone and levo have these properties making them more advantageous for pain outside the realm of somatic pain compared to your traditional opiate derivatives. With methadones analgesic/more pleasurable period only lasting 10-16 hours, and a 24+ hour HL, levo's 6-8 hour analgesic/more pleasurable period for it's 11-16 hour HL makes it seem a little bit more "recreational". Not to mention if the annoying methadone side-effects aren't there, it would be a fantastic change (probably to 2mg QID). Well, I tried to get my doc to switch me onto it for even just a methadone holiday as my insurance will now pay for all of it, but he didn't seem to want to go for it. Didn't seem to want to switch me to any other opioid for a short holiday (even 2 weeks off). Weak. I liked methadone alot more before I started using it daily (more than 2 days in a row the magic fades) /went over 70mg. It used to be my favorite opioid tied with oxymorphone. I was able to nod for about 8-10 hours on 40-50mg, that was fantastic.
Anyway, end ramble. Just pissed cuz I was so close to levorphanol, yet no dice. It looks soooo tasty.
1 - And high BA for other routes, atleast for methadone. I like to filter a soln of methadone pills and administer 150-200uL (.150-.200 mL), it has a more constant BA than oral (It can range as low as 40%), as well as seems to peak ime in 30 mins (seen to be closer to 7-10mins in the article I read and posted around the board). Not sure what the BAs are for the various ROA for levorphanol, but just having good oral BA for an opioid is fantastic, as I rather get the extra duration then a faster come up for opioids in general.