Pregabalin dosage

[involuntarydancer]

I take 75mg of pregabalin daily. I still get substantial Rls symptoms which I treat with Kratom.

This system is only partially successful for a variety of reasons and I’d love to find something more reliable.

I wasnt convinced the pregabalin was having much effect but recently noticed that if I forgot to take it my Rls was much worse. Consequently I am considering upping my dose to see if it could deal with my symptoms on its own. My gp works with me and has given me a prescription for a much larger dose of pregabalin. I intend to titrate up very slowly as previously I got unpleasant side effects from it which I suspect was from increasing too fast.

How much do people who use pregabalin alone to treat their symptoms take to control their Rls?

[Joolsg]

Hi ID

sciencedaily.com/releases/2...

This study may help you. The dose of pregabalin in the study was 300mg so you can increase quite a bit. Really hope a higher dose helps you. I think you are doing the right thing increasing slowly. Dr Buchfuhrer suggested I could increase 75mg a week.

Happy Christmas

[LotteM]

There are quite a few studies on the effect of pregabalin on RLS, including several comparing pregabalin with pramipexole. I have pdfs of most on my pc (but on phone now). I think the one in the link of jools is pretty typical in terms of its results, including the average effective dose. One of the general conclusions is also that chance of augmentation was low or non-existent during the study period of about 1 yr, if I remember correctly.

But as always, whatever the results of a study, every individual is different, thus these results only give general guidelines of how the meds may be used.

Anyway, I hope upping the dose only a bit proves to be succesful for you. Sleep well!

[Bganim1947]

This is going to be a long post, so sorry, but it is important to read it through.

It has taken me months to get my Lyrica dosage just right, but finally I got it working perfectly--no more RLS at all.

As many of you who been on this forum for some time know, I have gone through a horrendous journey since last January with severe augmentation due to a neurologist who overdosed me significantly on Extended Release Ropinerole, taking me from 2 mgs to 12 mgs in 3 months. With the help of the wonderful, caring, and knowledgable folks here, I was guided to titrate down off Ropinerole, which was hell, but I'm so glad I did it. I also had to titrate off Gabapentin--I was up to 1800 mgs to 2400 mgs a day, and it wasn't helping.

I was slowly titrated onto Lyrica, starting with 100 mgs once a day for a week by my GP, and 100 mgs of Tramadol. Then she increased it to 100 mgs twice a day, and another 100 mgs of Tramadol, then finally up to 3 times a day with another 100 mgs of a Tramadol. The Lyrica worked much better than either the gabapenten or the Ropinerole, but I was still getting occasional unpredictable bouts of RLS in one leg or the other in the afternoon, evening, or at night. WhenI got up to 100 mgs of Lyrica 3 times a day, combined with 100 mgs of Tramadol 3 times a day, it was mostly gone.

But, and here is the big BUT! I finally figured out how to get the Lyrica to work consistently and perfectly every day, with no RLS at all by being perfectly consistent in the times of my dosage every day.

One day I decided to look online to check out the half-life of Lyrica. It is 7 hours, which means that in 7 hours it was out of my system. So I worked out a daily schedule taking every dose exactly 7 hours apart. I took my first morning dose of Lyrica at 8 AM with my 100 mg dose of Tramadol. Then I took the second dose of 100 mgs of Lyrica and 100 mgs of Tramadol exactly 7 hours later at 3 PM; and the third and final dose of 100 mgs of Lyrica and 100 mgs of Tramadol at 10 PM. It worked like a charm. Whenever I accidentally forgot and took one dose even a half hour later, I got a mild form of RLS.

One day I really forgot and missed my afternoon dose by 2 hours, and got an even stronger bout of RLS. But being on the Lyrica made the bouts I did get much more mild and tolerable than when I wasn't taking it.

I recently got in to see a movement RLS specialist after a three month wait for an appointment. After explaining to her what I had been through, and what I was doing now by timing out my Lyrica doses in 7 hour increments, she said I was doing it exactly right. In three or four months she thought she might be able to slowly cut me back on the Tramadol without jeopardizing my treatment.

When I asked if I should increase my Lyrica dosage at any point, she said Lyrica works best at lower doses. She also said that 300 mgs is the standard dose for RLS.

So my advice to Involuntary Dancer and others questioning the efface of Lyrica is to find the dosage that works then take each dose exactly 7 hours apart.

[involuntarydancer]

Thanks for your detailed answer, Bganim. I well remember your courageous struggle when you were coming off ropinerole as well as my shock when you first told us how high a dose you were on. Also, a more recent post of yours regarding pregabalin was one of the reasons I started to think again about it. However, there are a couple of differences between your system and my situation.

I am lucky in that I don’t usually suffer Rls in the daytime. Only at night. In that situation is it so important to spread the dose through the 24 hours? Would it not be better for me to target the full amount at the night time hours?

Also I am reluctant to take opioids as I develop central sleep apnea so tramadol is not an option I wish to entertain presently. I suppose I could use Kratom in place of your Tramadol. I was hoping that the lyrica would work without much in the way of additional drugs. I hope you will keep us posted about how things go if you reduce/eliminate tramadol.

[LotteM]

Hi Barbara, well done to you for your persistence. And I am glad you have an apparently knowledgeable doctor. And indeed, it would be good if you will be able to cut down the tramadol at some point, as by now you will have heard that also tramadol has a -low- chance of augmentation; and the higher the dose the higher that chance.

Just wondering, I only get rls at night and in the evening, thus I only take my meds in the evening (8PM and c. 10.30PM). I think many do. Do you take your meds spread out over the day, because you had all day rls?

[wairoa36]

I was very interested in your account of your use of lyrica.

I only have rls in the evening and night.So I take pramipexole 0.25 mg at 4.30 pm.

Then 1 pramipexole same dose plus 1lyrica75mg at 7.30 pm

At bedtime, which varies I take 2 lyrica plus either I tramadol or 2 tramadol.

Sometimes I take temazepam instead of the tramadol as my gp will not always give it to me , which is infuriating.

This regimen gives me pretty good relief but the very best was OxyContin.This gave excellent coverage with no side effects but I cannot get it.I live in Australia currently.

I also need to watch my diet especially in the evening.

No sweet things, no tea or coffee after about 3pm, no alcohol.

I hope this helps.

[Ikeeptrying]

Is it possible the Tramadol is the drug that is so effective against rls? My neuro won't give it to me as I live in the states and I'm sure you're aware of the war on opiods being staged here. It doesn't matter if it's appropriate or not. Grrrr...

[involuntarydancer in reply to Ikeeptrying]

Yes; I too wonder if it is the tramadol that is affording the relief - or is at least the dominant partner.

I can’t take opioids as they induce central sleep apnea (I really want to avoid the mask) but feel for anyone trying to live with this disease in a country where an effective treatment is not available.