Pramipexole alternative.

[JenniferG]

Hi, I recently came off pramipexole after I started experiencing aching joints, and dizziness. I took tramadol for around 6weeks and got some amazing sleep. The tramadol is no longer working and I don't want to increase the dosage as it spaces me out the follwoing day, so I'm back on pramipexole. I know it will only be a few weeks before all the symptoms from the pramipexole come back so hoping to switch back to tramodol and keep going back and forth. Does anyone else do this, or have any alternative ideas?

[Hidden]

Hi JenniferG, Some people do what you are doing, its called a drug holiday. Where you take a rest from a med that is not working and use a different one for a few weeks. It can help to do that, i have done it myself. swapping from using the Neupro Patch to Pramipexole and back again. But if the Pramipexole is giving you bad side effects then maybe you need to try something different.

rlshelp.org the treatment page gives a list of medications used for RLS, its a USA based website, but most of the medications are used also in the UK.

[JenniferG in reply to Hidden]

Great thanks Elisse, I thinki ought to try the neupro patch next as it seems to get some good reviews on here. Thanks for your help. My doctor is useless so it will be good to go to them with a list of the meds.

[Pete-1]

There are alternative "Dopamine agonist's. the following list is taken from the wikipedia page on Dopamine agonists In practice there probably isn't much to choose between them or some of them anyway?

Agonists of full/unknown efficacy[edit]

Adderall(ADHD stimulant drug)

Apomorphine (Apokyn) (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Bromocriptine (Parlodel) (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Cabergoline (Dostinex) (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Ciladopa (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Dextroamphetamine/Dexedrine (ADHD stimulant drug)

Dihydrexidine (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Dinapsoline (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Doxanthrine (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Epicriptine (Similar to those of Bromocriptine) (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Lisuride (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Pergolide (Dopamine Agonist for Parkinson's disease/Restless leg syndrome) (Permax) - Removed from the market in the USA March 29, 2007.[6]

Piribedil (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Pramipexole (Dopamine Agonist for Parkinson's disease/Restless leg syndrome) (Mirapex and Sifrol)

Propylnorapomorphine (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Quinagolide (Norprolac) (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Methylphenidate (Ritalin) (ADHD stimulant drug,has also been used in treatment of Parkinson's disease)[7]

Ropinirole (Dopamine Agonist for Parkinson's disease/Restless leg syndrome) (Requip)

Rotigotine (Dopamine Agonist for Parkinson's disease/Restless leg syndrome) (Neupro)

Roxindole (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Sumanirole (Dopamine Agonist for Parkinson's disease/Restless leg syndrome)

Lisdexamphetamine (Vyvanse) (First-ever ADHD stimulant Pro-drug)[8]

Some, such as fenoldopam, are selective for dopamine receptor D1.[9]

[JenniferG in reply to Pete-1]

Thanks pete, will discuss these with my doctor.

[funnyfennel]

Just a thought..I have been tested for vitamin D and am very low. Deficiency can cause aches and pains, and sleep disturbance. Am hoping in a month or so, with prescription x800 4 times daily, it may help my RLS, Like you, I take x2 pra

mipexole or 3 per day and then sometimes tramadol, or temazepam. or co-codamol. They all seem to help but not reliably, allowing at least some sleep sometimes!! Dr. Chaudhuri seems in favour of a change in medication and adding on sometimes. This way you can avoid just increasing the dosage of the dopamine drug.

[JenniferG in reply to funnyfennel]

Is Dr chaudhuri in the uk or USA? I asked my doctor about seeing a specialist and she told me there was no one. My doc also doesn't seem interested in running any tests, I think they tested my iron levels once and that was it.

[Hidden in reply to JenniferG]

Dr Chaudhuri is in the UK. Jennifer you will probably need to ask your doctor for a ferrtitin level test. That is the test you need to see if your level is low for someone who has RLS. It should read 50-70 for us. Taking iron pills might help, or might not. but worth trying if your ferritin level is below the numbers i have stated. Lots of info on here about ferritin levels and iron pills, Put it in the search on here, and it will show the posts. There are Neuro's and there should be one at your local hospital, they deal with all movement disorders and should know about RLS, i would ask your doctor again about seeing one.

[JenniferG in reply to Hidden]

Thanks ever so much for all your replies. I feel as though I have something to work with now and know where to go from here.

[funnyfennel in reply to JenniferG]

In fact, having been to London once to the RLS clinic, I was very dissapointed, and felt that they were only interested in collecting stats. they changed me from ropinorole to rotigitine patches which caused so much skin irritation, but were quite effective otherwise as they did not make me as sleepy and lethargic. But I wrote to Mr Chaudhuri and had a telephone consultation and am now on pramipexole etc as I said. The vit D test was done by my doctor at my request.Hope this helps.

[JenniferG in reply to funnyfennel]

Thanks for the advice. My rls was on and off for a few yrs but the minute I got pregnant that was it, it became horrendous and hasn't gone away since having my son. i am sure i have become deficient in something and hope it can be corrected so that i can try for another baby so I really want to get away form all the meds. I'll ask for a VIT D, iron and ferritin levels to be tested tomorrow. Hopefully there is an imbalance that can be corrected, I've just got to find it!

[Grammieof4 in reply to JenniferG]

There is a specialist at Hopkins - Dr. Christopher Early. There is a 6-7 month waiting time to see him.

[Hidden in reply to funnyfennel]

Jen- I am living testimony to the fact that low vit D can cause some real pain.

I am on 50,000 units of D3 per day...yes, that's right, per day..

What a huge difference after 4 months it made for body pain. I live far in the northern hemisphere where we get minimal sunlight and extremely cold winters. For 6 months out of the year, I tend to spend less and less time outdoors as I settle in on middle ages..at least during those months and in summer, I cut down to taking that dose 2 days per week because I am outdoors and in the sun as much as possible. It will be a true test to see if it stays this way of reducing my body pain because the days are much shorter and the winter is here already.. I will be indoors most of the time until mid may of next year. (how depressing) but we stay where the jobs are and the economy is starting to bounce back....or so they say that..(not much evidence yet) I live in Wisconsin, USA.-the great lakes region.. X Karen

[Hidden]

You do know that a combination of the two are pretty effective in treating RLS. You can take the pramipexole and make the necessary adjustments to the dosage/time/formula - meaning extended release vs regular pramipexole and use the tramadol for those times when rls looks to be winning the sleep/rest battle. Many times just one drug is not enough. I know all about the trade-off of being tired, feeling spacey and out of it but hopefully the body will begin to adjust to the pramipexole and the head in the clouds feeling will dissipate, at least enough to get by.. I think that if you are going to medicate, you will suffer some of those side effects so deciding the trade-off is what you must do.

You can always try it and if it gets too be too hard, change your mind or your dosage.