GPs and Augmentation

I was surprised today when my GP said he didn't know about augmentation. Has anyone else found this.He is an excellent doctor though and at least admitted he didn't know this could happen with dopamine agonists.I am goimg to give him some info x

[Rosetta2014]

My GP didn't know anything about augmentation. I found out about augmentation when I mention in a post that she had increased my My pramipexole from 2mg to 3mg and I was alerted about augmentation from our site. I informed her about augmentation and she then turn me over to my pain specialist so he could manage it.

[Hidden in reply to Rosetta2014]

Hi Rosetta, what did the pain specialist recommend? I read you on some strong painkillers do they not help your rls? X

[Rosetta2014 in reply to Hidden]

Hi, p1pp1ns, He cut the dose to 1.5mgs at night and it that doesn't work he is going to as request my insurance to allow me to get mirapex time release they would not pay for it when it was requested by my GP they wanted my pain specialist to determine why my RLS was not being controlled. If the 1.5mg works then he will reduced it to 1mg. because as you stated the pain med. might stop the RLS.

[Hidden]

Mine didn't know either, we all have to educate our doctors about both our disease and all about the effects of dopamine.

[Windwalker]

The mechanism of augmantation isn't very well understood, but it usually happens when a patient says to themselves,''one is good so I will take one more and I will feel a lot better'', so two and then three and

d pretty soon they are taking large doses which overloads the metabolic mechanism and what some doctor call augmentation, may well be overdoses.

I have no scientific training but have many years of observation of the domamine enhancing drugs as well as growing up in Chicago in time when almost anything went without the public health people even knowing anything about it.

I stumbled ''accidentally'' onto a doctor whose practice is 100% sleep and body movement, two closely intertwined subjects. He gets all the really hard cases from Northwestern University Medical center and if the patient will listen and follow, he will usually help them. But remember the doctors here are always fighting the state regulators when they give ''off label'' drugs to anyone.

My doctor doesn't pay much attention to regulators and prescribes off label by slightly twisting facts to fit whatever he wants done. He worries constantly about augmentation, but admits it is a rare occurarance.

[Hidden in reply to Windwalker]

Hi windwalker, I think from what I understand a high proportion of dopamine agonist users get augmentation so wouldn't agree its rare.Unkowing GPs kept raising my doses as lower doses became less effective, Opposite to what they should have been doing!

[Hidden in reply to Windwalker]

Augmentation definately isnt rare, i think almost ALL members on here and on other groups i belong to, have experienced augmentation when taking the dopamine agonists. It can happen within weeks for some people or months and for the luckier ones it can be years. And it can happen on the lowest dose, so its not overdose. It isnt really known why augmentation happens, apart from it seems after a while it turns on the RLS and makes the symptoms alot worse. The more of the dopamine agonist you take to overcome those symptoms to get relief the worse the augmentation becomes. Thats why the dose needs to be kept as low as possible, if it dosent work, then that med needs to be changed. Doctors are the ones who keep upping the doses when a patient complains its not working.

[Hidden in reply to Hidden]

I got augmentation after a 3 month break from mirapex, after 8 nights on a dose of only 0.088, Once you have had augmentation on a particular med it is more likely to happen again and quickly second time around.Some are lucky enough to do a drug holiday then restart med without problems.

[Windwalker in reply to Hidden]

I guess I am lucky. I took Maripex for over 10 years and started having dreams while I was awake. The doc said that was the nature of that drug since it is a dirivitive of ergot (the hippies used it for trips much like LSD.

I have been on Requip since then with vicodin for Fibromylgia. two days ago i switched to 5mg of Methadone in place of the vicodin. We'll see how that works, but I slept two nights in a row----I really needed that too.

The Pharmacist was a bit bitchy when I gave her the prescription but I stayed in character and acted dumb--not too much of a stretch huh!

No Augmentation yet. Don't know how I would handle that. Maybe not well at all.

Windwalker

[nightdancer]

The patient does not have to be thinking "more is better" and act on that thought to get augmentation. It is caused by the meds itself, and if one's doctor thinks you need to up the dose, and he does not know about augmentation, that is what can cause it, too. At some point, many,many RLSer's on these dopamine meds report augmenation at very low doses, following doctor's directions, etc. It can happen after you have been on the same dose for years. When the dopamine meds want to stop working, it is sometimes hard to differentiate between natural progression of RLS and augmentation. Higher dose does not always mean better, in fact it rarely does with any med. But, I just want to make the point that the patient does not HAVE to do anything wrong for augmentation sets in. It can be a combination of a LOT of issues, one being the doctor does not "get" it. So, p1pp1ns, give your doctor all the info you can find on augmentation. Does not surprise me one bit that many doctors have no idea what augmentation with dopamine agonists. They are , sadly, not alone. Way too many uninformed medical professsionals. Sigh........... That is why WE need to do our own research. Can;t count the number of times I have printed things out for my docs.

[gretakmac]

Worse yet, my neurologist didn't!

[Hidden in reply to gretakmac]

Saw mine for first time today and neither did he!

[gretakmac in reply to Hidden]

Mine said "We don't do that here"!!

Pretty clear she did not have a clue.

[Hidden in reply to gretakmac]

omg! Mine just asked what it was then said'Do you want to control your own meds?' I said yes I will come backmin 12 months as ok on current regime.Its unbelievable! Dont do that here ha ha PMSL ! X

[Hidden in reply to gretakmac]

That is so funny. and not so funny, that she said that to you. Sooooo many doctors and so called specialists need more educating on RLS. And seems it is the patients who are educating them.