I want to try Rotigotine patch but worried about w/d's from Dihydocodeine.

[Bossy50]

Hi all, I've had RLS for years and tried all the usual. I'm currently taking Dihydrocodeine bt of course my tolerance has increased and although it works, I'm now sleeping too deeply and for too long which is effecting my life. I have never tried Rotigotine but my Neurologist did suggest it before I found that Codeine hit the spot. He's suggested titrating up to a max dose of 4mg's. However I am really worried about reducing down and coming off opiate as I know the RLS is going to be really bad. Has anyone out there tried to the same I would like to try...and any tips would be VERY gratefully received. My RLS is quite severe...daily from about midday everday all down right hand side of body and sometimes in left leg. Thanks people..

[Hidden]

Stop! 4mg is too high 3mg is meant to be the top dose and some experts would query that.

I've recently stopped the Neupro patch as it was causing augmentation. Since stopping not only have things improved but I think clearer and am much more relaxed - the drug was agitating me but I didn't realise it!

You can always switch between opioids - imho they are the best treatment option. Also you could take the drugs at a different time as that might help with the sleep.

Worth looking into iron supplements also - check out the search engine at top right of page.

[Bossy50 in reply to Hidden]

Thank you...I know it's different for everyone but I agree about Opiods, they have been the best for me too. I'm concerned about the amount I need to take though. It's a high dose. Ideally I'd like to take an 'holiday' from the Dihydrocodeine so I can return to it on a reduced dose but not sure what to take in it's place for the holiday period. I do worry about Rotigotine because I already suffer with anxiety and depression and can imagine I would feel agitated on the patch too.

[davidadill]

The standard dose of codeine when fighting conjunctivitis is 20mg 3 times per day, so I am shocked that your doctor would think the maximum dose should be 4mg per night. I use 24mg each night and currently am getting excellent results (1 RLS problem in the last 9 days). About 2 months ago the efficacy seemed to be wearing off, so I stopped using it for 10 days. I assume that I will have to suffer without it for 10 day periods every few months for the rest of my life. Early on 16mg was working for me, but that is no longer effective. Doctors seem fearful of addiction, but since I am sleeping while it is effective, I see little reason to expect any issues with addiction. The key is to stop when the effectiveness wears off and suffer with the knowledge that things will get better in 10 days.

By the way, when I do have RLS, I run in place for 500 steps. I run about 4 steps per second, so it takes just over 2 minutes to do so. Then I can go back to sleep. I also do that just before going to bed, which may help as well.

[Bossy50 in reply to davidadill]

Sorry maybe I wasn't clear...my Neurologist suggested up to 4mgs of the Rotigotine patch...20mgs of codeine 3 times a day wouldn't touch my RLS. I get it every day/night. I want to come off Dihydrocodeine and go on the patch but the withdrawals make RLS absolutely awful....

[davidadill in reply to Bossy50]

I never have problems during the day probably because I almost never sit more than 20 minutes at a time and I walk an average of 8.7 miles per day. So I only use the 24mg of codeine once each day just before going to sleep.

[thedragon]

All I take for my rls is cocodamol 30/500 . I usually need to take 2 when the symptoms start. Works most times.If I feel I need more, I cut it out and suffer for a few days without.

[Bossy50]

Thank you but Ihave very very severe RLS..I've gone on to Dihydrocodeine as nothing else worked...but the only thing I haven't tried is the patch. So I want to try it but the withdrawals from the DHC will be bad in terms of making the RLS unbearable...

[Hidden in reply to Bossy50]

The patch will offset the withdrawals but in my humble opinion I'd up the DHC or switch to Codeine or Tramadol.

The DA drugs are too severe and imo cause too much hassle to be considered if you can tolerate an opiate.

Did anyone double check were you taking antidepressants, antihistamines or any of the other drugs that make RLS worse? It may be a change of another tablet could ease things for you.

[Bossy50 in reply to Hidden]

Again thank you....I've tried Tramadol and it worked really well for a while, maybe a year and then I got augmentation from it..tried codeine tartrate on it's own and also codeine/paracetamol but neither were effective unless I took very high doses and I felt strung out in the day. I've tried Ropirenol and Pamprexole and Pregablin and Gabapentin...none hit the spot but DHC has worked a treat except atm I'm on 120-180 mgs a day..it's too much but lower doses don't work now because I developed a tolerance....I hate all this. I may try Naltraxone, I've read another Lady on here had a similar situation to me and has had good results.

[LotteM]

I hope you find another med soon. Have you tried or looked into the other opioids, e.g. oxycontin?

And then there are the “illegal” alternatives like kratom and cannabis.

[Bossy50 in reply to LotteM]

I really don't want to try Oxycontin, I think it's a devil drug lol...