Antidepressant to wean off Pramipexole???

[lbrosa]

I saw my GP yesterday to discuss help with weaning off Pramipexole. I gave her a list of the various meds I had tried over the last few years with no success! She had given me Tramadol before but it does nothing for me...it does not help with pain nor RLS for me. I asked if I could try Methadone as I read that it has properties that can be effective for RLS as well as pain. She informed me she does not write scripts for Methadone and that I would need to see a Neurologist. She will get me a referral but in the meantime she asked if I would like to try Nortriptyline that some of her RLS patients found it helpful. I asked about side effects and she said the worse should be drowsiness so I told her I would give it a try. She said I could start it right away along with weaning down the Pramipexole so I took one last night...what a night I had ... no sleep, worse RLS as well as pain in my back and legs. Back to square one!

[LotteM]

Ho lbrosa, nortryptyline is a tricyclic antidepressant and definitely one that is very likely to worsen rls. See the issue on antidepressant medication on the site rlshelp.prg by Dr Buchfuhrer.

Have you discussed oxycontin or targinact with your gp? One of those - I don’t recall which one - is actually licensed in UK for rls. And oxycodon, the opioid in both meds, is a stronger opioid than tramadol. Keep searching and discussing with your gp and keep posting. Good luck. But do realise than weaning down pramipexole will temporarily increase your symptoms. Can’t be helped, only suppressed to some extent with the appropiate meds.

[lbrosa in reply to LotteM]

Thank You LotteM...I read somewhere "Nortriptyline is mentioned in dr B's book as POSSIBLY RLS friendly; not a remedy for RLS.

" I will check with GP on Oxycodon...but I suspect she does not do scripts for anything stronger than Tramadol. Thanks for your encouragement...I definitely keep searching as well as posting results! My Dad had RLS also and his GP tried him on Sinemet and it did not help him so he suffered many years with no medicine to help (I do not know how he stood it)...once he got in his 90's he no longer had RLS...he lived to 96!

[Madlegs1 in reply to lbrosa]

Check out Clonidine.

[lbrosa in reply to Madlegs1]

Thank You Madlegs1...I will check it out! Have you used it?

[Madlegs1 in reply to lbrosa]

Yes- I found it very helpful for the last few days coming off Fentanyl. Also used valium 2gm as well. Both these are quite potent and should only be used for not more than a few days .

Good luck.

[M_argi]

I have this week been taken off pramipexole that have been on for around 18 months ,with no guidance to wean just replace with neupro patch and lorazepam for breakthrough RLS. I can say it worked out terribly ,as the patches caused me to not sleep at all for a week and the lorazepam (which I took sparingly) caused symptoms that I can only describe as being a clumsy (still yet irritated by rls) zombie ! So now I have no pramipexole, am just off them and kinda wingin it using a very small dose of oramorph in the evening ,if i take it in good time it does stop the rls from taking hold ,so a visit to the Dr is on the cards yet again .

[Kayakcarole]

I took half dose Pramipexole for 4 nights to wean off and they were bad nights. Then my (LDN) Low Dose Naltrexone arrived! I took 2 pills along with my half dose and slept beautifully! No symptoms! Anyone else try LDN?

[eglimark in reply to Kayakcarole]

Would like to hear how that goes for you. Apparently not FDA approve here in the US, but few side effects and no withdrawal.

[lbrosa]

I am also very interested in hearing more about patients with RLS using Low Dose Naltrexone! This could be SO helpful for so many of us with RLS. Thanks, kayakcarole for sharing and please keep us posted!

[Kayakcarole]

After 3 nights now I a man very excited. The first 2 nights I combined it with my half dose Pramipexole ( 1/4 of a .25 mg tablet ) and it worked beautifully. Last night I tried without the Pramipexole and had to get up with a crazy leg at 1:30 am. Took my Pramipexole then, also my Hyland’s homeopathic Restfull Legs sublingual tabs and NightTime Leg Calm essential oil on my low back, then went back to bed and was much better t morning. Guess I will continue the very low dose of Pramipexole with the evening dose of Naltrexone. This is a prescription that is compounded for me at a pharmacy. No side effects yet.

[lbrosa in reply to Kayakcarole]

WOW...that sounds very encouraging! May I ask if you are in the US and, if so, do you have a local pharmacy that makes your LDN? I live in central Florida. I will be down to 1/4 of a .25mg Pramipexole tonight and am dreading what my night might be like! Thanks, Linda

[Kayakcarole in reply to lbrosa]

I live in Wisconsin. You need to get this Rx from a compounding Pharmacy. I just called mine and they suggested you call your insurance company to ask which compounding pharmacy near you they would cover. Then ask your physician to write you a script. My Dr. said LDN for RLS does not have to be given incrementally. The doseage she gave me is 2.5 mg and to take 2 capsules daily. I will continue to take 1/4 pill of Pramipexole daily with it. Good luck.

[lbrosa in reply to Kayakcarole]

Thanks Kayakcarole, How long will you have to continue the 1/4 Pramipexole? Do you think the LDN will take care of the RLS after you quit the Pramipexole? I have already found that the privately owned and operated pharmacy in our little town is a compounding pharmacy and it is my insurance network. I will be pursuing this route as soon as I can get an appointment with my Dr. THANKS again and Good Luck to you! Linda

[Kayakcarole in reply to lbrosa]

Good for you! That was quick!!

Time will tell if I need to continue the 1/4 Mirapex or can give it up. My understanding is that the threat of augmentation goes way down with such a low dose. I would love to drop it altogether but have a car trip to AZ and a flight to Spain coming up. I need all the help I can get for both!

Good luck to you. Keep me posted.

[lbrosa in reply to Kayakcarole]

I understand...I would also continue the 1/4 tablet at least until your trips have been completed. I wish you luck and happy, safe travels! I am following your pill schedule and it is working well for me so far! I am down to 1/4 tablet and tonight will be my 3rd night on 1/4 tablet. My GP said it should only take 3-4 nights on each decrease but I think I will stay on 1/4 tablet longer than that before trying to go without the Pramipexole all together! Have a BEAUTIFUL day, Linda