Pramipeole

[Hooc]

I want to say a big thank you to everyone who replied to my last post re: neurologist.

I managed to get four hours sleep last night for the first time in two weeks feel a different person not suicdal like I was the previous day.

The only thing I did differently was instead of taking 4x.18 mg Pramipexole I took 3x.18 mg would this have made such a big difference or would it have just been a coincidence ? I must admit I don't understand this disease it never fails to confuse me!

I didn't take a sleeping tablet either last night! For the first time in almost two weeks which usually left me feeling knocked out the next day.

[Graham3196]

Great to hear. I wish you 6 hours tonight and 8 hours the next.

[Herve]

Hello Hooc

I am a long standing sufferer of primary RLS also a retired registered nurse so I have some insight in terms of drug therapy and modes of action.

I know very little of your medical history as far as RLS is concerned so it is very difficult to provide good and reliable advice.

Pramipexole belongs to a group of drugs known as non ergot dopamine agonists; the main role being to supply stimulus to brain neurons and enable improved function. One of the difficulties in starting with dopamine agonists is that the dose at starting medication needs to be very small and graduated slowly upwards until a maintenance dose is reached, usually about 350 mcg x 2 to 3 times daily. The dose you refer to of 18 mg (180 mcg) is relatively small but may well be sufficient in controlling your symptoms.

However, Sometimes patients require additional drug therapy to ensure a good nights sleep. For example, I take Tramadol 50mg x 2 and Clonazepam 5 mg x 2 at night in addition to the Pramipexole which the first dose is taken at around 4 pm.

One of the downsides of long term therapy is that dopamine agonists can cause augmentation i.e. tends to overcompensate and symptoms become worse and can extend to the arms.

Whilst it is working well then best to continue taking, although some neurologists believe that beneficial effect lasts only a few months and drug may require changing to an alternative dopamine agonist.

There are alternative drug therapies but starting with dopamine agonists is considered best approach.

Hope this helps.

Pierre.