Hi, all. I'm a new member to this great community. I took the name rls_optimist, because I strongly believe there are effective treatments (combinations, in my experience) that will work for everyone. One just has to experiment and never give up hope. And never cease searching out good, expert information (Drs. B, Earley, Winkelman, Allen, etc.)
First, some history: I have moderate-severe RLS, in legs only, so far. I've had it for 11 years. Previously treated with pramipexole, up to 2.5 mg (my GP didn't know better, nor did I). The inevitable augmentation followed. After several 10-14 day washouts over the years (with help from oxycodone, since I don't subscribe to Dr. Earley's needlessly brutal, cold-turkey washout method), I found a knowledgeable neurologist who moved me primarily to 2100 mg gabapentin, with just 0.5 mg pramipexole. Less augmentation, but still some. Now, after one more washout, he moved me to the 2 mg Neupro patch, plus 1800 mg gabapentin. Worked great for 7 days, but then failed. So I've just now started the 3 mg patch, plus the same gabapentin (we're going to try Lyrica instead, soon). So far, so good. I'm cautiously optimistic, recognizing that I may augment on this. No more pramipexole, though. I will also soon be discussing iron infusions with a hematologist. (Oral iron has not helped much; ferritin level got as high as 50, then dropped down to 18 most recently. More evidence for the theory of iron-leaching as possible cause of RLS.)
Now, regarding patch application timing. Have any of you experimented with more than one time of day, and if so, what has worked best for you? (Please also give best number of hours before your time of worst symptoms. For example, mine is just post-bedtime, as I'm drifting off.) Also, location: shoulders seems to work best for me, but that's preliminary.
I apply mine at about 8 AM daily, ~14 hours before bedtime, which seems to work well, but I haven't tried anything much different. I use as a guide the graph that plots rotigotine level in the body, vs. time. It comes in the patient info folded up in each Neupro package (also here: images.rxlist.com/images/rx...). I note that rotigotine level seems to be at maximum in the body around 15-20 hours after application. I also note that there are significant dips near both the beginning and end of the 24 hours. So I'm aiming to time it so it's maximized from bedtime to when I wake up.
Thank you all.