Weaning off pramipexole

[Yakester]

I am weaning off pramipexole under the watch of an internist. Not my internist but someone I saw after hours because I’m desperate to get my meds figured out. I’d been taking hydrocodone for backup and it doesn’t work anymore. So am weaning off the pramipexole and stopped the hydrocodone. I’m also weaning off citalipram. I talked a PA into prescribing some Tylenol 3 to try while waiting for my doc to get back from vacation. My RLS is not under control. I have a neurologist appointment the end of August. What I would like to do is just use an opioid and stay off of protein agonists and antidepressants. I don’t even know who I am off those drugs.

Does anyone have any thoughts. I’m going to be on a boat this weekend for three nights. I am a bit fearful of the nights.

[Joolsg]

Weaning off pramipexole and citalopram at the same time is going to be very, very hard and tylenol (paracetamol) is not going to help much at all.

The hydrocodone will be a much better help at this time. The reason it stopped could simply be because you are taking an anti depressant which worsens RLS or are augmenting on the pramipexole so your RLS symptoms increased.

Perhaps consider stopping the citalopram first as most anti depressants cause/exacerbate RLS. You may find your RLS improves after weaning off citalopram and you could continue with the pramipexole for some years until/unless augmentation hits you.

[Yakester in reply to Joolsg]

Thanks for the input. Weaning off the drugs at the same time was the doctor’s idea/plan. It is so discouraging to me that the doctors will go ahead and treat RLS without much knowledge. I have taken printouts of information to my regular doc but, like I said, he’s on vacation. I don’t know if he read it. I feel the hydrocodone doesn’t work anymore. I have been taking 1-1/2 tablets ( 5-325). Of course I can only get so much a month and have been running out early the last two months. How much would be an appropriate dose? I hate the pramipexole and really feel the need to get off of it. I will reassess the current plan.

Another question. While I wasn’t sleeping last night I looked up RLS specialists in our city. There are a few and they are also rheumatologists. What’s the connection between rheumatogy and RLS?

[Joolsg in reply to Yakester]

There is no connection between rheumatology and RLS. Most RLS specialists are neurologists or sleep specialists.

Hydrocodone is not a drug I’m familiar with ( I know it’s a synthetic opioid ) so I don’t know the correct dose for RLS but for all opioids you should be on the lowest possible dose.

If it’s stopped helping that is either because you have become tolerant ( very likely) or because the anti depressant is making your RLS worse.

Most anti depressants worsen RLS. Trazodone is a safe alternative.

You are on three drugs and it makes no sense to stop them all at the same time. Get off citalopram first and then see how your RLS settles.

You may find you can stay on the pramipexole for a few more years, but look out for signs of Augmentation ( use search box above)

[Madlegs1]

Listen to the lady!!!!

[Hidden]

Tylenol 3 is like co-codamol its, codeine and paracetamol its not a very strong med. I know the Hydrocodone also has acetaminohpen . I would be saying the same as Jools you need to get off one med at the time, and the citalopram should be the first to go. You will i am sure you will have some withdrawals from just one med, and the Pramipexole can give some very bad withdrawals.

[Yakester in reply to Hidden]

When you say withdrawals coming off the citalapram and pramipexole what kind of side effects do you mean? Worsening RLS? I successfully finished weaning off of citalapram and my dose of pramipexole is way down... 0.25 a day. But my RLS is out of control!!!i just moved in with my new guy and it’s so miserable having to deal with this mess. I have an appointment next week with a neurologist if I can stand it that long.