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Restless Legs Syndrome
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Taking Lyrica 300mg mornings with Lyrica 150mg nights

Hi I'm Steve a first-timer here! For past 3 months I have been taking Lyrica 150mg at night and 150mg mornings. I have had RLS for 12 years. Partial benefits with RLS symptoms; also getting some relief with trapeze nerve pain associated with childhood whiplash injury and nowadays degeneration of spinal discs C4 and C5 and C5 and C6. I had 7 Lyrica 150mg capsules spare and recently decided to experiment with taking 300mg mornings together with Lyrica 150mg at night. Definite improving outcomes with both conditions for that week. Am now considering asking MD to prescribe accordingly. Before I do though, I am keen to consider the advice of other persons with experience of taking same or similar differential daily dosages of Lyrica, please. Many thanks. S

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My GP would be of the thinking that Lyrica for RLS only starts being effective at the 150mg twice a day dose. I think it would be fair enough to ask the Dr to increase but be careful about saying you were experimenting on your own as it could scare the Dr a bit that you could potential misuse.

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Hey Rafs, thanks for the heads up. Totally agree with you about being "careful". Will do so definitely! It was the psych dr who told me in March that only through 'trial and error' would "we" find the right meds for me. I was having TMS (transcranial magnetic stimulation) therapy as Inpatient under his supervision. He said of themselves the TMS + ritalin 2 x 30mgs I also take won't be enough to get me past debilitating symptoms of PTSD. Am having further round of 20 TMS treatments over Xmas so will be back under psych dr's supervision. My MD knows about the 'trial and error' advice by psych dr. But as with all drs will 'proceed with caution'. Just wanted to know before I ask if anyone else is taking differential doses of Lyrica AM and PM and to what effect. Thanks, Steve

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Hi, Schwaerts, and welcome. I second most of what's been said so far, and want to add a little.

First, to get back to your original question about Lyrica: I take 300 mg/day, along with the Neupro patch. That 300 is now not sufficient to quell my RLS symptoms, so I may be asking for more. I agree with Raffs that 300 may not be enough, but to proceed with caution. Partly because Lyrica has its own set of side effects. If you go from 150 to 300 in the AM, you may experience more sedation during the day. Also, if you do that, I'd follow the recommendations to increase by 75, wait 3-7 days, then another 75.

Second, other meds: You have a complex situation, which entails a number of medications for things other than RLS. Two of those are known to aggravate RLS: doxepin (as Pippin said), and Ritalin. It is certainly not my place or intent to question your drug regimen. But I'll just quote the section on AD meds from Dr. Buchfuerer's very helpful website rlshelp.org , from the Treatments page:

"The oldest antidepressants, the tricyclics, tend to worsen RLS more than they help. The SSRI's will worsen RLS more often than helping but they seem better tolerated than the tricyclics. There is only one antidepressant drug, Wellbutrin, which has dopamine like effects, so it may benefit RLS. This however, has not been looked at systematically yet, although there are some case reports of Wellbutrin helping RLS. Trazadone may not help RLS but it does not seem to worsen the condition."

Good luck.

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Could you be in an augmenting (paradoxical response) situation with your meds? It’s hard to determine, and a real bummer, but rather than just increase those potent meds, I’d consider it.

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Thanks, Mona. You are right to suggest being cautious. I'm now leaning towards keeping the pregabalin where it is. I take 300 mg each evening, plus the 3 mg Neupro patch, applied in AM. Re: augmentation: I was on pramipexole for 11 years, at ever-increasing doses, up to 2.5 mg, prescribed by my GP (that's an all-too-common story here, isn't it?). I definitely augmented on that. After a 14-day washout with oxycodone, I got that down to 0.5 mg plus lots of gabapentin. Worked okay, but lots of evening sedation. So I tried the patch, first 2 mg, then 3. I'm pretty sure I've augmented on that, too. I also switched from gabapentin to pregabalin, on advice that it's better absorbed. I'll stick with my 300 mg pregabalin plus the patch for now, with 5 mg methadone occasionally as rescue drug. I've just gotten an iron infusion, so I think it's best to keep meds as they are, to assess effect of iron, if any.

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Hi RLSOptimist. Am finding no such daytime sedation with Lyrica, yet it DOES improve sleep. I HATE needing to take drugs. FULLSTOP! Am befuddled that am able to experience NO adverse effects taking some drugs, particularly Ritalin, and thus far Lyrica as well, but have ABSOLUTE intolerance of SSRI meds, some of which I was prescribed caused me permanent harm. EG Taking just 1 Lexapro pill left me with a permanent hearing impairment. Must add, my advice to all is, if a doctor prescribes you Zyprexa, change doctors! Taking this junk for 5 months 2007 led to massive weight gain with NO dietary changes; nowadays permanent obesity. Last year it took all that I had to constrain impulse to bash the daylights out of psych dr who for 4 months 2006 had me on Seroquel 50MGS PM = horrific nightmares that continued well into daytime hours, each and every following day, with psych dr arrogantly refusing to heed my concerns. The dude bilked me for 14 minutes each of the 8 half hour sessions I saw him. Was billed for "consultations no longer than 30 minutes, no less than 15 minutes". There was no 9th consult and yes, I did NOT pay him for the 8th!! Steve

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Hi Steve, that TMS is very interesting I've looked into it myself but there are no diy machines in Ireland. I wish you well with it and look forward to hearing of your success at Christmas.

Want to +1 on the post from rls_optimist too.

On the PTSD might be worth looking into EFT. I was involved in an incident that left me traumatised insomuch as I would often find it intruding in my thoughts and creating a lot of anxiety and near panic. My friend had learned how to do the EFT tapping and when I told him of my situation he asked to try out his new technique - less than 15 minutes later I was sorted no more anxiety or worry it eased to intrude in my thoughts even after I would deliberately think about it when I stopped the thoughts stopped. I was gobsmacked at the speed at which I found relief. Just saying might be worth looking into.

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That’s a generally typical response to EFT (I’m trained in it) done by a good practitioner. EMDR is also excellent.

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Amazing stuff that should be utilised by the health service instead of going down the antidepressant/drug route imho.

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(Hey guys, can I join in?)

Mona: Being trained in EFT, does that make you an EFT therapist? I think that’s neat, espiecally since I’m very interested in all aspects of psychology (that is, except when it’s being used on me in relation to the entire syndrome of RLS🤨). My mother went to a few therapy sessions where she was introduced to EMDR therapy. Does that mean that she went to an EMDR therapist, an EFT therapist, or are they one in the same? I am really curious, so thanks for yout reply!

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Hi Jess,

No, I’m not an EFT therapist, though I do have the training. EMDR is another very successful practice that’s hard to explain why it works, but it does, for many people. Bth EMDR and EFT are complementary therapy modalities that many therapists have trained in, some receive certification, and some specialize in one or both of them. EFT especially is easy to learn, with attention paid to the set-up and formation of the issue being released. EMDR is amazing - and can be done at home, also. Both are potentially very powerful so I recommend using them with a trained specialist first, until you know your way around your own issues and reactions. Your Mom may have seen an EFT or EMDR specialist, but not necessarily. Kudos to you for your curiosity!

EMDR and EFT are not fast, in dealing with core issues, but either can be a quick way to relieve excess energy around emotionally intense issues. That makes it easier to work with any residual memories or understandings.

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What is EFT, pardon my ignorance, Raffs; also Mona23 what is EMDR? Thanx from Steve

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EFT is 'Emotional Freedom Techniques'. It is a very precise way of tapping, with the fingertips, on specific points on the head and face, the hands, chest and trunk, while repeating phrases.

You will find it on YouTube, and it has its own website and Facebook page, no doubt.

It works for many people, for many issues, very fast.

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Many thanks, Parminter. This sounds VERY promising and I shall follow the leads you have provided. Reading the words "emotional" and "freedom" combined caused instant excitement!! Like, WOW!!!

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As Parminter said EFT is a tapping therapy that works on energy points and is imho one of hte quickest most effective treatments for anxiety producing thoughts/incidents.

EMDR - Eye Movement Desensitization Reprocessing - in which the person being treated is asked to recall distressing images while generating one type of bilateral sensory input, such as side-to-side eye movements or hand tapping, (similar to EFT as the distressing thoughts are recalled and made harmless).

I've read up on EMDR - it normally is carried out by Cognitive Behavioural Therapists, but never seen it carried out it seems like another version of EFT but without the fast results, (although the medical profession would argue the other way).

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Thank you so much Raffs. I shall similarly 'read up' on these therapies. I am familiar with CBT; personally I find ACT, IE ACCEPTANCE and COMMITMENT therapy more useful. Am presuming everybody knows all about "mindfulness". Due to inner ear impairment there can be no 'quiet meditation' for me; practicing mindfulness can be a challenge; when feeling well enough I will sit upright in a chair that has good spinal support, with Chillout tunes playing softly in the background. My purpose here is concentrating on gently inhaling, breathing deeply through the nose and actually feeling the air as it enters the nostrils. At the same time 'imagining' this incoming air as soothing BLUE light, then, as the air is on its way into the lungs and through the diaphragm, 'imagining' healing WHITE light is flooding my brain and extending to bodily extremities. Then, after some very slight pause, I imagine RED light softly exhaling through the mouth, experiencing the expulsion of toxic air, feeling the escaping air on my lips. Breathing normally and deeply as I repeat the process. Meanwhile, any and every thought that comes into my mind I allow to simply come and go. And when becoming aware my mind is starting to dwell on any thoughts, good, bad or otherwise, the trick is to gently return to concentrating on the BLUE-WHITE-RED light deep breathing sequence. Frequently I am too restless or too depressed to simply put on some tunes and settle myself in the chair. The above breathing technique was a beneficial outcome of CBT psychotherapy and is definitely worth having a go at! Thanks again for this new info. Steve

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That’s fascinating, Steve! I find CBT effective for me as well.

(Btw, hi I’m Jessica, I’m going to join in here if you don’t mind)

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All the therapies being mentioned in this thread are excellent and have their place. Finding out what works for each individual is one of the arts of being a good therapist - and client. Anyone can read up on these methods and make use of them, but for deeper or more complex issues, please work with a someone - none of us can have the amount of perspective on ourselves that we can get with the help of a therapist. And perspective is necessary for healing.

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We need an objective outsider in order to fully see ourselves:

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EMDR is NOT another version of EFT. They’re very different, though both work energetically. I’ve used EFT on myself with slower results; I’ve used it with clients with quick results; and I’ve used what we now call EMDR on myself (before I knew it existed), accidentally, with immediate results. So neither is fast on everybody. The idea behind the movements in EMDR is crossing the midline, which changes brain chemistry so there is less “charge” to the memories. EFT tapping shifts energy around like some forms of massage can do. After either is used, there are often issues still to deal with. The memories have a lower emotional charge, so can be addressed effectively.

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Hi, I have no experience with Lyrica. Do you mind my asking if that is the only thing you have ever taken for RLS? I was on dopamine agonists but developed augmentation and had to withdrawal from them. I currently take 10 mg methadone at night for rls but getting it is becoming more and more difficult here in the United States and I fear it may become impossible. Lyrica would be so much easier. By "partial benefits", are you getting enough relief that you get a reasonable amount of sleep and the symptoms are manageable? I'm looking for alternatives to the methadone. Thank you.

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Hi Cats! Until recently only meds I've taken for RLS is Clozzy 4mg (being a Benzo that I think some said was = to 20mg Vallies - but not 100% sure of the equivalent strength). I am recovering from PTSD and had insomnia really bad due to this. Had been getting reasonable sleep before this. Started taking 50mg Doxepin (Sinequen - a 'first gen' psychotropic drug) in May and this together with 150mg Lyrica is enabling reasonably restful sleep. The 'partial benefits' refers to daytime RLS symptoms. Have no experience Methadone but folks who do have told me it is a shitty drug. Maybe ask your MD to consider prescribing my night time combo? Probably will start you on 25mg Doxepin and 75mg Lyrica. Steve

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Thank you for getting back to me! I think I will talk to my neuro about this Doxepin/Lyrica regimen. I feel like my problem is two fold - there is the RLS but there is also the "can't shut off my brain" problem. It is an anxiety that I am going to bed and I still have so much I didn't finish that day. I sleep a whole lot better on vacation when I CAN'T work. I have not had any problems with the methadone - it is just that our government is so paranoid about it and each administration gets worse.

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Cool. I do think it's worth a shot to ask your neuro about it and will be interested to find out how you go with this. It was psych dr who started me on both Doxepin 25mg and Lyrica 75mg x 2. It was my regular MD who increased the dosages to 50mg and 2 x 150mg. S

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Thank you so much for the information. I don't see him again until January but he is very understanding about the difficulties of getting methadone and was willing to work with me on my unsuccessful attempt to switch totally to gabapentin so I'm hopeful. I keep thinking this may all get a bit better when I retire as well.

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Hi Catz doxepin is a tricyclic AD so would usually make RLS much worse .Just a word of caution x

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Hi Pippins2, thank you. I appreciate the information. I am hoping that the study I am in will show the crazy US government that methadone does have it's good uses... like RLS. It works like a charm for me and the current government antics regarding opioids are the only thing making me consider a change. "Opioid" is the current buzzword.

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Schwaerts, my experience of methadone is wholly to the good, apart from constipation, which can be dealt with. It is considered amongst the best of the opioids for RLS sufferers, by the best minds in the business. 5mg to 10mg.

For both insomnia, RLS and PTSD, consider Pratsiol, aka Prazosin. It is nominally a BP med, but it is used off-label for war vets. And me, not a war vet. It can do good very things for sleep.

As can Persantin, an anti-platelet aggregator, also used off-label to increase levels of adenosine in the brain. If you have RLS and PTSD, as do I, you do not have much adenosine. You can pretty much take that to the bank.

Take the greatest care with benzos, they are not your friend.

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Are you taking Persantin, Parminter?

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Thanks for this info P'minter; interesting your comments about methadone; good to have this to balance negative opinions I've heard! Will definitely look into Prazosin, especially given the comment re nightmares by IvDancer, thanks a bunch to you both! Update: I saw regular MD Monday who has 'bumped-up' Ritalin to 2 x 40mgs. I asked about upping the Lyrica dosage as well and was told "we can do this, but best not to increase both drugs together". So, 2 x Lyrica 225MGS is in the offing, perhaps differential dosage to follow after that. Three days into Ritalin @ 2 x 40MGS and obtaining improving mood state and better control over ADD-like predispositions I have, especially 'distractions to concentration', which come and go and also 'impulsiveness' to act first before considering possible consequences. The latter having wreaked havoc throughout my life from age 12 until I obtained reliable diagnosis for my condition in 2013. Government authorisation for me to use Ritalin followed. Benzos DEFINITELY suck. Withdrawal from 7 'bricks' IE 7x2MGS Xananx daily was THE worst!

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I have seen one or two people posting that prazosin has been prescribed for their rls and it was doing some good. My understanding is it is also used for ptsd - specifically to help with nightmares. It might be worth looking into.

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Prazosin has been very helpful for me.

My thought was this - that if RLS, ADHD and PTSD all have a thinning of the somatosensory cortex in common, and therefore hyperarousal, then Prazosin was a slam-dunk.

At the moment supplies where I am have run out, and the difference is very noticeable indeed.

The dose ranges from 2mg to 20 mg, so you can titrate away with a large safety margin. And it is short-acting. I take 2mg at bedtime, or a bit before, then another 1mg during the night.

Also, as PLMS and its accompanying rapid rise in BP during the night, possibly hundreds of times, is the cause of our higher rates of CVD, it would also assist with that lurking monster.

Do try it.

Just beware the first 1mg dose, there is a syncope. Just once.

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Thanks, Parminter. An interesting and knowledgeable post, as always. Prazosin sounds intriguing. I’d love to know in what way it helps you. Does it reduce the urge to move? Or is it more that it helps with hyper-alertness and induces more restful sleep? I notice that it might be counter-indicated with opioid use. Are you still taking an opioid?

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Here is the full shebang from Wiki.

en.wikipedia.org/wiki/Alpha...

Prazosin was synthesised in 1974, so one can consider that what ought to be known, is known.

And here is the article that first alerted me, after some angel on this site mentioned it as a sideline.

ncbi.nlm.nih.gov/pubmed/178...

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I take 225 mg of Lyrica broken up with 75 during the day and 150 before bed. I started Lyrica after weaning off of Mirapex (which had caused augmentation). Lyrica for me was and is a Godsend. No symptoms during the day and very little before bedtime. Lyrica, however, does not help me at night when I am startled awake with full body involvement RLS. For a while, CBD oil worked but I don't see any benefit nowadays. Tylenol 3 (with codeine) is the only thing that helps me at night. I like everyone else on here is still looking for what can give them a good night's sleep. I'm still hopeful that someday someone will come up with something!!!

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Hi - as Raffs said, try a therapist who practices EFT for the PTSD symptoms. EMDR is also very helpful for most people with PTSD, as would be a therapist trained in body-centered psychotherapy. Helping your PTSD is very important, not only because most of the appropriate drugs aggravate RLS, but also because the tension and anxiety accompanying PTSD aggravate the symptoms. Please let us know what helps!

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