Any advice please

[Kazspro]

I have been taking Pramipexole for a few months now with little or no relief. Previous to this I was taking Pergolide which worked perfectly for many years however now it is unavailable so I'm having to try alternatives. On top of this I've had a knee replacement and when the restless legs start it's like someone has put a clamp on my knee and is tightening so the pain is extremely intense. Due to the Prameipexole not having much effect and me not getting much sleep the doctor has decided to put me on Amitriptyline to help me to sleep. I took my first one last night and I'm like a zombie today.i am not happy about taking it as I've read the side effects and they are not good. Any advice on what I should do or people who have been in a similar situation please get in touch. Thanking you in advance

[Hidden]

Amitriptyline has been known to exacerbate rls, tred carefully, ( no pun intended).

[Joolsg]

Amitriptyline is a trigger for RLS in 99% of people. Pergolide is usually given for Parkinsons at much higher doses. What dose of Pramipexole are you taking?

First I would get off the amitriptyline and then see whether pramipexole is still ineffective. Usually dopamine agonists work immediately for RLS- but as you were on Pergolide ( similar drug that works on dopamine receptors) you could well be tolerant. In that case, See your doctor and ask for pregabalin, gabapentin or opioids.

[Parminter]

Amytryptiline can definitely make RLS worse, so that needs to be changed.

Sleep aids listed as safe for RLS sufferers are Ambien, Lunesta, Sonata and Suvorexant.

You have been on drugs which work on the dopamine system for a long time, so it is quite likely that you have augmented, in other words the drugs make the condition worse while masking symptoms in greater and greater doses.

If it is augmentation, then you must attempt to reduce it slowly while going on to another drug, such as gabapentin, pregabalin or an opioid such as oxycodone.

[Dudleyoliver]

I have been on pramipexole for about 5-6 Year’s now I’m taking 1 mg a day . My prescription says to take one three hours before bed so I take it between 6-7 in the evening , but if I should forget , it’s no good for me to go to bed I’m up all night . But even when I take them on time my rls will some times keep awake . RLS is a terrible thing to have , but so many people suffer from it .. hope this helps

[Joolsg in reply to Dudleyoliver]

1 mg is a high dose. 0.5mg is FDA maximum recommended dose.

Don’t increase any further and be aware of Augmentation.