Mirapex

[BigE123]

I have been on mirapex for about 10 years. For the most part I have had good success once I got to the 0.5 mg dose. I was just wondering why people try to wean themselves off Mirapex to go to another drug such a gabapentin. Just curiosity and wondering if I should follow suite. I have never posted on this site but read it regularly in hopes of solving my rls nightmare.

[Hidden]

Hi and welcome!

First I will tell you why lots of people on here (including me) wean themselves off Mirapex. Have you heard the term «Augmentation»? The literal meaning of this is «a worsening of the condition». Unfortunately, this is a known potential side effect of Mirapex and other dopaine agonists. If augmentation is going to happen (it doesn’t for some), it can happen anywhere from pretty quickly to years.

Second of all, telling you to follow suit is not for us to say. Who knows when, or even if, we will experience a certain medical side effect. I wish we did; it would make our lives so much easier.

I hope this helps.

[Hidden in reply to Hidden]

Just thought of something.

Does anyone out there know the statistics for Mirapex? Is there a percent likelihood for augmentation on it?

[Madlegs1 in reply to Hidden]

Not as far as I know. Rls seems to be a very personal affliction- each of us appears to have a different reaction to all sorts of things, including medications.

It may well be a matter of biological processing( I cycle medications faster than most) . Metabolism.

0.5mg of Prami would be regarded as double the top dose for rls--- sooooo-- you might be in red zone for augmentation . But maybe not.🤗

All the best.

[Hidden in reply to Madlegs1]

Metabolism? Interesting theory! That actually makes a lot of sense. I guess the metabolism theory would go with any medicine. What do you think? Thanks, Madlegs!🙂

All the best to you as well!

[Madlegs1 in reply to Hidden]

I'd reckon so.

I have to warn anaesthestists that I will come out of the effects early- and I really don't like seeing people with big knives standing over me!🤣

[LotteM in reply to Madlegs1]

There is currently a lot of attention to the amount or production rate (don’t recall which of the two) of enzymes in the liver that break down medicines or components thereof, e.g. CYP450. That may explain to a large extent why some people are more sensitive to a med, i.e. need less, than others. It varies with the breakdown route of a med and the enzymes involved in that route. Ideally people should get a ‘passport’ with the rates of most of these enzymes to enable more personalised and adequate subscription.

[LotteM in reply to Hidden]

Yes, the chance of augmentation has been calculated and published. Don’t know the figure by heart. But statistics being what they are, they don’t predict anything for an individual. Unfortunately.

[Parminter in reply to Hidden]

I have read that the rate of augmentation is 7% to 8% per year, and that after eight (?) years only 25% of those taking the drug had no augmentation.

In another paper I have read that augmentation, over time, will be 80%.

They have not kept statistics for that long, but it is possible that no-one escapes in the end. or very few.

[BigE123 in reply to Hidden]

Thanks Sails. It helps alot

[Hidden in reply to BigE123]

Not only are there genetic and metabolic differences between people which affects how well a drug works or which drug works, when a drug is taken during the day is also a factor.

If you've taken Mirapex for years you'll know this. I don't know if this is a factor in augmentation. I take Pramipexole at a fixed time, but have found switching the time around sometimes helps.

Ultimately, if it's not broken, don't mend it! If the Mirapex is giving you a good quality of life without augmentation, then why stop?

[Broadbandbill]

Never ever take Gabapentin for this. It is a nasty drug to come off and messes with your brain, Take a look on Face Book. Gabapentin withdrawal group

[Hidden in reply to Broadbandbill]

If you have had a bad experience of taking Gabapentin, then i am sorry, But alot of people can take it without problems. There are not many meds that dont come with side effects of some kind. And there are meds that can be hard to get off the DA's are one of them, opiates can be hard for some to get off etc etc.

[Hidden]

If it aint broke it dont need fixing,. If that dose is working for you then your dont need to think about changing meds. But as someone else has said, you are getting a higher dose than what the RLS experts are recommending. Just be aware of any symptoms changing, coming earlier in the day, maybe in other parts of your body that you didnt have before. That should be a red flag that you maybe be at the start of Augmentation.

[Lapsedrunner]

I think I’m right in saying that having a decent ferritin level decreases the likelihood of augmentation, as does having regular short breaks from DA medication

[TEAH35]

I've been taking Sifrol (Oz Mirapex) fot 10 years with 100% success. A couple of times i thought I was on the verge of augmentation but didn't happen. With all the talk about the inevitable I consider myself lucky.