What Meds are good for RLS for the elderly who hallucinate when taking Mirapex. How about Zolpidem/Ambian? I read zolpidem is an agonist.

[PleeZE2]

What Meds are good for RLS for the elderly who hallucinate when taking Mirapex. How about Zolpidem/Ambian? I read zolpidem is an agonist.

[Hidden]

Hello, I'm no expert on specific medications for older people. There are some medications that are not as well tolerated as you get older. This partly depends on whether the medication is metabolized by the liver or excreted by the kidneys PLUS the health of those organs.

The effect of one medication also depends on how it interacts with another medication. Medications which affect the nervous system can be a problem with older people especially if there is a decline in cognitive functioning.

since as people get older we tend to get multiple problems, find ourselves on a cocktail of medications combined with organs, (kidneys, liver etc) declining it becomes a minefield.

The best strategy for answering your question is to consult an elderly care specialist. Any medication prescription should be based on a thorough examination and perhaps blood tests, such as liver and kidney function..

If Mirapex is causing hallucinations, there may be some underlying cognitive dysfunction or organ failure.

As regards RLS specifically, logically if Mirapex, pramipexole is causing problems then it needs to be tapered off, not stopped suddenly. If it's causing such problems that it needs stopping suddenly, then that needs to be done under medical care.

Alternative medications for RLS can then be used. They will be the same alternatives as for younger people. There are different dopamine agonists that can be used for RLS, but perhaps as one is causing problems then so will the others. Next is alpha ligands, e.g. Gabapentin, which acts diffetently. It creates its own problems. Opiates can be used for RLS, they have their own problems.

Zolpidem is a "non benzodiazepine* sedative. It is not an agonist. It is usually prescribed as a short term remedy for severe insomnia. It is dependency producing/potentially addictive.

I'd say if someone is suffering confusion or even hallucinating at night, then sedatives are a definite no no.

Any suggestions you get on this aite, including mine, as the label says, should not be a substitute for qualified medical advice especially when it concerns toxic substances and vulnerable people.

[PleeZE2 in reply to Hidden]

Thank you for your reply. That you are well-informed gives weight to your suggestions. My sister didn’t take Mirapex for more than a day or so because of her reaction to it: She does take several meds for her heart and other conditions and one of those might cause Restless Legs Syndrome but none of her doctors seem to be fully informed about RLS, and since she is desperate and exhausted from lack of sleep , she insists on taking Klonipin, then when that fails, she takes flexirii and then, exhausted and desperate from very title sleep, she tried OxyContin. She is going to try to get a release so I can speak to her neurologist. I want to see what she knows about RLS/PLMD. However with the combination of meds she is on, it may be anybody’s guess as to the dynamics of her

situation. I will suggest a geriatric specialist. I suggested a sleep specialist.

We live far apart and talk in the phone but her hearing deficit is complicating our communications. But I will continue to look for help for her. Thank you again for your thoughtful suggestions!

[Hidden in reply to Hidden]

I got the feeling you weren't close.

i hadn't realised your sister was taking K!onopin (= Clonazepam).

Paradocicalky, that might be more likely to be causing the hallucinations and insomnia. i was once prescribed it under strict instructions not to take it for more than a month.

it can also raise heart rate and blood pressure. She really needs to stop taking it.

cchrint.org/2011/06/02/amer...

[Joolsg]

If Mirapex causes hallucinations then the best thing would be to get off it - slowly with help from your GP.

Zolpidem is a sleeping pill ( ambien) and is used to help during withdrawal from a dopamine agonist like Mirapex or occasionally to aid sleep ( it shouldn’t be used every night).

Other meds to consider for RLS are Gabapentin or pregabalin or opioids.

[Hidden]

Hello! Just a cautionary tale about Ambien: I took this on 3 separate occasions and did things I had no knowledge of all 3 times. When I reported this to my doctor she said that doing things you have no knowledge of is a known side effect of this sleep aid.

Good lick in your journey to find what works for you!

[PleeZE2 in reply to Hidden]

Thank you!!

[involuntarydancer]

Has she had her serum ferritin checked? Low iron can cause/exacerbate rls and raising iron levels improves symptoms in about 50% of sufferers. Many GPS are unaware of this. She would need to ask for the actual figure - not just that she is ‘normal’ or ‘good’ Etc. if the figure is below 100 she should start a supplement. Many in here find iron bisglycinate (aka gentle iron) to be particularly good. Eating liver (if it can be tolerated) is an even better means of raising iron.

[PleeZE2 in reply to involuntarydancer]

I will try to communicate to my sister once again about serum ferritin. Her hearing is minimal and when she is compromised by her frequent nights of little or no sleep and

sometimes extreme relentless restless legs, she doesn’t process info very well and so I have to wait until she is able to understand

what I am explaining. She is bright and dementia has been ruled out. Thank you for your reply!

[gingerf21]

I stayed with my mom in the hospital once. They gave her Ambian to help her sleep. It kept her (and me!) awake all night. She was hallucinating badly! We both were exhausted the next morning. They wanted to give it to her the next night as well, so I had to STRONGLY discourage the nurse from giving it to her. She had to call the doc to let him know what had happened. Mom fell asleep on her own that night with no sedative.