Stopping sifrol due to pregnancy - Restless Legs Syn...

Restless Legs Syndrome

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Stopping sifrol due to pregnancy

Catpeppa profile image
3 Replies

I have has restless legs for years and I have been taking sifrol, recently finding out I am expecting I was advised to stop taking sifrol.

I was to scared to at first but now I have stopped so I don’t cause harm.

It has been 3 days and my whole body is restless and twitching, I haven’t slept for 3 days I haven’t even been able to work because I have no sleep, I can’t even nap during the day or sit still without my body has really intense twitching.

Will this ease off eventually?!? And is there any safe medication to use

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Catpeppa profile image
Catpeppa
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3 Replies
Joolsg profile image
Joolsg

I can’t believe your GP is not helping you more.

The general rule on treating RLS in pregnancy is to avoid drug therapy -medications should be reserved for very severe cases where sleep disruption itself may cause prematurity and difficult delivery.

Are you in the UK? If in USA most experts prescribe opioids where necessary but not in last trimester.

You are in withdrawal from the dopamine agonists and you will suffer all over RLS for quite a while but it will ease off after 10/14 days

You have to rely on non med help remedies,

Ask for serum ferritin levels ( blood test) and raise it above 100 by taking gentle iron every other night; and folic acid and magnesium will help.

I would send an email to Dr Buchfuhrer

somno@verizon.net

He responds quickly and may be able to advise on how to deal with the withdrawal symptoms and lack of sleep.

What a dilemma. I read that both the UK National Institute for Health and Care Excellence (NICE) and the US Food and Drug Administration (FDA) who are the authorities in medicines both recommend that Pramipexole is NOT taken during pregnancy unless "the benefits outweigh the risks to the fetus". e.g.

bnf.nice.org.uk/drug/pramip...

Both however say that the risks aren't actually known as they haven't been studied and the data is scarce. So it's a case of don't because the risks aren't known rather than don't do it because there are risks.

This is something that you could therefore discuss with your doctor, i.e. balancing the risks of becoming ill because of the RLS against unknown risks to your baby. Add in to this equation that pregnancy can cause RLS.

I am surprised that if anyone professional advised you to stop Sifrol they didn't advise you of an alternative.

One alternative would be levodopa.

You may want to consider a study which showed no increased risk of any adverse outcomes for mothers taking pramipexole, levodopa or the two together.

onlinelibrary.wiley.com/doi...

There are also other medications that are known to be of little risk during pregnancy that can be used for RLS, including opioids, gabapentin and benzodiazepines.

See this link

ncbi.nlm.nih.gov/pubmed/186...

Just to emphasise, RLS can occur during pregnancy because of low iron, you need to get your ferritin level checked.

I hope this helps, you need to discuss this evidence from national authorities and academic journals with your prescribing doctor, which indicate you do not have to suffer so much.

Graham3196 profile image
Graham3196

I was talking to a doctor yesterday and the subject of RLS arose. She had severe gestational RLS when pregnant ( of course) Because she was pregnant she had no problem getting an iron infusion and the RLS went away to never return. Possibility its caused by the baby grabbing all the iron she ate and making her anemic.

Dr Buchfuhrer recommends raisin the ferritin to between 300 and 350 but he didn't specifically refer to pregnant women. I think it would be a good idea to write to him and ask if he would still recommend 300-350 during pregnancy and otherwise how high should you go. Of course check what he says with your own specialist gyno or a haemotologist.

Some people come with a natural ferritin level of 350 so it would seem strange if there was any concern.

Graham

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