Meeting with Dr. Winkleman at Mass General !

[sparkey1958]

Last summer I unfortunately had the experience of augmentation after many years on ropinirole. And even more unfortunately I had had both hips replaced....fortunately not at the same time! But still....3 months apart. This did not fare well with my RLS. Augmentation I believe is very "evil"....just recently read that somewhere. Research, research....would some agree this is what we have to do?? So....in August of last year I came up with a Dr. Winkleman. Back to "unfortunately "....I was not able to get an appt until this past Monday, April 29th!!. A very busy man!! His advice....to stop ropinirole...I take 6 mg per night, along with, 75 mg lyrica and a 150 mg lyrica and zolpidem. I also use marijuana. Also advises to stop zolpidem. Lyrica can be increased and also get off prosaic which aggravates RLS and take bupropion. I hate to say this....even though I'm not usually superstitious...but I haven't had symptoms for almost 3 months now and do not want to "rain on my own parade". I haven't written in awhile and glad to be back.

[Joolsg]

Dr Winkleman is highly regarded. I listened to his webinar a month ago and he discussed Augmentation and that opioids are his preferred drug for RLS after withdrawal- methadone coming out top as it doesn’t give a high and works at low dose.

His advice is accurate BUT he should have advised you how to reduce the very high dose of Ropinirole. Increasing Lyrica ( presumably to the recommended maximum of 300mg) will possibly work well for you but not until you’re off Ropinirole.

I don’t know why your Augmentation has suddenly settled- that is unusual. If you’re getting 7/8 hours sleep and no Augmentation symptoms then, yes , you could maintain the status quo.

However, if Augmentation flares up again you would have to reduce Ropinirole very slowly- 1mg a month maybe and if the RLS really plays up ask Dr Winkleman for opioids to help the withdrawal.

I’m surprised he didn’t mention or recommend methadone as it is his preferred drug. Do you react badly to opioids?

He’s correct about Prozac as well- switching to bupropion will help the RLS. Zolpidem is very addictive and stops working if taken all the time so reduce that and take only twice a week maximum.

I hope the settling of the Augmentation stays.

If not, go back to Dr W ( or email his registrar/Secretary) and discuss more powerful drugs to help you through withdrawal.

[Zedz]

Hi! I also have a hip replacement and immediately got RLS a week post op. This was 11 yrs ago. Also augmented. I am on day 6 of no mirapex and finally had a good night sleep last night. I have been looking for others who may have developed RLS post hip replacement. Is that when you developed yours? I am wondering about metals as well, have you ever had cobalt and chromium tested?

[tweedy66 in reply to Zedz]

Hi....Have had rls for years but the fact that I couldn't move as well made it harder to deal with my symptoms. I was limited with walking and exercises I usually do to alleviate things. Anyhow....I'm now in the process of gradually eliminating ropinirole and not looking forward to what I know will not be fun!