Gabapentin for RLS

[Dreamofsleep]

Hi All.

In January, I saw my GP for RLS which I seem to have had for ever! I was initially prescribed Ropinirole which did not agree with me and so I was weaned off of this. I was then prescribed Gabapentin. I started on a very low dosage which has gradually been increased. I am currently on 300mg 3 times per day. I seem to be able to get off to sleep but after a couple of hours, I wake up with RLS. I have to get up and move around until it goes. I am also incredibly restless all night. I think I should discuss this again with my doctor and am wondering whether I should be on a higher dose.

I should really appreciate some advice on this.

Many thanks

[Hidden]

Hi sorry to hear the Gabapentin's not working so well.

Certainly discuss this with your doctor.

I would be hesitant to increase the dose as this increases the risk of side effects.

However, you could discuss the following with your doctor -

1). Which form of Gabapentin was prescribed i.e. Gabapentin or Gabapentin Enacarbil. The first is usually used for nerve pain, the second for RLS.

2) If prescribed for RLS (at night) why take it in 3 divided doses? You might get more benefit from it at night if you took it all at night!

I also have RLS, but I am prescribed Gabapentin, in 3 divided doses, but it's for nerve pain, not RLS and the nerve pain occurs any time of day.

(Actually because of augmentation, so does the RLS, but that's another theme.)

So, it might be better, as apparently usual for RLS to have one dose of Gabapentin Enacarbil, in the evening.

Another option is to change to Pregabalin, which is a more potent form.

I hope others will add to this.

[Dreamofsleep in reply to Hidden]

Thank you so much for your reply. Yes it makes sense what you say. I have called this morning and have a telephone appointment with my doctor this afternoon. Incidentally I was up and about from about 2am to 4am this morning and very restless before I actually got up. Not feeling wonderful today! Thanks again.

[Joolsg]

I was about to advise the same as Manerva. He has said everything I was about to say. Unless you get RLS during the day, why take Gabapentin during the day.

Take at night only. Gabapentin will only last for 6/7 hours so maybe even take 600 mg before bed and 300mg at say 1/2am.

Gabapentin enacarbil ( Horizant) is only available in the USA.

Pregabalin is a similar drug and if switching timing of Gabapentin doesn’t help , discuss switching to pregabalin with your GP. It’s more expensive but often works better for RLS.

[Dreamofsleep in reply to Joolsg]

Thank you so much for your response. As I have just replied to Manerva, I have made a telephone appointment to speak with my doctor this afternoon. Hopefully we can get my dosage sorted! It makes sense what you say about splitting the dose during the night. Many thanks again. I will let you both know what happens after I speak with my doctor.

[RosieRow in reply to Dreamofsleep]

Hi

I'm in the UK and I've been on Gabapentin (Neurontin) since March, having weaned off Ropinirole and tried Pregabalin.

I currently take 100mg at about 5-6pm and a further 400mg at 9pm. My GP first advised me to try it in evenly spaced doses but when that didn't work he was very happy for me to try splitting it in the afternoon evening and find what was right for me. One reason is that if I take Gabapentin during the day I get excessively tired in the afternoon. That still happens but to a much lesser degree now with the dose split as it is. I've been told that 900mg is the maximum I can take. I did get up to 600mg at one stage but that increased the tiredness. I normally get through most nights with little or no RLS which, if/when it does occur, is usually relieved by a walk round and a hot drink.

I should add that I'm also on 5mg Oxycodone at 9pm and codeine split 15mg at 5-6pm, 30mg at 9pm and a further 15mg if needed during the night. I think I'm probably better on a mix of small doses of different drugs than a lot of one - but there may be no basis for that thought! Let's just say it seems to be the best option for me at the moment.

I hope you sort yourself out but, like Joolsg and Manerva I would recommend changing when you take the Gabapentin and perhaps even try reducing it as on both Gabapentin and Pregabalin I found that taking too much made the RLS associated symptoms worse.

all the best,

RosieRow

[Dreamofsleep in reply to RosieRow]

Hi thank you for your response. Speaking with my doctor this afternoon and will see what she recommends. Many thanks again.

[Hidden]

Get off that Gapenntin. That stuff does nothing but make you sicj

[Hidden in reply to Hidden]

I guess you must have tried it at some point. Sorry if it didn't work for you. It's worth trying though and it doesn't make everyone sick. You have been unfortunate.

I changed from Amitriptyline to Gabapentin to Gabapentin last year for my nerve pain which got significantly worse in August. It seems to be working quite well for the nerve pain and is possibly helping my RLS which Amitriptyline may have been making worse.

Everyone's different.

[Sinclair2009]

It might be too high of a dose. Gabapentin will make me restless if I take too much.

[Dreamofsleep in reply to Sinclair2009]

Thank you so much for your response. Speaking with my doctor this afternoon and will see what she recommends. Many thanks again.