Tiredness Prami vs Gabapentin

[gentoorax]

Hi -

I'm 33 and on pramipexole at the moment 0.088mg, I try not to go over 1 tablet a night as I have in the past and the tiredness and loss of focus I experience not nice! However, eventually it does lose it's effectiveness and I stop and try over the counter cocodamol for a few days. I'm at my witts end with this pattern though, as last night I only managed 3 hours sleep (without the prami) and took a large amount of cocodamol (my doctor won't prescribe me codeine alone or a higher dose - so I use over the counter cocodamol). I get very worried I'm go to OD with the paracetamol part of this.

One of the main reasons I don't like pramipexole is that I don't feel myself on this drug, I feel lethargic and tired during the day, I can't concentrate on my work with the brain fog! It does help a great deal at night, but it's hardly worth it if I'm like zombie the next day anyway. When I have a break from the drug, altho I've barely slept my mind is much sharper.

I'm wondering though, is it worth asking to try gabapentin? I've read that also has tiredness side effects, and I'm wondering if I will feel just as bad on this!? Has anyone tried both, and how can do you compare the side tiredness side effects? Does gabapentin cause tiredness well into the next day? On pramipexole the tiredness last till about 4pm for me.

Thanks for the feedback as always!

[Pam34]

Hi

From my experience all of the drugs associated with RLS cause tiredness. I take Pregabalin and it’s great for my legs but I do feel tired the next day and ropinirole was the same.

Catch 22 - if I don’t take drugs I’m up ALL night and tired the next day. If I do take drugs I sleep well but I’m still tired. Given the choice then if I’m going to be tired anyway I’d rather sleep!

Pam

[Leelee49]

I stopped pramipexole and was put on gabapentin it’s about 80% effective, you are best taking it as late as possible cos it will help you sleep, I don’t normally feel tired the next day unless my legs played up and I didn’t sleep

[Hidden]

I take both Gabapentin and pramipexole. I do get tired in the evening, but then I don't sleep well at night.

I took Pramipexole first and it made me tired but then got used to it, I didn't feel as tired. Then i added Gabapentin and it didn't really make me any more tired than I was, but I was sleeping badly at the time.

I've never been on Gabapentin on it's own.

The half life of Pramipexole is about 8 hours, Gabapentin 5 - 7 hours. The effects of Pramipexole therefore last a bit longer, but it depends on the dose.

Different people react differently to the same medication, so it might be worth switching to gabapentin, but it might not be easy.

It's as Pam says, either you take more medication which relieves your RLS and allows you to get to sleep, but makes you tired OR you take less medication because it makes you tired, but you can't get to sleep, hence you're still tired.

You might find SOME of the tips in this website will help

nhs.uk/live-well/sleep-and-...

[Oscarsaurus]

I have taken gabapentin for almost 6 years but it was prescribed for my chronic back pain. After weaning myself off morphine my restless leg syndrome kicked in at its worse but unfortunately the gabapentin didnot make any difference to my symptoms and i take 600mg 3 times a day. Everyone is different so it may work for you . I take pramipexole 0.088mg every evening at approx 7.30 pm and they help but i limit my sugar intake and try not to have anything with sugar in after 3 or 4 in the afternoon. The advice on here is brilliant and they will always try their best . Good luck

[Tinabugsu]

It's always worth it to try gabapentin. It helps augment my methadone but after 2 days even 1600mg didn't work for me. So now I'm on methadone 5mg and 100mg gabapentin.

Do not increase the dopamine agonist. If it stops working it's because your augmenting and that means the drug is making your RLS worse

[involuntarydancer]

Many people report a sense of tiredness when they first start gabapentin but this does seem to improve for many as they get used to it. It works well for some people and would at least give you another string to your bow if it did work for you. Unfortunately, it can take a while for gabapentin to become effective. It works straight away for some people but for others it can take a few weeks. In your shoes, I would be inclined to give it a try as you need a few more options. I would echo the other advise not to increase the parmipexole. You are doing well to keep it to 0.088mg.

Have you had your iron levels checked? Raising serum ferritin can make a huge difference to many sufferers. You need to make sure you get the actual figure from your GP (not just that you are 'normal' which can be far too low for rls sufferers). If you are below 100 you should start an iron supplement - or eat animal liver! A clean diet and avoiding exacerbants such as benedryl or red wine can also help a lot. As you become more tired this can also exacerbate your rls (in a cruel irony) so it is important to stay on top of symptoms.

[thoughtful12]

I've had almost no side effects from the Gabapentin but I'm only taking 300mg before bedtime. Everybody's different but the Gabapentin by itself is definitely worth a try. It certainly works for me. Good luck!