Pramipexole for RLS

[Dreamofsleep]

Hi All,

My GP recently put me on Pramipexole 1 x 0.088mg at nighttime for RLS after weaning off gabapentin which was not basically helping at all! I started on Pramipexole nearly 3 weeks ago and I must admit it has helped my RLS tremendously. I am sleeping through the night with no RLS which is amazing! Although I feel really good in the mornings, I am incredibly tired in the afternoons. My question is will this afternoon sleepiness get better after a while? I am aware of augmentation and am quite concerned that this might happen after a while on Pramipexole. My GP already said that I could gradually increase my dosage to a maximum of .54mg. After reading posts on here, it would seem prudent to keep the dosage to 0.088mg? Any advice would be so welcome! Many thanks

[Lapsedrunner]

Hi Dreamofsleep,

keep your pramipexole dosage as low as possible. I would even see if half a tab works. Do you know what your ferritin level is? For us 100+ is the aim and may be associated with lessening augmentation. It may also be useful to have regular “drug holidays” to avoid augmentation.

Your afternoon sleepiness hopefully is a transient thing, maybe related to having sleep after being deprived?

Let us know how you get on.

[Dreamofsleep in reply to Lapsedrunner]

Hi thank you so much for your reply. I was thinking about trying half a tablet so yes, I’ll try that tomorrow. I’ve already taken my tablet tonight. My ferritin level is 129. How would you suggest to manage a “drug holiday”? Maybe just not take a tablet for one night? Yes think you’re probably right about being sleep deprived! It’s wonderful at the moment actually falling asleep and staying asleep! Seem to have forgotten what that was like! Thanks again for your advice

[Lapsedrunner in reply to Dreamofsleep]

We can all identify with getting some good quality sleep after being sleep-deprived!!

[Hidden]

Hi Dreamofsleep, good to hear the Pramipexole is working. I found it really effective when I first took it, I'd say miraculous! I started on 0.088 mg and the first night I took it - absolutely no RLS.

It did knock me out in the evening however and a couple of days I had to literally crawl upstairs and into bed. Made no attempt to clean teeth or anything. If I recall correctly that settled down after about 2 weeks.

It was such a relief after months of sleep deprivation.

I was also told I could increase it up to 0.54mg, I did - do NOT do that!

[Dreamofsleep in reply to Hidden]

Hi thank you so much for your response and advice. Do you still take Pramipexole? How long have you taken it for? What happened when you increased the dosage? Do you take 0.088mg now and is it still effective? Sorry lots of questions! Many thanks

[Hidden in reply to Dreamofsleep]

Yes I still take it, I have been taking it for about 12 years.

Recently I have been reducing the dose slowly since last October when I was taking 0.54mg. I increased the dose fairly quickly because it came to be less effective. This is, I now know the wrong thing to do.

Without realising what it was I have been suffering augmentation for at least half that time. Repeated visits to a neurolgist did not offer much help.

The worst part of that for me was the chronic insomnia.

I am hoping to stop completely within the next two months depending on how wihdrawal goes. I am currently taking 1 1/2 0.088mg tabs.

[Dreamofsleep in reply to Hidden]

Thank you! I tried half a tablet last night and I slept without RLS for the whole night. Really hoping I can keep to the half a tablet. We'll see! Wish you luck with your withdrawal programme. What do you plan to take afterwards for your RLS?

[Hidden in reply to Dreamofsleep]

Great, yes see if you can stick to half a tab.

I've been taking Gabapentin since last August

[Dreamofsleep in reply to Hidden]

Hi good morning. It's 4.30am. Half a tablet doesn't seem to be working! Been up for quite a time now - my legs are all over the place again. Going to try again in a minute! Think I'll be back to a whole tablet tonight! Really appreciate all your input

[Lapsedrunner in reply to Dreamofsleep]

That’s great news!

[Ramrod]

You should consider taking a quarter of a dosage! If it doesn’t work go to half! Try it, nothing to lose but some sleep!

[Hidden in reply to Ramrod]

Wow, can you cut them that small?

[Lapsedrunner in reply to Hidden]

Yes, I managed it!!

[Hidden in reply to Lapsedrunner]

I need a magnifying glass, a surgeon's scalpel and very steady hands then!!!

[Hidden in reply to Hidden]

We talked about this a while ago you and me, cutting that 0.088mgs pramipexole smaller, i use a pill cutter. I cut my one 0.088mgs into bits, the make i am using right now, crumbles some what at times, so not easy to work out how much i take. Currently taking a half of that pill, but with me that changes constantly. So, can even be a quarter or less.

[Hidden in reply to Hidden]

Thanks Elisse, I have got a pill cutter. I get variable results with it.

[TheDoDahMan in reply to Hidden]

Hi, Friends,

1) Use a pill crusher instead of a pill cutter,

2) Empty the crumbly-powdery results on a clean hard surface,

3) Use a knife to separate the pile into as many little piles (halves, thirds, quarters, whatever) as you require. Just eyeballing will be close enough. But make sure that the pill you are dividing up is okay for this method; that is, NOT a time-release, gel-cap, et cetera.

Best of luck--let's all sleep tonight!

[Hidden in reply to TheDoDahMan]

Thanks for the info for a pill crusher.

[Dreamofsleep in reply to Ramrod]

Thanks Ramrod. Think it would be difficult to actually cut this tiny tablet into quarters? Just read some of the other comments below!

[Ramrod]

Have Dr prescribe less dosage!

[Lapsedrunner in reply to Ramrod]

There isn’t a smaller tablet!