Hi

[Jane190]

Hi guys been to the doctor again and have had my ropinerol upt to 6mg a day the Gabapentin stays the same for now she has also given me folic acid and cholecalciferol 20,000unit 1 capsule 2 days a week for 7 weeks can anyone relate to this

[LotteM]

Doesn’t your doctor know that 6mg of ropinirole is 2 mg above the maximum recommended dose for RLS? I had the same experience with my (first) neurologist, who said I could go up to 8 mg. But that is for Parkinson’s Disease, not for RLS. Check the leaflet, as you will see, 4 mg is the max for RLS. How much have you been taking up until now?.

Also please read this paper will your full attention first and then take it to your doctor to discuss. Meanwhile, do NOT increase the dose of ropinerole from what you took before. If you read the paper (link below) you will see that in your situation the RLS specialist of the IRLSSG recommend a reduction rather than an increase.

sciencedirect.com/science/a...

You may also want to read the pinned post (top left? on HU when on your computer) about augmentation.

Read, read, read, as for us, people with RLS knowledge is power and may help to avoid disaster. The disease as it is, is difficult enough to deal with.

[Jane190 in reply to LotteM]

I have been on 3mg so far

[Hidden in reply to Jane190]

So you have gone from 3mgs to 6mgs Double your dose! Go back to your doctor or really you need to see a different one. This doctor knows nothing about RLS to double your dose or what augmentation is you also need to read your leaflet on side effects which should include it might cause you to gamble become addicted to shopping etc.

[Hidden]

Hello again Jane.

Well that is an improvement on STOP both Ropinirole AND Gabapentinj and take Amitriptyline.

But it still seem to me that your doctor is very erratic and not very knowledgeable about RLS. First it's stop the Ropinirole now it's increase it!

It would have been better to reduce the Ropinirole and increase the Gabapentin if anything.

I second what Lotte says Don't increase the Ropinirole. Especially, as Lotte says, this is above the maximum recommended dose and will possibly make your symptoms worse, not better.

These are the NICE guidlines on the maximum dose of Ropinirole for RLS i.e., 4mg

bnf.nice.org.uk/drug/ropini...

Folic acid and Vitamin D (Cholecalciferol) are good for RLS I read IF you have deficiencies of these. Did you have a blood test for them? If you're not deficient, then they may not have any effect.

Did she do a blood test for Ferritin to see if you need some iron?

I'll put the link to the NICE guidleines for RLS here again

cks.nice.org.uk/restless-le...

Note the mention of augmentation in the section headed "Before commencing drug treatment, ensure the person is aware:"

NICE - the National Institute for Health and Care Excellence issues evidence based guidelines for all UK NHS doctors. If doctors are ignoring these guidelines or contradicting them then they are putting themselves at risk of being accused of malpractice.

In your last thread I suggested you change your doctor I still think you should consider that.

[Jane190 in reply to Hidden]

I have had my blood tested and yes there is a dificeincy excuse the spelling

[Hidden in reply to Jane190]

The folic acid and vitamin should be of some help then.

It still appears your doctor is ignorant about RLS.

[Hidden]

Oh my, your doctor doesnt know much about RLS if increasing your dose for Ropinerole was his answer. Please listen to what the other members are telling you, The RLS experts recommend to take no higher than 1mgs Ropinerole even tho doctors should see 4mgs when they look in their book. Read the pinned post about Augmentation.

[Kaarina Administrator]

The following article on Augmentation by Dr Mark Buchfuhrer is one of the best RLS-UK have read:

sleepreviewmag.com/2015/02/...

Your doctor should read the article too.

[involuntarydancer]

I definitely would not increase ropinerole. In fact, if it used to work at 3mg and now doesn’t, I would be inclined to reduce it. If you try to ‘chase’ your symptoms with ropinerole (or any dopamine agonist drug) you will find yourself in an endless game of catch-up until you can go no higher with the dopamine agonist (your rls will always eventually outrun it) and you will have the tortuous process of coming off a high dose of dopamine agonist.

Do the research suggested by the others. You have had responses from some exceptionally knowledgeable and thoughtful posters. If your serum ferritin is low currently you might find that raising it has a positive impact on your rls. That would be my primary focus if I were in your shoes.