Oxycodone Dopamine Agonist? - Restless Legs Syn...

Restless Legs Syndrome
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Oxycodone Dopamine Agonist?

Meddersm
Meddersm
67 Replies

So I have just come off of ropinirole for restless leg due to augmentation and I’m now taking oxycodone 5 mg before bedtime. This is really been helping and I was hoping it would be good for the transitioning from Ropinerol. I just read that oxycodone is an agonist. Does this mean I will have augmentation with Oxycodone as well?

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raffs

Oxy is an opiate - it is a k-opioid agonist NOT a dopamine agonist. Many use Oxycodone coming off a dopaminergic drug - its a very effective treatment licenced in the UK & Ireland as - TARGINACT.

Best of luck.

5 likes
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Manerva

Hi Meddersm

As raffs says, Oxycodone is an opiate.

Did your doctor not tell you that?

Brilliant that you managed to get a prescription as I believe that it's really good for weaning off a dopamine agonist.

My GP flatly refuses to prescribe any opiate to help me wean off my dopamine agonist.

IF, IF your doctor didn't tell you that oxycodone is an opiate and what the possible risks and side effects of it are. then I think it irresponsible of them.

I hope you've read the leaflet that comes with it.

Additionally, did you discuss a plan with the doctor? Is the oxycodone just a temporary measure to help you stop the Ropinirole, or is it a permanent replacement for it.

If it's just a temporary measure is the plan to replace the Ropinirole with something else or are you going to stop taking anything at all for your RLS?

Most of the drugs used for RLS have some nasty consequences e.g. augmentation and some of them even more serious consequences. Some (in the UK) are controlled drugs. i.e. they're considered dangerous.

They are safe enough if you are aware of the risks and side effects, but I think it's really important then that you find out as much as you can about any drug you're prescribed especially when your doctor hasn't apparently even told you what the drug is.

As an example, did the doctor who prescribed you the Ropinirole not tell you about the risk of augmentation?

This is not your fault, but I hope you can see how careful you have to be with these drugs.

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Meddersm
Meddersm
in reply to Manerva

I knew it was an opioid. Tramadol wasn’t helping so we went with Oxy. He is great about listening to the research and trying new things. I have tried to ween off of dopamine agonists before but with no success. I always research my meds so when reading up about Oxycodone, I read that it helps your body release its own dopamine and then read it was an agonist of some sort. I’m just super leary of anything that states “dopamine” and “agonist” in the same paragraph! By the way, it’s a 5mg dose and I only have a 30 day prescription. We are trying to get back to a baseline so we can treat without dopamine drugs. I don’t know where we will go from there but I’m hopeful that the true symptoms are nowhere near as bad as the augmentation.

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Manerva
Manerva
in reply to Meddersm

That's great. I am relieved that you know your medication.

I have come across people who are on a lot of medications who haven't a clue what any of them are.

I can see you're quite astute

I appreciate that if you've suffered augmentation you will be wary about anything that associates "dopamine" with "agonist".

" Dopamine" is actually a necessary neurotransmitter and performs many functions in the brain and is harmless in the right quantities. It's particularly important if feeling pleasure or reward. A few drugs stimulate dopamine secretion in our "reward circuit", opiates and cocaine being two of them.

On the downside of Dopamine, it is highly associated with addiction. Anything which boosts dopamine activity can lead to addiction.

Neurotransmitters are the chemicals by which one neuron (nerve cell) communicates with another. The first cell releases the transmitter which passes across a microscopic gap to the second. The neurotransmitter then "locks" into a "receptor" in the membrane if the second cell and causes an electrical impulse in the cell. Complicated stuff! The receptors are very specific and depend on the shape of the neurotransmitter molecule.

This action can be stopped by using "blockers", ,(e.g. "beta blockers"), these are chemicals similar to a neurotransmitter which lock into a receptor site but don't cause an electrical impulse. When the real neurotransmitter comes along, it can't get into the receptor because it's blocked.

Blockers are properly called "antagonists".

Other chemicals however can help neurotransmitters lock into a receptor and trigger the electrical impulse. These being the opposite of the blockers are called "agonists".

Simply put an antagonist is anything that stops neurons reacting and an agonist us anything that boosts the cell reaction.

A further complication is that any excess neurotransmitter is either neutralised or is taken back into the first neuron that released it. This process is called "reuptake". There are chemicals that prevent this process and so they're called "reuptake inhibitors" and these can help boost the amount of neurotransmitter.

Some reuptake inhibitors consequently can exacerbate RLS., e.g. SSRI antidepressants.

In summary dopamine is a natural substance, problems arise when there is either too little or too much of it how effective it is in triggering receptor sites.

Antagonists, agonists and reuptake inhibitors interfere with the normal processes.

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LotteM
LotteM
in reply to Manerva

Great explanation, Manerva. Thanks.

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Meddersm
Meddersm
in reply to LotteM

Yes it was!

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Meddersm
Meddersm
in reply to LotteM

Yes it was!

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Meddersm
Meddersm
in reply to Manerva

Wow. Very informative. I am currently weaning off of my antidepressant as well with doctors ok. I had read the same and discussed stopping it. I think I feel much better now than when I started it. I have terrible sleep apnea and as long as the meds help my legs at night, I’m getting great sleep now. I was undiagnosed with that though when I started taking the antidepressant. Thank you for the explanations. So much to process but great stuff!

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bdbengtsson
bdbengtsson
in reply to Manerva

Very good write up, Thanks

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Joolsg

No- oxycodone is an opioid and is used to help the withdrawal from Ropinirole and to deal with RLS thereafter.

As Manerva says, you’re lucky your GP agreed to let you have it as many GPs refuse unless a neurologist approves it.

It doesn’t cause Augmentation. I’ve been on the same dose of OxyContin for nearly 3 years.

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Meddersm
Meddersm
in reply to Joolsg

I’ve been on Ropinerol and in augmentation for so long I don’t actually know what my baseline discomfort is. I have been on the Ketogenic diet for about 10 months. The lack of some nutrients may be contributory. My ferritin is 17. I’m now taking iron supplements, eating a lot of greens and adding fruits back in to my diet. Do you have any idea how long it takes your body to ween off of Ropinerol?

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Heatherlss
Heatherlss
in reply to Meddersm

Hi Meddersm,

There really is no specific timeline to weaning off DA. I'm myself now on the 22nd day but there hasn't been any respite contrary to the general feeling that it takes about 10-14 days. I still have constant RLS through the night. The only comfort for me in these days is that my RLS was never like this so perhaps this could well be still withdrawal symptoms. Don't know when the agony shall end

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Meddersm
Meddersm
in reply to Heatherlss

Im so very sorry. I’ll say a prayer for you and me both!

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Joolsg
Joolsg
in reply to Meddersm

Your ferritin is so low you would qualify for an IV iron infusion in the USA. If in the UK you could ask for a referral to your local hospital to see a haematologist. Print off the research articles on iron infusions from Johns Hopkins university to help persuade them as it will take about 2 years to raise serum ferritin above 100 and serum iron above 60 by taking ferrous bisglycinate and iron patches from PatchMD every other night.

My withdrawal took about 3 months. I reduced my Ropinirole from 4 mg to zero by reducing 0.5mg every 7/10 days.

I couldn’t have done it without tramadol every 4 hours during the last 10-14 days as the RLS was constant and affected every part of my body. I also used illegal cannabis.

Once off Ropinirole I tried tramadol and Gabapentin for 3 months but was still suffering so switched to OxyContin & pregabalin. After about 6 months my RLS settled and I was getting 8 hour’s sleep over the course of 12 hours. I still wake at least once or twice a night at least 4/5 nights a week but I accept that.

As your ferritin is so low, I suspect you will be one of the few people who may not need any meds once through withdrawal as long as you can get an iron infusion.

Definitely start taking ferrous bisglycinate and PatchMD iron now. Take every other night ( studies have shown levels rise faster by doing this).

Withdrawal is very, very tough but stick with it because Augmentation is horrible.

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Franklin123
Franklin123
in reply to Joolsg

Hi Joolsg - update, as you can see my progress is slow! My doctor told me my iron would increase slowly, it is in the 60`s atm. Obviously the pregabalin is no good for me. I may ask again for the tramadol - my life is passing on with no relief. So glad you are ok and coping.

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Joolsg
Joolsg
in reply to Franklin123

Hi Franklin

I’m sorry to hear that. If your RLS is still troubling you in the day, ask your doctor about adding a low dose opioid. Two meds at low dose often work better than one at high dose.

You could then take a lower dose of pregabalin at night only and the opioid twice a day in the evening and morning to provide 24 hour cover. I take OxyContin 10mg at 9 am and 9 pm and 5 mg at 2am. I only take pregabalin an hour before bed ( I reduced dose from 150 to 75mg as I want to take the lowest possible dose that allows me sleep)

That’s the advice Dr. Buchfuhrer gave me. I still get RLS at least 4/5 nights every week but I can get sleep in 3/4 hour chunks, then do stretches and squats to relieve the sensations and manage to get back to sleep within 15 minutes. As I am retired I can sleep until late morning. I realise others may not be able to do this if they are still working.

Also, as your ferritin is still low , consider pushing for an infusion using the links I added above in reply to meddersm.

If they refuse, review how you are taking the iron. Best way to raise levels orally is with ferrous bisglycinate and patch from PatchMD EVERY other night. Studies have shown levels are raised faster this way by fooling Hepcedin ( the chemical which stops iron absorption).

acpinternist.org/weekly/arc...

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Franklin123
Franklin123
in reply to Joolsg

Hi Joolsg - once again, thanks for your advice. I was diagnosed with Fibromyalgia about 15 years ago. Amytriptiline was first med, then codeine added a little while later because of pain. My then doctor changed the Ami to a similar but he said less `dirty` drug to Lophepremine. P ain clinics attended for ages as I also have spinal problems (lots of fusions). Usage of gabapentin and codeine with paracetemol, pregabalin was tried also . Facet joint injections didn`t last long, so I no longer attend. -rls has increased, and sleep has decreased significantly during the last two years, pain and numbness in arms and lower legs when trying to rest. I developed eye problems - I blamed it on the meds, and they said I had AMD, but were giving me eye exercises. I asked for tramadol recently with your info in hand - new doctor. She listened then went to consult and would not give me tramadol so pregabalin again. two weeks of confusion and headaches and exacerbated tinnitus! No more sleep either. I made the decision to stop the pregabalin (low dose 25`s) and tinnitus eased immediately and the foggy mess in my head! I am taking the iron tablets, and rub on the CBD oil sometimes during the night. I now split the ropinirole - I take the 1mg around 5 o.clock before dinner so that I can sit to eat, then take the 2x 0.25mg around 7.30 with a drink (tea). Sleep patterns - Probably, a brief nod after dinner (I think this is the meds). I retire about 11.30 p.m. I read in bed until around 12.30 - take codeine and baclofen, sleep in 2/3 hr sessions. 2.30 a.m. take paracetemol and try again - legs full of pain and numbess. Restless and try many positions - around 5 ish get up. Here I sit.

Is the Oxycodon the answer? I will ask for another doctor.

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Joolsg
Joolsg
in reply to Franklin123

It sounds like you’re having many problems, not just RLS. Clearly the spinal fusions are the main cause of the pain and RLS.

It’s definitely worth having a long discussion with your doctor about your meds. The alpha2delta ligands seem to disagree with you. I had double vision with both Gabapentin and pregabalin and brain fog. I now take pregabalin at the lowest possible dose and only at night and that has alleviated some of the side effects.

If your doctor refuses to consider tramadol, she will very likely refuse OxyContin as they are both opioids so I would ask for a referral to a pain clinic or a sleep clinic so they can assess you properly.

Perhaps you could change the timing of your Ropinirole- take 0.25 at 5 pm and then the remaining doses just before bed. If you cannot sit still for dinner it does sound like Augmentation and usually it’s best to get off the dopamine agonists. However,your RLS will need treatment and if you cannot take dopamine agonists or alpha2delta ligands, opioids are really your only option. So- get the referral to the pain or sleep clinic to see if they will consider low dose opioids.

Are you here in UK or in the USA?

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purpleizzy59

Is the tramadol for pain, I am on 2mg ripinorol,I have just stopped my mirtazapine and my GP gave me amitriptyline but after just 2 bad nights I am not taken anymore and I don't think the ripinorol is working so good, I am worried my depression will plumet

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Manerva

Tramadol is not just for pain it can also help relieve RLS symptoms and also withdrawal effects from dopamine agonists like Ropinirole.

You certainly should NOT attempt to take Amitriptyline, it is known to make RLS worse, as are most tri-cyclic antidepressants and SSRI antidepressants.

If your Ropinirole is not working so well, don't be tempted to increase it. You may benefit from taking Gabapentin as well.

I am sorry to hear you suffer depression. It does seem to be a modern affliction. I find it a real shame that mental health services are insufficient to deal with the issue and all that GPs feel they can do is prescribe drugs. In most cases drugs are not the solution.

Taking drugs is the easiest option but there are things you can do to help yourself deal with it and there may local organisations, that can help.

If you can, I recommend doing a mindfulness course, or you can buy mindfu!ness programme books.

I know when I am seriously depressed, part of it is feeling helpless to do anything about it, but it's not true, you can.

If you're not yet acutely depressed, do something to prevent it becoming acute.

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Joolsg
Joolsg
in reply to purpleizzy59

Tramadol is for RLS. Also to reduce severe RLS during withdrawal from Ropinirole and other dopamine agonists.

Mirtazapine will worsen RLS in 90% as will amitriptyline,

Safe anti depressants are Trazodone and Wellbutrin. Ask your doctor to consider these for your depression.

When you say Ropinirole is not working so well any more- can you be more specific?

The anti depressants you were on would make your RLS worse so wait until you have tried others and have your depression under control.

Then assess your RLS.

If the Ropinirole is still not helping or making the RLS more intense, read the pinned post ( top right) on Augmentation.

Also ask for a full blood count test and make sure your serum ferritin is above 100 and your serum iron above 60. Ask for the actual numbers because your doctor will say your levels are fine if above 15 for ferritin and 12 for iron ( we need much, much higher levels).

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purpleizzy59
purpleizzy59
in reply to Joolsg

Thank you so much for the advice I am at GP on Wednesday so I will ask questions

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Meddersm
Meddersm
in reply to Joolsg

Thank you so much. I will check into the patches. On my CBC my iron is within a normal range. 12 is the cutoff on that particular report. My doctor doesn’t think it’s low enough for infusion 🙁

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Joolsg
Joolsg
in reply to Meddersm

Doctors don’t know the levels of ferritin and iron needed for people with RLS. It’s over 100 for serum ferritin and over 60 for serum iron.

You can always write to the haematology department at your local hospital and attach the link to Johns Hopkins. Maybe the haematology department would be more willing to pay attention to the research than your doctor.

ncbi.nlm.nih.gov/m/pubmed/2...

rls.org/file/member-publica...

Please read the articles, print them off and show your doctor. If he’s unwilling to listen to the science, write to your haematology department and include the links.

The USA is taking iron infusions seriously and they resolve RLS in 50% of patients. Your ferritin levels indicate you would definitely benefit.

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marsha2306
marsha2306
in reply to Meddersm

Wow, you’re ferritin is really low. Could you possibly have an iron infusion rather than just take iron pills and possibly still suffer as much til it reaches at least 100?

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Meddersm
Meddersm
in reply to marsha2306

I’m going to talk to my doctor again and show him my research. Hopefully that’s an option.

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Shumbah
Shumbah
in reply to Joolsg

Joolsg

I’m just wondering what does of oxy you are on ?

Do you take during the day and at night

I’m on 20 mg oxycodone at night , it works great

However my afternoons and early evening are horrendous .

What time do you take your night time does ?

Kind Regards Kester

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Joolsg
Joolsg
in reply to Shumbah

Hi Kester,

I take Oxycontin ( prolonged release). 10mg at 9am, 10mg at 9pm and 5mg at 2 am. Apparently, it is better to take at spaced intervals to prevent 'mini withdrawals'. I don't get any RLS in the day or early evening any more so maybe the advice I've been given is correct.

I do know a lot of people who only take the oxycodone at night like you though.

Maybe you could ask for 5mg pills and take 5mg in the afternoon to prevent the daytime symptoms, and 15mg at night? Spreading the dose may help.

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Shumbah
Shumbah
in reply to Joolsg

Thanks Joolsg

Do you mind if I ask how long you have been taking oxy ?

And have you contacted doctor Winkelman to be part of his opiods study .

I have contacted his office whilst I’ve been travelling I will be joining his study when I get back to Australia

Kind Regards Kester

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Joolsg
Joolsg
in reply to Shumbah

I’ve been on the same dose of OxyContin since February 2017 & yes, I am taking part in Dr Winkleman’s study & have been part of it since the start. You don’t have to be a US citizen- I’m here in UK.

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Shumbah
Shumbah
in reply to Joolsg

Hi Joolsg just found the answer that you have been on oxy for 3 years

Has your dose adjusted much during the 3 years ?

I can’t wait to get my dose right so that I can have some symptom free days and nights

Still curious if you have joined Winkelmans opioid research ?

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Joolsg
Joolsg
in reply to Shumbah

See previous reply. I’ve been on 25mg since Feb 17 & haven’t changed dose & I am in Dr Winkleman’s study.

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Joolsg
Joolsg
in reply to Shumbah

It’s still very early days for you Kester. The withdrawal symptoms from Ropinirole can last months. It took me from August 2016 until February 2017 to find meds that gave me 85-90% cover.

Try changing the timing of the meds to see if you can deal with the daytime RLS but remember it will take time for your body to get over the Ropinirole.

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Shumbah
Shumbah
in reply to Joolsg

Thank you Joolsg

I am looking forward to speaking to Dr. Winkelman in the coming weeks

Do you use Skype to speak to him on your initial intake with him .

Does he offer any dosage advice .

I will see doctor next week re 10 and 5 mg slow release I am finding just the last 2 nights when I take the 20 mg I am getting some respiratory depression for a few hours which of course keeps me awake but my body is still.

I just wonder if it has built up at all over the weeks .

🙂

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Joolsg
Joolsg
in reply to Shumbah

Dr Winkleman’s assistant Julia phoned me using apple internet phone ( but I presume Skype or WhatsApp are other possibilities). Julia has now left to start med school and I don’t know who will take over her role.

After the initial phone call ( which takes about 50mins) you complete a 6 monthly online questionnaire. It’s all very easy.

Dr Winkleman and his team do not comment or give any advice on the dose of opioids or the timing. They leave that to your own doctors.

Hope that helps.

Please discuss the respiratory issues with your doctors as that needs to be checked. It is a side effect of opioids, but maybe taking 10mg in the morning and 10mg at night may prevent it.

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Shumbah
Shumbah
in reply to Joolsg

Thanks Joolsg

I will change my dosage from my next dose to10 mg I have 3 on me

And will see the doctors about another script also some 5 mg slow release see if I can get a better handle on things

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Franklin123

Hi - I am wondering what you do during the day? My rls comes on mainy in the afternoon, but also when sitting for a while any time. My doctor does not want me to go on Tramadol so we tried pregabalin again!! It is no good and even exacerbates my tinnitus which is horrendous. Violent headaches and confusion. Yesterday I decided I had enough and did not take any more. Do we have to go through the procedure with these drugs before we can get something to help??? I assume your rls is during the night?? Anyhow, I am so glad you have relief - take care.

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Meddersm

I went through the same list of drugs, about 3! I am a teacher and was hoping I can get it solved over the summer but unfortunately I just kept running through different medications to try to get me off of ropinirole. When I was on the panel room, the symptoms were worsening and occurring earlier and earlier in the day. I did not have that issue now but they are still hurting at night but the oxycodone helps me tremendously with that! My next stop could be the mayo clinic. We have one here in Jacksonville and they have a division specifically related to restless legs.

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Meddersm

Perfect! Thank you!

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Tinabugsu

No. The only opioid that causes augmentation in some people is tramadol, I think because it containes a dopamine agonist. Dopamine Agonists are the only drug that turns on you. Your safe with the oxy

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LotteM
LotteM
in reply to Tinabugsu

Tramadol does NOT contain a dopamine agonist. Reports of augmentation on tramadol have been extremely rare. Even here on HU, where reports if augmentation on dopamine agonists are not rare.

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Tinabugsu
Tinabugsu
in reply to LotteM

Tramadol acts on opioid receptors and increases the levels of dopaminepresent in the brain like other opioids, but it also inhibits norepinephrine and serotonin from being reabsorbed.

I belong to several restless legs groups and it is not rare. It doesn't happen to everyone but I find comments often.

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Not-methadone-addict

Hi, while tramadol isn’t a dopamine agonist my neurologist doesn’t prescribe this particular opioid (he trained under Dr. Buchfurher) as it does effect your dopamine levels and acts like some antidepressants causing worsening of RLS. According to this PDF sheet on augmentation it is the only opioid that causes augmentation: rls.org/file/augmentation-f... (which was originally sourced from here 2015 Summary for the prevention and treatment of RLS/WED Augmentation a combined task force of the IRLSSG, EURLSSG and the RLS Foundation. irlssg.org/summary/ Accessed November 30, 2015)

I know for some this drug is a lifesaver but I think all should be aware of the possibility of augmentation while taking it as this, rather than worsening of symptoms, etc., may be the problem. It did nothing for my RLS personally. Just some extra information to help make decisions and to make your doctor aware of.

Sus

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LotteM

Thanks for the info and the links, sus (the irlssg one doesn’t exist any more). I learned something new. “Tramadol is a mixed opioid with dopaminergic properties.” May explain the potential for augmentation.

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Not-methadone-addict

I’m glad to provide some useful information. You all have provided a great deal. I think there really is so much that just is not known because:

1. Doctors don’t listen to their patients and/or believe them. “Well that’s not what the guidelines say “.

2. Guidelines are just that a guide but as we all know no single one of us can necessarily be treated the same way.

3. More, more, more research needs to be done. Some research isn’t even research but compiling information together.

4. Just because your particular doctor has never run across let’s say a way you’re reacting to a drug doesn’t make it not true.

5. So much teaching to be done even to neurologists who say they treat many refractory RLS patients just like you but you’re not responding like they do. Turns out RLS is not even close to this doctor’s sleep specialty.

6. Doctors don’t be arrogant, listen to your patients. Unless you’ve lived it how can you know.

I’m sure there are many more. It’s so incredibly frustrating and some of us have to go through so much more suffering than is really necessary. I’m a RN and dealing with the “god complex” of some doctors got so old. It got really old with my last neurologist who kept saying she followed all the latest news and research but literally had zero idea how to treat refractory RLS.

Sus

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Elisse2

I used to have a great doctor who i saw for my RLS. He would actually ASK me if i had heard of any new meds that were coming out. He knew what i would call basic about RLS but was not a specialist. He knew i researched, something most doctor dont have the time to do. He would listen and i would see this same doctor for my RLS. Then he retired early, i was gutted, upset, thought i will now never get another doctor like him, and i never have, Now at the surgery i go to, you dont get to see the same doctor, when i do go for my RLS, so no doctor patient understanding. I very rarely go now about my RLS, there is nothing they can give me which i havent already tried, So, i keep to the meds what does help some what.

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Not-methadone-addict

I’m so sorry Elisse and I lost my doctor at one time too when he went on sabbatical and never came back. Can’t you get to see a specialist somehow? I know you’re not in the US as I am but doesn’t the U.K. (am I right about that being your location?) have a system that can get you seen by a specialist? I know (personally unfortunately) not all specialists are equal but I just was so desperate I kept going until I found the right help. RLS is so horrible much less not having someone to properly help. I’m praying I’m where I need to be right now. He’s assured me I am, however, I was promised that before when a lie derailed it all. I wish I could help or at the very, very least hug you. I’m so sorry. My thoughts (not much help) are with you.

Sus

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Elisse2

Hey i am ok, honestly seeing a specialist i dont think can help me. My problem is i am sensitive to all the meds. They all give me bad side effects IF i take enough to sleep at night, those side effects last all day and i cant function. I am dizzy or drowsy or both, so i juggle the doses of one tramadol and i cut one Pramipexole into pieces. When the tramadol becomes too much then i change to one tramacet and the bit of the pramipexole, then when the tramacet is not working aswell its back to the tramadol. Sometimes i misjudge how much Pramipexole to take, which results in a bad night, I never sleep through the night. So, for me its not that i cant take the meds which will work, i cant take too much of them. I have tried them all Ropinerole, the Neupro patch, Gabapentin, Pregabalin, codeine, even co-codamol which has a teeny bit of codeine in it all have the same effect on me. But thank you for your concern and the hug. x

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Manerva

Great information thanks.

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Not-methadone-addict

Thank you too because you often get me to think in ways I never have. I love your sense of humor sometimes. At least I hope I’m not hopeless and you mean nothing to be funny....... Wow, hope not 🤓

Sus

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Manerva

Sus

I am very familiar with the "god complex" and I often find that (some) doctors don't follow the guidelines. Some don't apparently even know what the guidelines say.

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1234kids

May I ask what kind of doctor do you see that has given you the oxycodone?

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Meddersm
Meddersm
in reply to 1234kids

Family Practitioner

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1234kids
1234kids
in reply to Meddersm

Because you said you have RLS?

BTW I went to gyn today and she didn’t know what RLS was 😕

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Joolsg
Joolsg
in reply to 1234kids

Most doctors don’t know what it is. That’s the main problem we all have. It’s really appalling that RLS is not taught at medical school.

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marsha2306

Not an agonist!

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Tinabugsu

Correct but it does affect dopamine.

Tramadol acts on opioid receptors and increases the levels of dopaminepresent in the brain like other opioids, but it also inhibits norepinephrine and serotonin from being reabsorbed.

I belong to several restless legs groups and it is not rare. It doesn't happen to everyone but I find comments often.

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marsha2306

I was replying to your statement that you read that oxycodone IS an agonist.

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Tinabugsu

I didn't say that. I said she would be good with oxycodone. Maybe that was someone else?

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1234kids
1234kids
in reply to marsha2306

I feel dumb but what is an agonist

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Manerva
Manerva
in reply to Tinabugsu

Opioids ARE agonists, but they're not dopamine agonists, to quote an analogy that's like saying everything that has four legs is a dog.

(or everything that has two legs is human hmmm).

Sure opiates can increase dopamine levels in certain parts of the brain, specifically in the "reward system" part of the brain. So can other drugs e.g. cocaine. That doesn't mean cocaine is a dopamine agonist either

RLS is partly dopaminergic receptor dysfunction in OTHER specific parts of the brain. Parkinsons Disease is a lack of Dopamine in another specific part of the brain.

You don't treat RLS or PD with cocaine.

Incidently, lots of non drug things can increase dopamine levels (in the reward system). No agonists involved e.g. making love, gambling.

Neither prescribed for RLS.

I have heard in some cases that Tramadol can lead to augmentation, I don't know why. In fact why augmentation happens at all is still a mystery.

However, it's nothing to do with Tramadol containing a dopamine agonist.

Oxycodone IS licensed for using to treat RLS in the UK.

Getting someone to prescribe it can be a problem

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Tinabugsu
Tinabugsu
in reply to Manerva

I said "I think" tramadol causes augmentation in some people because it is a dopamine agonist. Ok. So it affects dopamine levels. Whatever it is, my point is that tramadol is different. I take an opioid for RLS. Specifically methadone! So I don't know what your problem is. I clearly said "oxy is good." I'm very aware of the different approaches and classifications of meds to treat RLS. I've had it 3 decades! I'm a member of the RLS foundation. All I did was tell her that the opioid she was on doesn't cause augmentation and warn her about the only one that might. She seemed to think that all drugs cause augmentation. I wanted to assure her that it was only DS's and tramadol. End of story.

If you want to educate and say, "actually tramadol isn't a dopamine agonist but it sometimes causes augmentation because . . . " That's fine. My guess is because it affects dopamine receptors. I think it's an educated guess. If you know why that is, then go ahead and put it out there. I'd be interested.

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Manerva
Manerva
in reply to Tinabugsu

Gosh, sorry, I didn't intend to offend you.

I do recognise the value of the advice you gave.

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Sara_2611

I don't know I'm really sorry I've never heard of the drugs you mentioned so I can only suggest you to speak to your doctor

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involuntarydancer

If 5mg of oxycodone is affording you relief even while you are withdrawing from a dopamine agonist and your serum ferritin is that low, maybe you should consider staying on it. When I was withdrawing from pramipexole I needed 30mg oxycodone all in one dose to get relief during the night (I just suffered the daytime symptoms). Obviously it would be worth seeing if you could do without drugs altogether once the dopamine agonist is completely washed out and you raise your serum ferritin but if you find you need a med, 5 mg of oxycontin is a relatively low dose and all the alternative meds carry side effects.

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Meddersm

Agreed!

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Painallthetime

I would ask how you werw ablw to get a scripr for this when it is basically not possible unless your in a pain management program who I refuse to do since its not covered by insurance and is a highly addictive medication

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