Treatment for a recovering alcoholic

[MATTIELUKE]

I first want to thank everyone for sharing. I have learned a lot. I have had RLS since my twenties and I am now 68. I took Mirapex for about 7 years before I began experiencing augmentation. Even though I was seeing a neurologist I was never guided through the withdrawal. I went cold turkey which was hell. I am a recovering alcoholic and the only options for treatment are narcotics which dosen't work for me. If take them I eventually end up in relapse. If I don't take them I don't sleep and cannot function. I had to retire on disability. I feel hopeless. Most docs don't get it. I feel pretty dang hopeless but I will never give up looking for answers. I have tried magnesium, cannabis and everthing on the books. Is there something I can do. Life becomes difficult for me and those around me. Thank you.

[Joolsg]

I think you’re in the USA. Has your doctor considered methadone? As a recovering addict it could be a good option for you.

If you let us know what state you are in, we may know an RLS specialist who is familiar with RLS and methadone and can help you.

[Hidden]

I can see that your situation is difficult. There's quite a lot of RLS sufferers who benefit from using a low dose opiate such as Methadone.

Unfortunately, if for whatever reason narcotics don't work for you, that sort of excludes that as a possibility.

The first thing you could do is have checks to see if there is anything that is contributing to your RLS. Low iron stores can lead to RLS in some people and can occur even without there being iron deficiency anaemia. A blood test for Ferritin levels would indicate how good your stored iron levels are. I believe it needs to be at least 100, but you need to know the actual result as "normal" can actually be much less than that.

You might also have your B vitamins levels checked, particularly B12. Alcohol problems can cause vit B deficiency and hence neuropathy,

which exacerbate RLS.

Additionally, there are quite a few things that can trigger RLS, i.e. make it worse. I don't know what your recovery plan is, but any alcohol is a RLS trigger. For some people, so is caffeine.

Some medications can also trigger RLS, antihistamines, antidepressants and antacids.

Dopamine Agonists (DAs), are an established "first line" treatment for RLS e.g. Pramipexole (Mirapex). As you've experienced, they can cause augmentation.

There is however another class of medications which you haven't mentioned, that act in a different way to DAs called Alpha2delta ligands. e.g. Gabapentin and Pregabalin. which can also be used as first line treatment for RLS.

These have some advantages over DAs. They are unlikely to cause augmentation or "Impulse control disorders", (i.e. addictions). They are also not metabolised in the body so don't place any stress on the liver, they are eliminated by the kidneys

They have hardly any interactions with other medications.

Their downside is that they don't work for everyone and they're not quite as effective as DAs.

If you haven't already tried, you might think about trying Gabapentin or Pregabalin then.

[MATTIELUKE in reply to Hidden]

I appreciate all the suggestions. This a great forum. I do see an RLS specialist. I have only seen him a couple of times. I live inSeattle. I started a low dose of Methadone. Not helping but I have finally found a good doc....I am not sure he can help. I have tried everything.

[martino in reply to MATTIELUKE]

I send my very best wishes to you on your journey. I know all about the recovering and to be doing that and having RLS is hard. I am very interested in the methadone. Are you persevering with this.? I ask as it was suggested to me and I am wondering whether I can get my doctor here in the UK to prescribe it. I currently take tramadol, pregabelin (lyrica) and use a Neupro patch but despite this I am struggling again.

[Dougg]

Hi. Another possibility that you might want to explore is kratom. A number of people on this forum, myself included, have found that it works very effectively in controlling RLS symptoms. If you choose to go down that road, I suggest researching carefully to find a kratom supplier who doesn’t add anything to the plant, and who tests for things like salmonella.

Glad you found this site. It’s a wonderful resource for information and support.

Wishing you restful days and nights.

[Jumpey]

I have nothing to add to the great suggestions from others.Just wanted to send love and support. X