I’m experiencing really bad RLS augmentation from supplementing with L-Dopa for three months, but wondering if I switch to other dopamine boosters such as Chlonine, Uridine, L-theanine, will the effect be the same?
For context, this is what they specifically do:
Hi.
Have you been taking L Dopa without a prescription? I note you say you've been "supplementing" with it. If you mean a food supplement like vitamins or minerals then Dopa isn't a supplement. It's a drug.
If you're using it to supplement something else you're taking for RLS then what else are you taking?
The other things you mention appear to have nothing to do with RLS.
As far as "dopamine boosters" are concerned, there's really only two classes of drugs that "boost" dopamine. One class is drugs that increase levels of dopamine in the brain. L Dopa is an example of this.
It's particularly useful for Parkinsons Disease in which there is an actual lack of Dopamine. These drugs as you know can quickly cause augmentation.
The second class of drugs that might "boost" dopamine are the dopamine agonists. (DAs). However, these do NOT increase the level of dopamine in the brain. They are more commonly used for RLS since RLS is not due to a lack of dopamine, it's due to a dysfunction with dopamine specific receptor sites in brain cells. The DAs correct this dysfunction, not by increasing dopamine, but by making it more effective.
The simple answer to your question is "Yes", other drugs which boost the action of dopamine also cause augmentation.
The chances of DAs causing augmentation are less than L Dopa, but they still do it.
Additionally, they are all more likely to cause augmentation if you've previously had it caused by another drug i.e. like L Dopa or another DA. Therefore, if you've augmented on L Dopa, if you switch to another "dopamine booster" you'll probably augment again.
As regards your other post. You are looking for an RLS specialist. I'm afraid I can't help you with that, but you are looking for a RLS specialist.
"Specialists" are usually a Consultant with knowledge in a specific field of medicine.
GP specialist is therefore a contradiction, "General" is the opposite of "Special"
If a NHS GP diagnoses or suspects RLS, they don't necessarily refer you to a consultant. There are guidelines on this. If they do refer you, they usually refer people to a neurologist. Most neurologists however do not specialise in RLS. RLS specialists seem quite rare in the UK.
I have heard that there may be neurology consultants in London and I know there's at least one member of this site.who sees one. Hopefully he'll chip in.
Perhaps before you consider paying to see a specialist, (who may in fact possibly be no better at managing RLS than a GP, I suggest you find out more about this condition and how to treat and manage it . A good GP, even if they're not knowledgeable about RLS, will be willing to discuss it with you, and should be familiar with the drugs.
A good starting point is the UK national guidelines for managing RLS.
Here is a link to these guidelines.
cks.nice.org.uk/restless-le...
Even if a G P is unfamiliar with these guidelines, they will be familiar with the national body NICE, and how they should adhere to them.
Such a thoughtful reply, thank you so much.
So I basically read that RLS has to do with low dopamine levels and so bought a dopamine supplement on Amazon.
Now Foods Dopa Mucuna, 90 Vegetarian Capsules, 1 Units amazon.co.uk/dp/B00CJD6FD2/...
Yes I know that’s foolish.
The other supplements I mentioned do affect dopamine, I’ll paste from the article I linked in the original post.
My question is, if I take these will these cause augmentation, like L-Dopa did.
L-Theanine
L-theanine is an amino acid that induces alpha brainwaves for a state of alert relaxation.
Found in green tea and some mushrooms, L-theanine can cross the blood-brain barrier to boost dopamine levels. It's natural antidepressant and anti-anxiety effects reduce the symptoms of mental and physical stress and improve learning and memory.
In addition to increasing dopamine and other brain chemicals that promote feelings of calm, L-theanine reduces brain chemicals that are linked to anxiety and stress, helping to protect brain cells against the long-term effects of stress and age-related neural damage.
L-theanine works with caffeine to enhance cognitive skills. Research shows L-theanine combined with caffeine can improve attention, enhance visual information processing, and increase accuracy while multitasking.
A single dose of L-theanine - as low as 100 mg - significantly improves attention and focus compared to placebo.<10>
More on Mind Lab Pro® L-Theanine
Citicoline
CDP Choline, one of the major components in Citicoline, encourages dopamine release and improves overall dopamine levels by acting as a dopamine agonist and inhibiting dopamine reuptake.
Because Citicoline is water soluble, the body readily absorbs it into the bloodstream, giving it a 90% bioavailability rate and increasing its effectiveness. But this is just one of many reasons Citicoline is one of the best overall nootropics for dopamine.
Research along with preliminary evience in clinical trials on its effectiveness at reducing cravings in cocaine users suggests that Citicoline's effect on the dopamine-reward system can help reduce food and drug cravings and control appetite.<11> And Uridine, the other major component in Citicoline, may help when combined with CDP choline.
Uridine, along with CDP Choline, promotes the growth of new dopamine receptors in the brain by activating D1 and D2 receptor signaling, helping to prevent dopamine receptor burn out, especially in brains with fewer dopamine receptors.
This mechanism helps optimize mental function and improve both mood and cognition.
More on Mind Lab Pro® Citicoline
Rhodiola Rosea
Rhodiola rosea, or golden root, is a popular plant used in traditional medicine across Asia and Eastern Europe.
Some of Rhodiola's benefits include boosting mood, increasing energy, enhancing work performance, and reducing the symptoms of physical and mental stress.
Rhodiola exerts multiple effects on the central nervous system, including improving dopamine's stability and inhibiting dopamine reuptake, helping to reduce anxiety and fatigue and boosting the brain's ability to handle stress.
Evidence from human studies suggests rhodiola can significantly reduce feelings of depression, anxiety, and stress-related fatigue compared to placebo.<12>
Rhodiola can enhance the permeability of the blood-brain barrier, allowing for better transport of dopamine - which improves physical and mental energy, and promoting overall brain and mental health.
Hi again, thanks for this further information.
Just to reiterate that RLS is not due to a lack of dopamine.
You will read all sorts of claims about all sorts of supplements, diets, devices, potion ks, creams and other remedies that people think might help their RLS. Some of them possibly work, for some people.
I've never heard of the supplements you mention.
Of course if you do have a lack of dopamine and you take supplements which contain the "precursors" of dopamine, i.e. the substances it's made from, then at least you're providing the raw materials for it.
You might consider that if you're eating a nutritious balanced diet you're getting all the raw materials anyway.
Taking supplements doesn't necessarily mean you'll produce more dopamine. Even if you do it might not necessarily help with RLS.
As for anything that promotes dopamine receptor regrowth, I am sceptical since I wonder why drug companies haven't exploited it or renowned RLS experts researched it.
You also have to consider that Dopamine is used in many parts of the brain which serve different purposes. Depending on what particular problem there is with it and in what particular part of the brain, it will result in different consequences. The role of dopamine in Parkinson's disease is different to its role in the reward circuit, addiction, different to it's role in psychosis or ADHD. or RLS.
"Stabalising" dopamine in one part of the brain, or boosting energy don't necessarily. relieve RLS.
Unfortunately, remedies which. can treat dopamine imbalances in one condition can cause a condition in another. Anti-psychotic drugs can cause Parkinsonism, antidepressants can cause RLS.
Your information is helpful, there are many members on here seeking to find ways of managing their RLS without medication. In some cases, probably of milder RLS there are successes in this.
Personally, taking into account all the "natural" supplements and remedies that members on here recommend, I'd end up paying out a small fortune with no guarantee of any of them being effective.
It's much easier to bob down to the chemist to get my free prescription of Gabapentin once a month.
I may have misunderstood your question actually. Perhaps you were looking for other natural remedies or supplements that boost dopamine which won't cause augmentation.
I also thought you were taking the drug L Dopa
I haven't really come across any dopamine boosting (non medical) remedies on here nor any "natural" dopamine agonists. Unfortunately, if there were such other things then they would probably run the risk of augmentation.
If you are successful in finding a RLS specialist, I hope you won't be disappointed if all they offer you is one of the currently accepted first line drug treatments for RLS. If you're worried about augmentation an alpha2delta ligand is preferrable.
Again, thank you for this thorough and thoughtful reply.
So yes to clarify, my question is: are there natural dopamine agonists that don't cause augmentation, as my understanding is that only commonly prescribed Dopamine Agonists like pramipexole and Levodopa have been test.
The three I suggested, which all can be bought on Amazon, are:
Chlonine, Uridine, L-theanine, will the effect be the same?
For context again, this is what they specifically do:
mindlabpro.com/blogs/nootro...
There are lots of things you can do to boost dopamine such as take certain probiotics, so wondering what non augmentation generating options I have.
Two background questions:
How does augmentation occur? How does something remedying a dopamine shortage / malfunction exacerbate symptoms?
If SSRIs trigger RLS (this is what happened to me) can it be reversed over time? I noticed that the first time I went on it (6 weeks, two years ago) I had it mild, but it came and went, and then when I went on them briefly (2 weeks, three months ago) its now quite bad.
Thanks so much.
Just to clarify, assuming that the things you nention are successful in either increasing dopamine levels or increasing receptor sites, it doesn't necessarily mean that they do this in the parts of the brain affected by RLS.
Furthermore they will not "cure" RLS, because the factors that lead to receptor site dysfunction will still be present. This is analgous to a leaky bucket.
One such factor is brain iron metabolism and there is some evidence that cellular mitochondrial dysfunction is involved in this.
There is also evidence that Glutamate levels are implicated.
As regards augmentation. There's no clear evidence as yet about what exactly causes augmentation.
There is a theory that that receptor site activity is regulated by dopamine levels i..e. the higher the level of dopamine the more receptor sites are "downregulated".
In RLS particularly, since dopamine levels are already at a normal or raised level, anything which boosts the level will lead to a downregulation of receptor sites i.e. a high level of dopamine will lead to a greater dysfunction of receptors hence dopamine will be even less effective, symptons will worsen.
Since drugs such as L Dopa increase dopamine levels significantly, they can quickly cause augmentation. Since dopamine agonists also increase dopamine levels indirectly but not as significantly they can also cause augmentaion but not so quickly.
This may be soemthing to do with the "speed" at which a dopamine agonist is released into the blood stream. There is some evidence that slow release versions of dopamine agonists are less likely to cause augmentation. The Rotigotine patch (Neupro) is considered less likely to cause augmentation. There has been a study which looked at the effectiveness of switching to a slow release form of Pramipexole for treating augmentation.
If that's the case, I can't imagine that natural dopamine boosters either raise dopamine levels significantly or at a sufficient speed to cause augmentation. It probably follows that despite any general evidence on their effect, don't be disappointed if they have little effect specifically on RLS. If you can fill a leaky bucket or not, depends on how fast you can fill it.
Fill it too fast and the extra pressure makes it leak faster!
In answerto your question, will taking these supplements cause augmentation. I'd say, probably not. I'd say try them for some time and if they do work for you that would really be great.
It avoids possibly wasting money on seeing a private specialist.
There are lots of triggers for RLS, remove the triggers (if that's possible) and the RLS will improve. If an SSRI causes an excerbation of RLS, stop taking the SSRI and the RLS will improve.
NOTE - you have to suffer RLS in the first place. SSRIs do not "cause " RLS in someone who doesn't alteady have a predisposition. Remove a trigger and it removes the exacerbation, it doesn't cure RLS.
I hope that helps.
It does help so much, thank you for your time and patience explaining this.
I kind of understand, it’s all very complicated!
I’ve stopped taking L-dopa for a few days and my symptoms are very bad which I assume is withdrawal. Do augmentation symptoms go away once the drug leaves your system. I heard a report that they go away after about a week.
If you stop taking L Dopa, especially if you go cold turkey, you will experience withdrawal effects. It isn't advisable to stop cold turkey.
If you have RLS, once withdrawal effects decline, if you've not replaced the L Dopa with some other effective RLS treatment, then you will continue to experience RLS symptoms.
Augmentation will improve, but you will still have RLS.
Mucuna Pruriens contains l-Dopa. It is an ancient Ayurvedic herb made from the Velvet Bean.
I would imagine that in sufficient quantity it would certainly cause augmentation, just as Big Pharma's l-Dopa does.
It cannot harm to try a little bit and see. It might give you a little energy, but I think the information you cite is not for anyone with a disease condition like RLS, in which it is not a good idea to mess with dopamine receptors. You will probably waste your money. Long ago and far away I wasted mine.
L-theanine is great for anxiety, and anxiety often goes hand-in-hand with RLS.
Thinking of coming off of dopamine agonists and seeing what my rls is like. Anyone do withdrawal with the help of zopiclone or other meds? X
augmentation on neupro+Gabapentin. should I switch to a different dopamine agonist? All that’s helping is cannabis. 
L Tyrosine may be helpful
Freaking out about augmentation so how do u prevent it?
Ropinirole and augmentation, when do I change drugs and how will I cope?
