I saw my third neurologist today a young female who seemed a lot more understanding than the previous two. When I told her I didn't want to go down the path of trying another dopamine agonist she suggested that I goin to Gabapentin tarting with 100mg three times a day end increasing gradually to 300mg over the course of weeks and at the same time reducing my intake of pramipexole gradually.
I think this is probably the best course of action but would welcome any advice my main concern was and is insomnia but I know it's not going to be a walk in the park.
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Hoochybaby
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When I switched from Pramipexole to Gabapentin, my insomnia improved significantly. So I hope you found the same.
It's not up to me to prescribe medication, but a split dose of 3 x daily is what you'd expect for the licensed use of Gabapentin i.e. epilepsy or for nerve pain.
It sounds as if the neurologist is therefore prescribing it according to the BNF. (British National Formulary).
However for RLS (not mentioned in the BNF), I take it only once a day, in the evening. I have recently read an evidence based article that advises this. You can take doses up to 600mg at one single dose in the evening. Doses over that can be split into two doses. One third of the daily dose at midday and two thirds in the evening.
E.g. if you were taking 900mg, you could take 300 mg late afternoon and 600mg later.
I can give you a link to this article if you wish.
My prescription actually says 300mg twice daily, but as I only take 600mg, I take it all at once..
I reduced Pramipexole in steps of 44 mcg (0.0625mg) i.e. half an 88mcg (0.125mg) tablet.
This the link to the article. I've amended the reference to split doses of Gabapentin, the article suggests 1/3rd of daily dose at midday and the other 2/3rd in the evening.
Be aware gabapentin does not work for everyone. It didn't help my RLS. I fell asleep on it standing up (and woke up again in time to save myself from hitting the floor) — but it didn't help, as far as I noticed, with getting enough hours sleep at night. Falling asleep standing up was also not the only adverse effect I had with it.
I have experienced falling asleep and waking to save myself from hitting the floor. Only sometimes I wasn't able to save myself. I also would fall off of chairs and out of bed. I blamed it on ropinirole and reduced the dosage and I don't experience it any more . I also took gabapentin at the same time and now I'm off of it because I didn't think it was doing any thing for me. So which drug was it ? Any thoughts ?
Well, I take 6mg of ropinirole between 14:30 and going to bed, and I don't have any side-effects, I don't even notice any brain fog any more.
While taking gabapentin, besides the falling asleep standing up, I also walked into door jambs, missed my coffee mug with near boiling water (before I had an eyesight problem), and had near syncopes when out walking or shopping, such that, in the worst case, I needed to perch myself somewhere until my strength came back. I should say though that before taking gabapentin, I did use to come over weak when out walking but would manage to just about keep going for the few tens of seconds it lasted. However, as soon as I stopped taking gabapentin, these syncopes disappeared altogether. All the other problems must have been the result of taking gabapentin, I feel.
I also walked into walls etc. This all started for me after I had been on ropinirole about 10 yrs.. I did search google and found some mention of this and some people on HU had a similar experience .
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