Cutting back on Requip

[kate819]

When I started RLS only happened at night, now its all day long. Im suppose to take Requip 1mg four times daily. Also Gabapentin 300mg 3yimes a day. Problem is I seem to need it every 3 hours or I am miserable. Can I cut the Requip in half so I dont run out? If I take 1of each pill when I go to bed I sleep for 2 hours then I need to take more meds and take a hot bath to stop the pain. Then I get about 3 more hours of sleep. Im tired and dont know what yo do. This goes on all day.

I think Im augmenting but dont know how to cut back on the meds and still be able to function at work. I take up to 4hot baths to get relief throughout the night. I have forgotten what a normal night sleep is. How do I start cutting back?

[Hidden]

You are augmenting. As you have realised, you need to cut back on the Requip.

Three things

1). Your gabapentin regime is for nerve pain or epilepsy i.e. 3 x a day. For RLS you only normally need to take it once, or at most 2 X a day. That's because normally you only get RLS at night. Taking it once at night means you get more of it at night when you need it.

2) I found that when I was augmenting on a dopamine agonist and taking gabapentin at the same time, simply reducing the dopamine agonist reduced the augmentation. That's because when you're augmenting, not only is the Requip not working, it's actually making you worse.

3) To minimise withdrawal symptoms you need to reduce the Requip very slowly in small steps. I'm afraid it will take time and it's probably not going to be easy at all.

I suggest you start by cutting the dose in steps of 1/2mg. at weekly intervals. You'll have to cut the tablets the tablets in half to do this. Since you're taking it 4 x a day, I suggest you cut the morning dose first, You may need to do this by trial and error you could

either cut the am dose to 1/2 mg, then cut the midday dose to 1/2 mg,

or cut the am dose to 1/2 mg then zero, then cut the midday dose to 1/2 mg.

At some point, I suggest you switch to taking 300mg gabapentin at midday and 600 mg in the evening, 2 hours before bedtime. If all daytime sypmtoms subside and you're not too groggy next morning, then you coukd switch to taking just one dose of 900mg at night.

The worst time for withdrawal symptoms is if and when you cut the Requip from a daily total of 1/2 mg to zero. Depending on how it's going, you might consider taking time off work. At this time it would also help if you c oukd get your doctor to prescribe a short course of Zopiclone to help sleep. If you could also get th e m to prescribe a short course of an opiate, even better. It's unlikely that they'll agree to that however.

It is safe to take 900mg or more of gabapentin a day in ONE dose. It is recommended for RLS

I hope this helps.

[Arkangel]

Hi Kate, have you asked your doctor about changing your medication? I used to take Reqip and it stopped working for me. I have been using Pamipraxole for over a year now and while I still have symptoms, they are not nearly as bad.

[Hidden in reply to Arkangel]

Hi Arjangel, just to say that if someone is augmenting because of taking a dopamine agonist like Requip, ultimately it doesn't help to simply switch to another dopamine agonist, especially pramipexole which is the worst.

All dopamine agonists cause augmentation and if you've already augmented on one, then the chances of augmenting on another are increased.

Up to 60% of people taking pramipexole suffer augmentation after taking it 8 to 10 years.

[Hidden]

Everyone's symptoms and cures are different. I took Requip for many years and then it stopped working. I switched to Pramipexole and it is working fine. My prescription is for .75mg 3 times a day. If I don't stretch it out, it doesn't work. I take 1 pill at 10:30 am; 1 pill at 4:30pm and the final pill around 10:30 pm. Sometimes my legs ache at night so I also take 1 Aleve with the 10:30 pm pill. The only thing I found out is that if I'm on my feet all day the RLS doesn't bother me. However, if I don't still take the Pramipexole during the day, it will catch up with me and the 1 pill at 10:30pm won't work. I have to keep it in my system all day long. Like I say, everyone is different and you will have to find out what works for you. You will get all kinds of advice, but everyone is different. I've been taking either Requip or Pramipexole for probably 20 years now and have no adverse reactions; except for augmentation with the Requip after about 15 years. All I did was stop taking that and start with the Pramipexole. Good luck.

[Hidden in reply to Hidden]

Wow, I'm stunned. I wonder if you have misquoted your dose of pramipexole or I have misunderstood it!

The absolute official maximum daily dose of pramipexole in the UK is 0.75 mg. However some experts would say this is too much and is high risk for augmentation.

You say you are taking three times this dose. You also appear to be having symptoms throughout the day and mention it not working.

If this is the case, then unsurprisingly, it seems as if you're augmenting. Perhaps you might find you can manage your RLS better by getting off pramipexole, or any dopamine agonist and switching to an alternative.

There is lots of information on this site about augmentation, how to wean off a dopamine agonists and alternative treatments.

I does sound as if you're really suffering and things could be much better for you.

[Parky1949]

Find a neurologist who knows RLS, sounds like the augmentation I went through. My neurologist backed off on the dopamine and brought up the gabapentin with tramadol at night so I could sleep. It took 90 days for me to make the transition( I was addicted to dopamine).