Difference between gabapentin and pre... - Restless Legs Syn...

Restless Legs Syndrome

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Difference between gabapentin and pregabalin?

grandpianoman profile image
12 Replies

My first and only experience with gabapentin resulted in such dizziness when I got out of bed in the morning that I had to lean against walls and furniture in order not to fall over. I need my brain for work but was quite incapacitated that day, and never took another dose. I am reading about pregabalin as something different from gabapentin. Maybe I can take that, as currently I'm not taking anything that works very well after getting off DA--and so, I"m not sleeping much at all, and definitely not enough. Big surprise there! So ... has anyone had better results with pregabalin than you did with gabapentin? I am almost out of options; am working to build up iron, have tried everything else I can think of, can't find anything except opioids to go, and don't want to go there. Tramadol have very negative side effects. Need feedback re pregabalin vs. gabapentin.

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John_naylor profile image
John_naylor

Tramadol is my saviour! 100mg a day plus Gabapentin makes life tolerable. I still get bad periods for no apparent reason (and a few undisturbed nights) but don’t have major side effects. Nodding off in an afternoon if I relax is a nuisance but better than agonising RLS continually.

johannasuar profile image
johannasuar in reply to John_naylor

John, I didn’t see your response before I wrote my input about Tramadol. We sound like clones, I LOVE my Tramadol and with great success, and like you, I only take 100 mg but split in two 50 mg doses. I have the perfect schedule for myself, 50mg at 5:30 PM, and the next one between 10:30/11:00 PM. I also loose a bit of sleep, but for me it’s a small price to pay than having an RLS attack. If I have to travel by plane I’ll take one 50mg or if I’m going to a movie. Other than loss of some sleep, I suffer from just some constipation which I take over the counter products that help and that’s it!!! By the way, I’ve been on Tramadol for 9+ years and haven’t changed my dose, no augmentation whatsoever. I don’t use any other drugs, the Tramadol is enough for me.

John_naylor profile image
John_naylor in reply to johannasuar

Thanks for your response. I’m not doing quite as well as you as I get attacks in the afternoon and evening if I sit down. I try to keep active but only have to sit for a cuppa and am fast asleep and wake up with RLS and feel absolutely vile for up to an hour. I’ve found previously that altering the dose times can make a big difference so I may well split the Tramadol like you.

Thanks

John

Omegadcuj profile image
Omegadcuj in reply to John_naylor

Same here John particularly the collapsing to sleep and feeling vile after a few minutes. I'm on pramiprexole not sure how that relates. All the best mate

I've never tried pregabalin, only gabapentin but can say that according to the British National Formulary (BNF), the side effects are more or less the same. Since pregabalin is an "analog" of gabapentin it has virtually the same effect.

I do note that "dizziness" is a side effect of gabapentin and for pregabalin it says "vertigo". Subtle difference!

The end result is the same, you fall over.

How dizzy gabapentin makes you varies between people, but it also varies according to how much you take and when you take it. It also varies according to how long you've been taking it.

The higher the dose you take, the more likely side effects will occur.

The later you take it in the evening, the more likely you'll experience side effects in the morning. Generally speaking you won't be aware of side effects when you're asleep.

You could try taking the gabapentin a little earlier. Something else you could try is splitting the dose i.e. taking some 3 hours before bed and the other 3 hours before that. This mean that levels in your blood are highest when you most need it and will be lower in the morning.

I found that side effects faded after taking gabapentin for a few weeks.

I take my gaba at 9.30. When I wake, and when I get up ( I'm retired) varies, but the earlier I get up the more "unsteady" I feel. It fades fairly quickly and isn't that bad. I also stumble a bit, another side effect. Both preferrable to not sleeping!

When I first starting taking gaba, the main effect was drowsiness. I recall literally having to crawl on all fours to bed, could barely stand up. It wore off.

There are a couple of differences between gaba and pregab that might help.

One is that pregab is more easily absorbed than gaba, hence you don't have to take as much. That may possibly reduce the risk of side effects.

The other difference is that the rate at which gaba is eliminated is more variable. This is expressed as a "half life" i.e. the time taken for half of it to be eliminated. For gaba the half life can be as short as 5 hours, but as long as 7 hours. For pregab it's 6 hours. This gives pregab a slight advantage, the time taken for side effects to wear off can be shorter and is more predictable.

I'm sorry that it appears gabapentin doesn't suit you. You could try what I suggest and/or you could try switching to pregab, some people find it different.

The other option, but only if you live in the US, is gabapentin enacarbil.

Failing all of these, Sinemet, dopamine agonists or mucuna, it seems your remaining option is an opiate.

johannasuar profile image
johannasuar

Have you actually tried Tramadol or are you going by word of mouth. I have been on Tramadol for over 9 years, the only side effects I have are some sleepless nights and some constipation. The sleepless nights don’t bother me, it’s not a complete night without sleep, just not as many hours during the night and not always. Like all narcotics, it causes a bit of constipation but I take over the counter products to help with that. Aside from those two things, I have only had wonderful results with Tramadol, I also haven’t had any augmentation which other drugs cause. During the day I function perfectly, there’s no dizziness or foggy feeling in my head, and if I get a bit sleepy from a partial sleepless night, I take a little nap. I don’t know what you have heard about Tramadol, some people on this website also use it with great success like myself, but unfortunately for some others it doesn’t. If you have any more questions I hope I can be of help. Maybe someone else might enlighten you with more information about Tramadol. Good luck. By the way, gabapentin did NOTHING for me except gain a tremendous amount of weight in a very short time.

Heatherlss profile image
Heatherlss in reply to johannasuar

Hi Johan, glad to hear that Tramadol is working for you. What dose do you take and have you ever had to increase it over the years ? Do you get RLS during the afternoon ?

I am so sorry I have a lot of questions for you.

johannasuar profile image
johannasuar in reply to Heatherlss

Hi, you can ask as much as you want. I have been on Tramadol for a little over 9 years with no augmentation. I also have been on the same dose the whole time which is 50mg at 5:30pm and another 50mg between 10:30/11:00 pm. This schedule works for me. What I found is that my RLS would start around 7pm and through trials I realized that you have to be ahead of the attack. Tramadol takes about two hrs to kick in, so that’s how I scheduled myself for the 5:30pm dose, the second dose gets me through the night. Very very rarely have I had a daytime attack, actually I don’t remember when or what I did about it. I am an active person, not a couch potato so I move all day even if it’s just putzing around the house, so as long as I’m moving I don’t feel any RLS. I do sit and watch tv during the day, but not for hours, and even if I don’t feel any RLS I take my medication to avoid that horrible feeling.

Heatherlss profile image
Heatherlss in reply to johannasuar

that makes sense. do you ever check your iron levels between all this ? Thanks for explaining in detail. I really appreciate it.

johannasuar profile image
johannasuar in reply to Heatherlss

Yes, I had my ferritin level checked, it’s done by bloodwork. My doctor said it was fine, however, I JUST read right now going through all the responses, that some doctors that do know a little about RLS say that the level of 50(?) is perfect, but for RLS it really should be around 300 (?). I’m going to ask him what exactly was my level. Hmmm, this left me thinking 🤔. The good part is that my doctor didn’t know anything about RLS and instructed himself, I couldn’t believe he would bother. When I told him about the ferritin test he contradicted me saying that it had nothing to do with RLS, so I showed him the advice here and he did the test. What he probably doesn’t know, or myself, is what us the correct levels it should be..

wildlegs profile image
wildlegs

I’ve been taking Tramadol for 10 years and have had no side affects. The only problem I’ve had is that if I miss taking it I get twitchy in both arms and legs (like Parkinson’s). But it’s a lot better then jumpy legs and not being able to lay flat and sleep, which I had for 20 years before that.

grandpianoman profile image
grandpianoman

After I went off DA, I went to Tramadol. I didn't take it during the day since I'm quite active, but in order to stop the legs at night so I could sleep, I had to take 100 mg three times a night, as each time it wore off after a few hours, the legs would start and I'd have to take another dose. I notice that those of you taking Tramadol don't take such a high dose. And not only that, Tramadol had other side effects for me: 10-12 bowel movements a day, hot flashes returned with a vengeance (I'm 72!), and when I got sleepy, the urge to sleep was so strong that if I was driving, I had to quickly find a place to pull off the road or I would be sure to fall asleep driving. One day I hardly made it and it was scary. My day was starting later and later, and of course, once evening arrived, the legs became more active all over again. So ... that was my short experience with Tramadol. I surely wish my taking it had the beneficial results others of you have had.

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