Alternating Requip and Mirapex?

[Pizza_mom]

I, too, had problems with requip augmenting. Has anyone tried switching to Mirapex when Requip starts augmenting and then back again when Mirapex starts augmenting?

[Hidden]

Hi, that sdoesn't sound particularly helpful since they both cause augmentation. I've never thought of trying it but if you switch immediately between one and the other perhaps the augmentation will just carry on.

If you wean off one befoer starting the other then you'll have to go through withdrawals.

I have read some people find taking a dopamine agonist (DA) holiday helpful i.e. weaning off the DA and not taking one for a while.

Neupro, I believe is the least likely DA to cause augmentation.

[Joolsg]

The only time switching will help is if you haven’t suffered augmentation. If you’ve had augmentation on one, switching to the other will also cause augmentation ( because the dopamine receptors have been over stimulated/damaged) fairly quickly.

Drug holidays and drug rotations on dopamine agonists don’t work for the majority if augmentation has already occurred.

Switching to another class of med is a better option.

I know some people have returned to DAs after a long time off them ( at a very, very low dose) & that is another possibility.

[Pizza_mom in reply to Joolsg]

Thank you both for your prompt replies.

[TeddiJ]

Hi, Pizza_mom. I have done exactly that-toggled between Ropinirol and Pramipexole. It absolutely works for me in the moment. BUT, as you are finding out, the goal should be to get off of both.

I am trying to titrate down on Pramipexole right now. A week or two ago I was on ROP and I could tell I was augmenting.

Last night I got by with one .125 PRAM pill and 1/4 of another. I also downed THC gummies...hoping to get through the night.

I am not really sure what I am doing or how fast I can titrate down, and would appreciate any advice from the senior members who know I need to do this.

I have been on and off both drugs for a number of years and really wish I had never started them. If you are reading this and haven't started DA drugs-do not start. Work on your iron/ferritin levels and nutrition instead.

Best of luck to All!

[Joolsg in reply to TeddiJ]

Advice from top US doctors is to titrate down slowly- at least 3 months- up to 12 months.

After each reduction wait at least 2 weeks before the next reduction.

The slower the better. The longer you’ve been on DAs and the higher the dose- the more difficult the withdrawal.

Read all the posts by Manerva and his replies to posts about Augmentation and pramipexole.

All the links you need are there.

You should ideally start replacement meds while you’re reducing the pramipexole.

[TeddiJ in reply to Joolsg]

Much appreciated info, Joolsg! Thank you so much.

[TeddiJ in reply to Joolsg]

PS-when you say "replacement meds," do you mean Gabapentin? Anything else I can try? I was/am hoping the THC can help. Some say they got off the DA drugs with it.

[Joolsg in reply to TeddiJ]

Gabapentin or pregabalin are in the same class of meds. Gabapentin had too many side effects for me so I switched to pregabalin. I’m on low dose OxyContin and low dose pregabalin.

Getting off Ropinirole was really difficult for me and I needed tramadol and cannabis (illegal) to get through it.

I think if you can get THC where you are it will definitely help withdrawals.

[TeddiJ in reply to Joolsg]

Thank you! So helpful. Do you happen to know how much THC per night would work? I cannot figure it out, thus far. (Yes, I am in IL and it became legal in Jan.)

[Joolsg in reply to TeddiJ]

I wish I could tell you. Cannabis is illegal here in England and my adult children bought it for me. As it’s illegal, there is no way of finding out how much THC was in the stuff I smoked. All I know was that after 3 days with zero sleep, a few puffs knocked me out for a blessed hour. If it were legal, the quality could be regulated and we could ask for the perfect strain. Actually it was made legal for epilepsy and MS last November but this Government hasn’t organised anything to ensure we actually get it . Madness.

Ask your local dispensary for advice- they’ll be able to tell you which strain will help and whether edibles would be better.

If you get bad withdrawals - you may need an opioid like tramadol or OxyContin short term. Withdrawal lasts 10-14 days after the last dose of pramipexole/Ropinirole and symptoms should then start to settle.

It can take a few months to find the right combination of meds that will work for you.

[6220 in reply to Joolsg]

The strain you want is “grandaddy purple” same strain Parkinson patients use.. ive grown it and used it for two years now, no RL no Augmentation.. just blissful sleep

Not a cure but the next best thing.. buy seeds on line, very easy to grow indoors...there are ways around the illegality.🙏

[Joolsg in reply to 6220]

Thank you so much. I will look into that. They can arrest me if they want but imagine arresting a pensioner with MS and severe RLS - especially when it was supposed to be available legally for us last year. I shall enjoy gardening.

[TeddiJ in reply to Joolsg]

PPS-how much ROP were you on? I kept upping my dose over the years-no surprise there.

[Joolsg in reply to TeddiJ]

Likewise. I started on 2mg and upped it to 4mg. I then started to reduce back to 2mg and it actually stabilised again for a while. The augmentation crept up on me again and it was only when I started needing to take it at midday so I could sit still during my monthly hospital MS infusions that I realised how bad it had become. I was terrified of stopping it - a sure sign of Ropinirole "addiction" and then came on this site for help.

The knowledgeable people advised me how to reduce it with the help of tramadol. Persuading my GP to prescribe opioids was impossible but my MS neurologist helped me by writing to tell her she had to help me get off ropinirole by prescribing tramadol ( and then Oxycontin). I was lucky I had a neurologist who was willing to read all the info I sent her on safe low dose opioid use for RLS. I really feel for those who have ignorant, negligent GPs who put them on DAs at high dose and then refuse to believe in augmentation or withdrawal or prescribing opioids.

Withdrawal was hellish but once off DAs my RLS is much milder and only affects my legs at night. I manage to get back to sleep quickly by doing yoga stretches.

Life is so much better off Ropinirole. I wish you strength in getting off DAs.

Let us know how it goes.

[freshstart-100]

I have found the Holistic approach to RLS to work better than Mirapex and Requip .I take 3 pills that melt in your mouth- Hylands Restful Legs. I also use a Magnesium Lotion that works very well. You massage it onto the legs - It is by Ancient Minerals- Magnesium Lotion. Both of these products are available on line from Amazon. I also take a liquid Magnesium supplement- 400mg with juice and I take Restavin with juice. I take all the above before going to bed and no longer have to take Requip with the dangers of augmentation. I hope this regiment works for you!!