Pregabalin 300+?

[wantokporo]

I have had great success with Pregabalin for my PLMD for the last six months, although, of course, I have had to put up with daytime sedation. AND it has been necessary to increase the dose around every 5 days by 25 mg. in order to have my sleep maintained (I also suffer from sleep onset and maintenance issues). My general doctor said 300 mg is maximum dose; my neurologist said dosage is only limited by side effect tolerance implying I can go much higher. I am concerned because of the horror stories I have heard about higher dosages of this. Comments?

[Joolsg]

If 300mg has been a great success, why would you want to increase beyond that?

I would stick with the dose that is working. There are other conditions where pregabalin is prescribed at higher doses ( nerve pain for example) but 300mg does seem to be the maximum dose for RLS. It would certainly make daytime sedation worse.

[wantokporo in reply to Joolsg]

I don't think I was clear enough. I am just beginning the 300mg. dose. I have been moving up from 50mg. every 5 days or so when the dose started not working well. I am expecting the 300 mg. daily dose to stop working well in 5 days. I might get lucky and it might actually work for longer. I sure hope that is true. The question I was throwing out there was about going up on the dosage, as the neurologist seems to think is okay (but then he mainly treats other kinds of movement disorders and health conditions with Pregabalin so maybe he isn't locked in to thinking 300 mg. is the top dosage).

[Joolsg in reply to wantokporo]

I would stick at 300mg for 2-3 weeks. Pregabalin takes that time to become fully effective.

[wantokporo in reply to Joolsg]

I'll try that. Thanks.

[LotteM in reply to wantokporo]

If you inly use the pregabalin for RLS and/or PMLD, then it might be sufficient to take the pregabalin in the evening only. Not taking it during the day most likely will greatly reduce daytime drowsiness.

Another thing is never to expect full coverage of your symptoms. But that is a tricky balance. For a long time I found myself accepting too many symptoms because I wanted to remain on an as low as possible dose. But something that gives you the feel of say 90% coverage seems good to aim for.

[wantokporo in reply to LotteM]

I only take it at night.

[LotteM in reply to wantokporo]

So that's good then. But nothing much to gain from dose combination. I do hope the 2-3 start-up weeks will work out and you can remain on this dose or even lower again after a while. Keep in touch!

[rls-insomniac]

I take 300mgs per day split into two. 100mgs at 6.00pm and 200mgs at 9.00 pm. In addition, I'm also taking 10mgs of oxycodon and 50mgs of tramadol at 9.00pm. This is what my consultant has suggested because my symptoms were still troublesome. 300 mgs does seem to work for me in that I now manage to get a reasonable night's sleep, but I still suffer with symptoms in the evening. I also feel a bit drowsy in the afternoons but I'm okay as long as I'm doing something. If I'm relaxing on the sofa, eg. reading a book, I do sometimes nod off!

I'm not thrilled with taking 300 mgs of pregabalin as I understand that 300mgs is the maximum dose for RLS in the UK. Are you in the UK?

That said, I seem to be doing fine on taking 300 mgs without too many adverse side effects.

[wantokporo in reply to rls-insomniac]

I'm in the US.

[rls-insomniac in reply to wantokporo]

You've had some good advice from the contributors in response to your question. It certainly is a case of trial and error and what works best for you as everybody is different.

[Sampsie]

Hi,

I adapt my dose each night depending on my legs. If I've had a trigger drink or food, I need more, if not, I need less. Joolsg is right, you do need to give it a chance to work.

I have found that some nights I can come down quite low, others I go up again. I have found my lowest dose is 100mg, quite rare, but I start there and add 25mg until the symptoms go away. Then if I get breakthrough in the night, I take another 25mg. On a really bad night, I add in codeine but I try to avoid this. This might not work for you. It's a case of finding what does work but it's worth experimenting.

[wantokporo]

Thanks, Sampsie.