Augmenting on everything

[Loopylegs]

Hi, I've been on codeine phosphate 60mg for the past 6 months and it's been fantastic but once again I seem to be augmenting on it, I've augmented on everything, tramadol, dopamine agonists, etc.. I really thought codeine was going to work this time, iron supplements really helped over the past 2 years I went from having RLS all over, arms, legs, shoulders etc.. to just my legs, I have tried every drug that treats RLS but can't find anything that I don't eventually augment on, it drives me mad I'm so tired from the constant disturbed sleep, I've no problem falling asleep but the crawling in my legs wakes me 2 hrs later, then I'm up walking the floors for hours until it eventually eases, I have upped my codeine but it doesn't last, has anyone found a combination that works? I know how lucky I am that I no longer have it during the day and if I'm off work I'll have a nap during the day but the sleep deprivation is getting really hard to deal with, any advice? Thanks

[Amrob]

Hi Loopylegs

I'm really sorry to hear that you haven't managed to find anything that brings you ongoing relief. It can be such a roller-coaster trying out new meds only to find that their effectiveness wears off quickly.

I'm not sure that you're necessarily augmenting on all of these different meds. Augmenting describes a worsening of symptoms on a particular medication (most commonly experienced with dopamine agonists and also possibly tramadol but not commonly with other RLS medications). It appears as though you are developing a tolerance to the medications. This can occur far more rapidly in some people than in others.

Have you considered checking with your doctor the possibility of taking two medications at once? Sometimes using a lower dose of two meds can bring about synergistic benefits that aren't obtained with a single med.

[Loopylegs in reply to Amrob]

Yes, I think you're right I may be developing a tolerance to the codeine and it's just not working, I augmented on tramadol and dopamine agonists but I was so tired last night I took a requip and slept a solid 6 hrs, I'm beginning to wonder if I should be rotating meds so I don't develop a tolerance to them, I must check with my doc and see if it's safe to do so! Thanks for the advice!

[Joannebbk]

I was also managing my RLS but with 180mg codeine daily and had done so for about 18 months. I started taking gabapentin about 3 months ago at 300mg a day whilst weaning myself off codeine.

The 300mg of gabapentin wasnt enough and over a period of a few weeks I increased this to 600mg. After a month on this amount I was still suffering so my Dr increased it to 900mg and said I could increase up to the maximum dose of 2700mg daily over a period of time. I did get up to 1500mg daily but was still suffering with RLS.

At the start of last week I started taking 60mg of codeine (still had some left) about 4 oclock in the afternoon and 3 x 300mg of gabapentin over the course of the afternoon and evening. This has worked really well for me so far and I am managing a decent amount of sleep with mainly no RLS symtoms.

I have occasionly needed to take a 4th dose of gabapentin but some days I can manage with 2 x 300mg of the gabapentin. I havent spoken to my Dr about the codeine as I have enough to last me a good few weeks.

It has been a few months of trial and error to get to this point as has been the case with most people in this group. I know a few people take all of their gabapentin at night in one dose but this didnt work for me.

I wasnt convinced about the gabapentin even though this has been a successful treatment for alot of sufferers on here. But the combo of this with codeine has been a life saver for me.

[Loopylegs in reply to Joannebbk]

I was the same with gabapentin I kept upping the dose and I wasn't noticing any relief it made me feel a bit down in the dumps when I was on 900mg, I might try 300mg of gabapentin & 60mg codeine tonight, I took a requip last night and slept for 6 hrs, like u say its prob trial & error at this stage, hope it continues t9 give you relief! Thanks for the advice x

[Hidden]

Oh Loopylegs,

I complete get this and so sorry you are suffering so much with it.

Codeine worked wonders for me too and it was the only thing that did work - everything else caused a problem, either physically or mentally. And then it stopped working wonders.

I've just started to do two things before bedtime. A fifteen minute soak in a magnesium salt bath followed by hemp cream (it's on Amazon - like an active gel with menthol etc in it). That seems to be taking the worst of it off for a good while and enough to get a chunk of sleep.

It seems to be doing something. I've managed to drop a dose of codeine in a day, which was impossible to do before. It's also helping with other aches and pains, which I'm sure trigger my RLS.

I hope you find something that works for you very soon.

Pix

[Loopylegs in reply to Hidden]

Thanks so much for the advice xx

[YodaDog in reply to Hidden]

Hello Pix - just curious, why hemp oil? Thanks

[Hidden in reply to YodaDog]

Hello YodaDog,

Only because it seems that hemp oil can help with pain. I have fibromyalgia and find that as my pain increases, my RLS gets crazier. I thought that if I could help control the pain a bit better, it might help. However, I read quite a lot through the reviews, and people were saying they had used this for RLS alone and got some very good results. I'm willing to try anything that might not make me react badly, like just about anything else I take!

[YodaDog in reply to Hidden]

Ok, thanks, hope it works for you.

[Sampsie]

Hi Loopylegs,

I've read of sufferers and physicians who recommend a drug holiday to reverse tolerance. So you swap to another drug for some time, sometimes for three months, then go back to the ones working well, but on a lower dose again. This prevents the tolerance increasing.

One sufferer, it might have been on here, reported that he stopped taking codeine for two weeks when he was becoming tolerant, then went back to the lower dose without any issue. I'm not sure what he did during those two weeks to cope with the RLS though. He did this regularly.

I hope you find a solution.