I have written previously about my experience with rls and augmentation. For about 3 weeks now I have been cutting the 0.25mg Ropinirole tablets in half and with 50mg Tramadole capsules am experiencing serious withdrawal with an average of 2 to 3 hours sleep achieved each night but at 20 to 30 minute intervals.
I am very tired!!
My doctor is trying to understand rls . She has received from me appropriate copies of Health Unlocked articles!!
She has tried to refer to me to a Guys sleeping clinic as advised by one contributer to Health Unlocked but it was rejected!
She has prescribed 200mg Ferrous Sulfate tablets one to be taken daily for 2 months to see if it will help my rls with a blood test to see if my present measurement of 99... can be increased? However upon reading another contributor I am now concerned about the 'type' of iron that has been prescribed? Any advice here will be appreciated.
The doctor has also stated that she reluctant to prescribed Gabapentin of Pregabalin as they are controlled drugs?
I am at the point where I am desperately in need of a programme but seem unable to enlist the services of anybody in the medical fraternity!
I guess the iron question could help but at what stage can I withdraw completely from my DA Ropinirole? And what medication should I progress onto?
I have been suffering from RLS for many years which became worse after a prostate Brachotherapy procedure in 2012.
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m1946
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Just an update!! The iron mentioned in another post was "if values are not high, you can take otc iron bisglycinate once every other day on an empty stomach (eg before bed). This way you raise your iron as fast as taking it 3x or once daily but with far less stomach problems."This seems different from my present prescription as mentioned above ie 200mg Ferrous Sulfate one tablet each day?
"Gentle" iron, ferrous bisglycinate is recommended for being kinder to the gut. Prescription strength iron is more upsetting.
In addition it has been found that taking iron every two days is more effective than taking it every day. Further, drinking a glass of orange or taking a vitamin C tablet at the same time helps it be absorbed more easily.
It is been found that if ferritin is below 75 then some benefit can be gained from taking an oral iron supplement. However, if it is higher, as yours is, then it it less likely to be effective. You can try, but it may take longer than 2 months and you would gain more from an IV iron infusion.
It's true that gabapentin and pregabalin are controlled drugs, but that's not a very good reason for not prescribing one. They are commonly used for RLS. I have been prescribed one for years.
Additionally they are recommended by NICE as an alternative to dopamine agonists, especially when augmentatiion has occurred.
I was on Ropinirole, up to 4mg, but started suffering augmentation and so ramped down over a year to zero and then switched between ropinirole and pramipexole at the lowest doses. I also took 300mg pregabalin (as mentioned it is a NICE option). Basically I had a similar sleep pattern to you until I came off the DAs completely and started taking 200mcg Temgesic (low dose opoid) 5 weeks ago. Since taking Temgesic I have slept through the night and life is just so different.
It will take time to ramp down the ropinirole (do not stop taking it as the side effects can be quite bad - a gradual reduction is best) and there will be a few sleepless nights once you finally stop taking it. However if you can persuade your GP to prescribe Temgesic then it might be worth trying it. There are links on the site to medical professionals who advocate Temgesic - just search for Temgesic.
I had also asked about a sleep clinic but the consultant said that there was not much to be gained from it as the cause was already known - RLS!
There is light at the end of the tunnel, however hard the journey may be.
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