COMPULSIVE EATING WITH PRAMIPEXOLE

[Josana13]

Has anybody have trouble with compulsive eating while taking Pramipexole? I need help, please. Thank you. God Bless

[Hidden]

Unfortunately, this is probably because you have developed an Impulse Control Disorder caused by the pramipexole.

The only way this can be treated is to stop taking the pramipexole.

[Josana13 in reply to Hidden]

Working on it. Thank you.

[Josana13 in reply to Hidden]

Manerva, I reduced the Prami from 1.5 to 1.25 two weeks ago. Last night I got very ill. BP 215/115, nausea, vomiting, headache, etc. Did I reduce too much? Also reducing Duloxitine from 60mg to 40mg. Thank you

[Hidden in reply to Josana13]

The nausea and vomiting may be due to DAWS (Dopamine Agonist Withdrawal Syndrome).

However DAWS is more likely to cause LOW blood pressure NOT high.

Hopefully you know that you must sit down and relax before taking your blood pressure for at least 5 minutes.

Take the pressure 3 times with 2 minutes between each reading. Then the best (lowest) of the three readings is the one you should go from.

Don't take it too often, twice a day max, the more often you take it, the more anxious you'll become which will further raise it.

My best advice is that with a blood pressure of 215/115 you need to consult a doctor fairly quickly. The upper value, the systolic, is worrying.

[Doings]

I’m in U.K. and exactly the same as you. Mainly in afternoons. I’m fat. I’m on 0.88mg tablets Pramipexole x 4 a day. I’ve been cutting one in half for a couple weeks so now on 3 and half a day. I think it has made a difference to appetite already. I’m going to wean down further but don’t know what else I can take to replace Pramipexole as our doctor doesn’t know much about it.

[Josana13 in reply to Doings]

Hello Doings, Well there is hope for my appetite. I've gained 40 pounds since I went into augmentation. I'm on 1.5 pramipexole, cut down to 1.25 mg. Hopefully, my appetite will decrease as I decrease the medication. I am taking Gabapentin, here that it is great. Just started so don't know if it will help. God Bless and let's get off of this poison.

[ELLSBELLS in reply to Josana13]

I had an insatiable appetite when taking both pramipexole and ropinarole. I could have cooked 500g raw pasta, eaten all of it and still been hungry. Appetite returned to normal after stopping DAs. I have a problem with overeating anyway and it felt like dopamine agonists worked on things that give pleasure and over stimulate these impulses. They also seem to block any ability to control these impulses. A horrible feeling being so out of control but they stopped RLS and I slept so I took them. This all happened very soon after starting on DAs and I did not take them for years but still horrible time stopping them.

[Josana13 in reply to ELLSBELLS]

Thanks. I have gained 40 pounds in the past two years without realizing what was happening until I found this site. I didn't have problems with compulsive eating prior to this. I was on 1.5 mg of pramipexole and reduced two weeks ago to 1.25 and today I feel horrible. Diarhea, headache, shaking, sweating and dizzy. Wonder if I went down to much?

[Hidden in reply to Doings]

Firstly, I am assuming that you are taking 0.088mg tablets not 0.88mg. There are no 0.88mg tabs and if there were it would be in excess of the maximum dose of 0.54mg.

Pramipexole can cause weight gain. More worrying if you weren't aware of it, it can cause two major complucations one is Impulse Control Disorder (ICD) and the other is "dopaminergic augmentation".

Augmentation very commonly occurs. For pramipexole up to 60% of people taking it for 8 years suffer augmentation and nearly 100% after 10 years. The risk increase the higher the dose. Since you were taking 4 X 0.088mg tabs this would put you at high risk of augmentation and it is possible you may have started suffering this already without knowing it.

The weight gain is another matter. There are two possible reasons why you have gained weight and you should be able to judge for yourself which one applies to you.

The first reason is that this is simply a side effect of the drug. In which case it may become less of a problem as you reduce the pramipexole.

The second reason is that you may have developed an ICD. In your case this would be compulsive eating.

If you find yourself unable to resist overeating, then this is compulsive eating. If you gain weight despite dieting then it is a side effect.

Please see this link

cks.nice.org.uk/topics/rest...

There is another thing to be considered if you do have an ICD. This is that people with an ICD are at risk of developing Dopamine Agonist Withdrawal Syndrome, (DAWS) when attempting to withdraw from a dopamine agonist (DA) such as pramipexole.

This can be a very serious condition and there is no treatment for it.

Please see this link

pubmed.ncbi.nlm.nih.gov/236...

The amount you appear to be reducing by i.e. half a 0.088mg tab is a reasonable amount to try reducing by. Wait at least two weeks between each reduction and longer if withdrawal effects are severe or last longer than 2 weeks.. You may find withdrawal effects get worse at each reduction as the dose gets lower, so you may have to slow down.

The alternative first line medicines to the DAs ie. pramipexole, ropinirole or rotigotine are the alpha 2 delta ligands pregabalin or gabapentin. For RLS pregabalin has some advantages over gabapentin.

These also have significant side effects, but they don't cause the major complications that the DAs do, certainly not ICD.

They can also cause weight gain, but this is NOT ICD it is due to increased appetite and water retention.

Hopefully you are aware that iron supplementation can help treat RLS. If you have a ferritin level less than 75ug/L then it's possible taking iron supplements can help.

If you're takinjg any other medications, look at these, because many other medications can make RLS worse.

Please see this link

cks.nice.org.uk/topics/rest...

[Hidden]

I did not have weight gain from Pramipexole (Mirapex).

Pregabalin (Lyrica) did and does cause or rather, made it worse for me . I already have a compulsion to overeat which I deal with through Overeaters Anonymous.

I had insidiously put on about 40 lbs (about 2.75 stones) over the span of a 18 months. When I realized what was the matter and that this was real common with Lyrica, I made a concerted effort to be aware of it. I have since dropped 15 lbs. (1 stone) and continue on the way down back to my normal body weight. If I am going to have extra food and I do from time to time, it is nutritious and low-cal.

[Remember we are all adults here] I did develop compulsive-obsessive addiction to pornography out of the blue with Neuro (rogotine) patches. Like most guys, I will look at porn from time to time, but one day this compulsion showed up and it was debilitating. I did not even want to leave the house. I had taken 3 mg/day of Neupro for a year with no problem.

But when I began to experience issues with breakthrough RLS, my neurologist upped me to 4mg. Two days after I switched to 4mg of Neupro , this issue came out. I made an same-day appointment with my neurologist who managed my RLS and switched back to 3mg. The porn addiction disappeared within a day or two . Sometimes with this disease, you have to have a sense of humor and the neurologist and I laughed about this until we had tears running down our faces.

[Josana13 in reply to Hidden]

That's wonderful that you are able to be mindful about it. When the hunger hits me I eat anything that is in sight and don't realize what I did until the next day. I feel like shit and yet do it over and over again. Don't have sugar products in the house. Husband makes sugar free jello, which I like. Also cereal, grapefruit and need to get rid of other stuff. I get like a crazy person looking for food. I am pretty much in control of shopping and gambling. I think the eating is also because of the stress. It's my comfort.

[fishinphil1946 in reply to Josana13]

Josana13 and Health Unlocked community,

I have been on Pramipexole (P) and Gabapentin (G) for about 7 years. Presently 2.0 mg (4 pills) P and 1200 mg (4 pills) G per day. I have gained 50 lbs and last night attacked the frig and cupboard. Mark Twain said ' I know how to quit smoking; I've done it a thousand times.' I can say the same about overeating. Recently I upgraded my fly fishing gear by 2 rods, 3 reels, 2 spools, and 5 fly lines. I am in south Texas where the wind limits the number of days for fly fishing. At 74 I worry that I will die before my wife and she will need to dispose of my mini fishing store inventory.

In addition to P for RLS and G for inherited peripheral neuropathy I have sleep apnea and use a CPAP (nose and mouth). My neuropathy in my feet and ankles and knee replacement woke me up and provided the opportunity to raid the frig, etc. I know from sleep studies that my weight gain increased my apneas (stop breathing for 10 or more seconds) from 5/hr at 184 pounds to 20/hr two years later at 204 pounds when I qualified for a Medicare CPAP machine. The heavier I get; the more I wheeze. I think it is useful to share some other depressing problems with P assisted, compulsive weight gain: depression after binge eating, crabby attitude with spouse, hard to put on pants, socks, shoes, lack of energy from only 3-4 hours sleep per night, pants slide off my stomach, high blood pressure, hard to trim toes, have a storage box of Medium, and Large underwear and shirts, lots of size 34, and 36 pants (now a 44 waist), shy away from the bathroom mirror when showering, won't go to the pool, and difficulty getting out of a chair or in and out of boat.

What helps me stay sane? The CPAP mask stops snoring, a sore morning throat, and sleep apneas. Compression socks help after 5pm when my feet are intolerable. I use a device called a Sock Slider to put them on and a long handled shoe horn or my wife to remove them. Recently I started taking 50mg trazodone for sleeping and I could increase to 100 and 150mg. I am getting 5-6 hours sleep. This is a rather inexpensive ($4/30) sleeping aid with my insurance. Last night 800mg ibuprophen helped my knee and foot pain caused by a long day of fishing. My wife bought me a $140 pair of ZEBA shoes that allow me to slide my feet into the shoes without needing to bend over to lace them. The back "springs" up.

I do not understand augmentation, but I do know that if I forget to take my 9pm pills including 1mg P and 600mg G, I am in for a very bad night. I am afraid to go off P and G. I have to keep trying to override the overeating problem in spite of P and G. I am determined to find my metabolism level for my age and activity level. This is made more difficult by the overweight choices in south Texas. The Latino population has a serious weight and diabetes problem. Where else can you find a 4 foot x 3 foot x 2 foot deep display of 1lb lard packages?

I am sorry for the long response, but I think that sharing our problems and some medications, devices, and behaviors is at the heart of this website. Thanks to ALL for sharing your experiences and insights.

Berteau

[Josana13 in reply to fishinphil1946]

Where in Texas do you live? There is a doctor in Houston that can help you get off of the P. Please contact the Restless Legs Foundation for the doctor in Houston to help you. I can relate to what you are going through and I pray we both come out at the other end.

[Josana13]

Wow!!! Have you thought of getting off of the P? I started to get off. Started too fast and got real sick, so I will slow down. I have to get off, due to augmentation. It isn't working anymore and causing me too many problems. I am so sorry for what you are going through, but can relate to most of it.

[fishinphil1946]

I am in near South Padre Island. I think it is a 5 hour drive to Houston. Perhaps in the era of Covid 19 the Dr. can counsel me via video.

Thanks

[Josana13 in reply to fishinphil1946]

Please contact the RLS Foundation and they will hook you up with the physician in Houston. Please do not go at it alone. Very dangerous and a nightmare. Blessings and prayers for you