Levadopa and RLS?

[Rwall]

The doctor just put me on Levadopa for nights when I want to scream. It helped and I was able to sleep. Is this a good idea? It has made the tinnitus rear its ugly head, but I'll take it over not sleeping!

[Hidden]

L Dopa can be useful on its own for intermittent RLS e.g. where it only occurs a few times a month.

If L Dopa is the only medication you've been prescribed for your RLS, I'd say it's not a good option especially if you need it more than a few times a month.

If you're already taking another RLS medication, then it could be useful for breakthrough symptoms, again only on an intermittent basis.

If you're currently regularly taking a dopamine agonist for your RLS then I'd say you should avoid taking L Dopa altogether.

The reason for this is that taking a dopamine agonist already brings the risk of suffering dopaminergic augmentation, taking L Dopa on top of this further increases the risk and hence you may find your RLS getting worse.

If you are currently taking any medication for your RLS then it may be better to have this reviewed rather than adding L Dopa.

Overall, not a good option.

[Rwall in reply to Hidden]

Well, that's discouraging. I'm on Pramiprexole ..not sure of spelling... cause had augmentation from Ropinirole. Needed to take the L Dopa last night...The Prami is a very very low dose, which I refuse to raise, hoping to avoid the augmentation. Meanwhile, will see expert here in Georgia on Wednesday for bloods, etc., and will ask about iron infusion, as mine were low last time I had blood drawn. I will make sure to only take the L Dopa on those few and far between cases. Thanks so much for the info!!!!!!!

[Hidden in reply to Rwall]

In your case I certainly wouldn't advise using L Dopa and if you do only once or twice a week temporarily until you see the expert.

If you augmented on ropinriole then you should never have been prescribed pramipexole, pramipexole has a significantly higher risk of augmentation than ropinirole.

Certainly ask about an IV infusion if you can.

The best thing to do if augmentation occurs, as well as an iron infusion, is to switch to an alpha 2 ligand, Neurontin, Lyrica or Horizant.

I hope your expert recognises this.

[Joolsg in reply to Rwall]

I think you need a new neurologist. Once you've augmented on one DA, you'll augment very quickly on another. You should see someone with experience of augmentation and get off all DAs and Levodopa. There are better meds out there. Johns Hopkins in Baltimore has RLS specialists.

[Rwall in reply to Joolsg]

Well, you're right, I've already started augmenting, and this guy IS the new specialist from Emory in Atlanta! I want to cry. I'm seeing him again on Wednesday. What should I ask him to try me on, besides Neurontin, which I'm on already and it seems ok, though I really can't tell if it's doing anything. Thanks!!!!

[Joolsg in reply to Rwall]

Get off the pramipexole by reducing very slowly over a minimum of3 months. Neurontin ( gabapentin) won't help until 3 weeks after last dose of pramipexole but you may have to try opioids like methadone or buprenorphine as the alpha2delta ligands sometimes don't help those who have augmentedon pramipexole and ropinirole ( I'm one of them).