Tomorrow I take my last .25 tab of Ropinirole. My neurologist is switching me from Gabapentin to Pegabalin which I welcome. I had a welness visit with my GP yesterday and she has messaged me about Neupro. I do not want to go through anything like coming off Ropinirole ever again. My question is which is better for me the Neupro or Pregabalin? Cost for Pregabalin is really low for me and cost is a factor I must consider. Also efficacy is important of course -
B534967
When you ask which is "better" you have to ask better in what way?
In terms of problems
Neupro (rotigotine) as I assume you know is a dopamine agonist (DA), the same as ropinriole. It is the least problematical of the 3 DAs used for RLS.
However, if you've had problems with a DA before (ropinirole) then you're just as likely to have the same problems again, including withdrawal.
The other problem is that I believe the patch often causes skin rashes.
Pregabalin on the other hand does not carry as high a risk of probelms as the DAs.
In terms of effectiveness.
There's conflicting information about which of the two is more effective. Some sources say pregabalin has an edge, some that DAs have an edge. They do have some differences e.g. DAs are better if you have depression, pregabalin if you have anxiety.
In terms of effectiveness, evidence so far (pregabalin's not been used for as long), suggest that the risk of the major complication of "augmentation" . with pregabalin is much less than for DAs. So in terms of long term effectiveness, not so good!
Currently, pregabalin is recommended in preference DAs because of this.
Alongside this comparing gabapentin and pregabalin, they both act the same way but pregabalin is more potent and more consistent than gabapentin.
Hope this helps.
Yes this really helps. I have no intention of going through the withdrawal of anything like Ropinirole again. So Pregabalin it is. I take my last .25 Ropinirole Wednesday evening and look very much forward to that... thanks again, B534967
Good morning from London. I weaning slowly off Pramipexole awill start on Pregabalin in 2 weeks or so. I’d be interested to hear how you are getting on with it, I’m quite anxious about it as no doubt you are too.
Hello, just be aware that Pregabalin has it's own complications if you have to stop it for any reason. I have not experienced the withdrawal effects but I understand that withdrawal can be very unpleasant if not done very very slowly.
There are other potential problems people may experience which are well documented on the information leaflet provided with the medication.
I do not find it as effective as a DA so I also take some Hemp oil and have a small amount of cannabis at night. This combination works well for me. I would never go back to taking a DA. I have been left with an annoying tremor of my hands and arms since ceasing the DA plus I personally don't like them.
I am in a rather unusual position as I take Pregabelin and also use a 2mg Neupro patch. The reason is that in addition to RLS I also have a painful Peripheral Neuropathy. Once or twice I have managed to dislodge the patch and have realised this before the end of the day. I am very fortunate in that even though I have been using the patch for about five years I have not experienced augmentation. I realise that none of this is particularly helpful but instead of going for objects or the other both can be used. Who knows? Perhaps the combination is what is working.
Objects should be one!
I would strongly recommend pregabalin.It really worked for me.Good luck.
Thanks! Tonight is the final Ropinirole - starting Pregabalin next week, till then still doing Gabapentin which is working ok. Thanks again - B534967
My correct "handle" is fishinphil1946. I messed up and listed a second name (Berteau) and the site administrator brought the matter to my attention. I have been on 1200-1500mg gabapentin for about 7 years. In addition, I am on 0.5mg times 4 of pramipexole. I don't feel qualified to comment on the gabapentin because of the mix with pramipexole. I am trying to get off pramipexole. My plan is to reduce by 0.125mg every 2 weeks until at zero (32 weeks). I want to lose the 50 pounds gained while taking pramipexole. I am not sure what medication may replace it. I also joined the US based Restless Legs Syndrome Foundation. It looks like others have provided some useful replies. Best wishes to you B534967!
Hi There, I had almost finished my reply to you and it disappeared. In any case tonight is my last night with Ropinirole. I had started with 900 mg split to 300 3 x daily. The neurologist them moved it to the 900 before bed which worked fine with Ropinirole. Now as I have reduced the Ropinirole I added Gabapentin to a 1500 to 1800 mg and it's working perfectly. Tomorrow I pick up Pregabalin and will be moving over to it as the Neurologist thinks its better as it lasts longer in the system. I am hoping I do not experience weight gain.
On the weight gain - I did not gain any weight with Gabapentin. My spouse on the other had gained approx. 50 pounds using Gabapentin so go figure. I am glad I did not gain the weight and recognize the pain and depression the large weight gain can have.
Best wishes to you - and welcome to this group! B534967
Hi I take 2 gabapentin x2 300mg about 5.30pm then another 600 mg before bed so 1200mg is this not enough? not working at all now I've done the DAs withdrawal but now on sertraline as I suffer with anxiety so think it may be this that's setting me off again. Feel in catch 22 I need something for my anxiety low mood but yet my rls is bad and gabapentin not touching it now. Back to separate beds for us as I'm so bad again!! #gettingnowhere with GPS. I have an appointment with a neurologist if u read my posts I've had a nightmare with the GPS!! I'm going private but I'm not sure if they know a out rls!! Fingers crossed I get some kind of answer from this otherwise don't know who to turn to for medical advice it's a constant battle isn't it!! Take care
Hi - last night was first night with zero Ropinirole. I took 600 mg Gab. at 7 pm then 1500 mg Gab at 9 pm and had a terrible time - sleep finally came around 2 am. I had not split the dosage the last few nights of .25 Ropinirole and slept just fine so tonight I am just going to take 2100 mg Gabapentin and see how it goes - which I think the result will be a good nights sleep like before. I am starting sertraline Tuesday of next week to treat the anxiety and depression which has increased due to the RLS. The dosage for Sertraline is going to be 25 mg for two weeks then 50 mg on going, so not a terribly high dosage which I am greatful for, I had been taking 150 mg Wellbutrin XL which my neurologist said was the wrong Rx for this, that being the reason for the switch. I wish you the best - maybe increasing the Gabapentin will help you out. I have not had problems with the higher dosage. B534967.
that was 900 mg of Gabapentin split to 3 x daily. I had only used 1.5 mg Ropinirole before starting to reduce and remove it from my regimen. Sorry for any confusion. B534967
I’m on my last dose of Requip (0.25mg). I tapered off from 1.5mg due to augmentation. What an awful experience. I’m currently taking Gabapentin 600mg in the evening and it isn’t providing any relief. I read that higher doses aren’t always helpful either so I’m disappointed. I will see a neurologist next month and wondering if an opioid is next. I’m exhausted from minimal sleep as everyone here understands.
Thanks for your note, and yes coming off Ropinirole is one nasty experience. My neurologist has given me a prescription for Pregabalin and I am to take 200 mg before bed - this is a replacement for Gabapentin. He finds it to be better and I am very hopeful it is better. I begin it on Monday or Tuesday when I pick it up. He also said he avoids the Opiates as much as possible. I had originally thought he'd prescribe Buprenorphine but as I mentioned he really wants to stay away from that -- he has one patient who is on it as nothing else has worked. Best luck to you - perhaps trying more Gabapentin will work for you. Might be worth a try. B534967
Experience with Neupro?
RLS and the Neupro patch
Advise please on Pregabalin
pregabalin for RLS and libido 
Gabapentin vs Pregabalin for PLMD without RLS
