Does RLS ever go away? One week off patch and no issues

[Discopage]

I was diagnosed with RLS about 2 years ago and I’ve been on 1mg Neupro since then, after trying another med that didn’t help.

Recently I ran out of patches and had a struggle reaching my doctor for a new prescription and then another struggle getting a coupon for a rebate. Long story short, I haven’t had a patch for a week now and haven’t had issues with restless legs or any identifiable withdrawal symptoms.

Could it be that my RLS has gone away or been reduced to the extent that I might not need the med anymore?

And if someone is on 1mg patches and wants to wean off, what do they typically do? I was told never to cut the patch in half.

[Hidden]

Hi, it seems you went from 1 mg rotigotine to nothing overnight.

This isn't a good idea because there is a small risk of a serious reaction. However, you should now be safe.

It's usually best to reduce the dose in small steps and some say you should take at least 3 months reducing it.

As for cutting the patch.

Manufacturers recommend you shouldn't, (fear of litigation)?

Different patches are made in different ways. "Reservoir" patches are made in such a way that if you cut them it destroys the slow release mechanism and you may get an overdose. I don't believe neupro is made like that.

Many members of this forumsay they've cut them with no problem.

In any event here you are on zilch rotigotine for a week and no apparent withdrawal effects.

You have the option of continuing on zero rotigotine to see if withdrawals start to occur. Obviously, if they don't then there's no problem. If they do you can either choose to stick through them or start back on the patch possible at a reduced amount, then wean off again slowly.

Does RLS ever go away?

In some cases RLS may be caused by some other underling condition. Secondary RLS. It just depends on what the condition is.

Anaemia can cause RLS, in which case, curing the anaemia may cure the RLS.

Peripheral neuropathy can cause RLS. If you could cure the neuropathy then it may cure the RLS. BUT not all cases of neuropathy are curable.

Primary RLS the inherited condition is not curable. Sorry you can't rely on it going away. It used to be at one time that if a Dr was switching you from one medicine to another they'd have stopped you taking the old one a couple of weeks before starting the new one. This was called a "washout" period to see if the RLS has somehow gone.

I don't think is done so much now, except by the ignorant or the cruel.

An option for you then, as you've already started, is to continue taking nothing. It would have to be a few weeks. If your symptoms started again, you couldn't really be sure it's withdrawals or what it's going to be like without any medication.

After thatyou have almost the same options as when you first had RLS.

1). Have blood tests for iron deficiency and if your ferritin is below 75 start an oral iron supplement.

2). check if you're taking any other medication for any other condition, that it's not one that makes RLS worse.

3). Identify and avoid any other possible aggravating factors e.g. in the short term sugar, alcohol, caffeine, chocolate etv.

In the longer term other food elements you may be sensitive to.

If you ever need to take a medicine again avoid taking rotigotine, ropinirole or pramipexole. Try instead pregabalin or gabapentin.

[Discopage in reply to Hidden]

Thanks for all the info. I appreciate it. The smallest Neupro patch is 1mg so I guess to wean off, you'd need to cut the patch. Medical sites always say not to cut it. I'll give it more time and will monitor carefully. Want to reconnect with my neurologist on this, too.

[Hidden in reply to Discopage]

Right and right, to get 0.5 mg cut the patch in half, to get 0.25mg in quarters.

Medical sites do say don't cut, they have to say that. But as I say many do.

[macewan13]

Hello. Discopage,I live in France where the lowest level patch is 2mg. Right from the start, a couple of years ago, I’ve been halving them, on the advice of the neurologist. At one point I was using three quarters of a patch.

[Discopage in reply to macewan13]

Something tells me I’d have been better off cutting mine and gradually weaning off. At this stage I don’t think it makes sense to go back to say .75mg unless I start to struggle with restless legs and sleep. I am experiencing some depression now and I believe that’s linked to dopamine agonist withdrawal. I take an SSRI as well. I’ve contacted my psych to get guidance on whether to increase my SSRI dosage.

[Hidden in reply to Discopage]

I agree it doesn't really make sense to go back to 0.75mg unless you do start to really suffer. However, if you do, you can't be sure that it's withdrawals or what your RLS is like without taking any medication for it.

It doesn't go away, there is no cure.

It might be better to assume the latter.

In which case you should be thinking about what you're going to take instead of the rotigotine. This should not be another dopamine agonist, e.g. ropinirole or pramipexole.

The standard alternatives are either pregabalin or gabapentin.

I'm sorry if you're suffering depression. Unfortunately SSRIs will make your RLS worse. You therefore have a dilemma, if you increase the SSRI then your RLS will get worse. If you decrease it it will improve your RLS, but your depression may increase.

It does seem as if you'll have to some medication for your RLS to counteract the effect of the SSRI.

Please see points 1) and 2) in my first reply to you.

[Ert223]

I have heard with some people it comes and goes...some are lucky that it leaves completely...