Neurologist

[Bellamcc]

I had been to the hospital to a neurologist. I was given ropinirole after gabapentin stopped working for me. I read that rls is caused by lack of dopamine in the brain.

[Hidden]

Hi Rosemary, firstly I'd suggest you change your username. If this is your real name, for your own security it's generally not a good idea to use it. It may also compromise confidentiality.

I'm sorry gabapentin stopped working for you, it is preferable to ropinirole.

I presume you are stopping the gabapentin.

You will probably find that the ropinirole works for you fairly quickly. It can be very effective.

RLS isn't exactly due to a lack of dopamine, if this is what the neurologust says, it's been shown to be a lack of dopamine "receptor sites". In fact, some people with RLS have raised dopamine levels. Ropinieole is one of three "Dopamine Agonists (DAs) used for RLS which stimulates the dopamine receptor sites. Unfortunately the long term effect of the DAs is then they further reduce the number of receptor sites available.

I do hope however that the neurologist gained your informed consent to taking it before prescribing it. Health professionals are supposed to do this by law for any treatment in most western countries

Under the law the neurologist should have told you the benefit of ropinirole, but also the alternatives, risks and any possible complications. They should have also checked that you have understood what you've been told.

I appreciate that doctors don't always do this, especially when it comes to medications.

However, in the case of ropinirole he/she should have warned you of the major complications associated with ropinirole. These ar Impulse Control Disorder (ICD) and augmentation.

These are both severe complications, augmentation being very common and ICD less so.

The other things the neurologist has apparently failed to do is blood tests for serum iron, transferrin and ferritin. These are tests for iron deficiency which is a major cause of RLS.

If your ferritin is less than 75 then it may help you to start taking an oral iron supplement. Your Primary Care doctor can do the tests, but they must tell you the number, not just it's "OK" or "Normal". This is of no help to somebody with RLS.

Apologies if the neurologist or other doctor has done these blood tests, but if they have, you should find out the results.

see this link about iron and RLS

sciencedirect.com/science/a...

A third thing your neurologist/doctor have apparently failed to do is discuss if there is anything aggravating your RLS. This is mainly other medications you may be taking such as antidepressants, sedating antihistamines, some antacids, some statins, some antiemetics, some blood pressure/heart tablets, non-potassium sparing diuretics and others.

This article gives an good overview of the traatment of RLS. You can refer your doctors to this.

uptodate.com/contents/treat...

This is a link to the official UK guidance for Doctors for the managment of RLS. If you don't live in the UK, you won't be able to access it.

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

[yohlense]

Very good info from other person. I take 1 1/2 mg Ropinirole and have gone through augmentation (Not recommended). I found supplements to work with the medication that keep things to a minimum in episodes. I do exercise as well and have used bodywork to help. Two supplements I've used one is from the UK - Quiet Legs and now I'm using one from US and cheaper - Seratame. Also monitor your dopamine. Triggers, stress..

[Cange]

I’ve been taking Ropinerole for years now. I started with 1/2 mg, then one, then 2mg. I don’t want to take anymore than the 2mg because for me they knock me out. If I take even 1mg at 7:00 by 8:30 I’m struggling to stay awake and need to go to bed. When I took Gabapentin, that made it hard for me to wake up in the am. I’m not sure if it’s just me or if this happens to others but it gets annoying needing it for the RLS and then needing to sleep. Hope you find relief for your RLS, it’s so annoying! Stay well