All Help Appreciated

[Woody4]

Augmenting big time on pramipexole. Being told to get off of it but how?? If I just quit taking it I know I will really go nuts. It is affecting me all day and really bad at night, both arms and legs.

[Madlegs1]

Very slowly, and by the smallest decreases possible.Please search " augmentation" in the tool bar at top of page.

Good luck

[Hidden]

I had the same problem some years ago. It is possible to get off pramipexole and I would describe the result, for me, as life changing.

As you may know, if you've ever missed a dose of pramipexole, withdrawal symptoms can occur within 24 hours and can be severe.

It is dangerous to stop taking pramipexole suddenly unless you intend to replace it with another dopamine agonist and that's not advisable.

The main thing you can do to minimise withdrawals is to reduce the drug slowly.

Whenever you reduce the dose you can get withdrawals, but the less you reduce by, the less severe the withdrawals.

When I was augmenting it sounds as if your symptoms were similar to mine.

I reduced the pramipexole by half a 0.125mg (0.088mg) at a time. I only reduced once every 4 weeks.

It's a trade off really, the longer it takes you to reduce the dose, the longer it will take for augmentation to subside. It can take about two weeks for withdrawals to subside, so I wouldn't reduce it more often than that.

The other thing is that as the dose gets lower, the more severe the withdrawals can become.

Some people manage to get a prescription for an opioid to help with the final stages of withdrawal.

You also need to consider other treatments.

With augmentation it's recommended you have blood tests for iron deficiency. A simple guide is, if your ferritin is less than 75, then start on an oral iron supplement.

Check if there's anything that'd exacerbating your RLS at this time. This could be any other medication you're taking, stress or any inflammatory condition you may have.

If you intend to stop taking any medication at all for your RLS, you could try this, but if you intend to start taking a replacement for the pramipexole then you could start one now. This may help a little with withdrawal.

The recommended alternatives are pregabalin or gabapentin.

[silkyreg]

I know the augmentation of Pramipexole very well. If it kicks in I take something else and stop Pramipexole immediately. THIS IS NOT A HEALTH ADVISE! It's just how I do it and I do it cause Pramipexole works best for me and the sooner my body gets rid of all remains the sooner it responds to the drug normally again and I can go back to it.

[Toast5577]

My doctor had me transition to lyrica before I tried to slowly decrease the pramipexole. It took a month or two on the new medication before I reduced the pramipexole. I went down 25% at a time. I didn’t reduce more frequently than every two weeks. It took months to totally get off of pramipexole and the worst was the last tiny bit. I hope this is helpful.

[Doings]

I just came off it after decreasing by quarter pill every 2 weeks, strangely enough as dose became lower it actually eased my rls which was very confusing. As i lessened it further i began Pregabalin as replacement, i believe it takes about 3 weeks to kick in and it hasn’t as yet. I haven’t slept properly for a couple of weeks arms legs shoulders waking me constantly plus i think pills make me pee more which is another waking up issue to contend with. I pray the Pregabalin works soon or ill chuck myself in the bloody river which is right outside my apartment.

[Hidden in reply to Doings]

PLease don't resort to the river!

You may need to adjust the dose of the pregabalin, i.e. increaase it steps of 25 - 50mg until it does work.

Obviously if it you get to 300mg and it's till not working, it's not looking so good. The max recommended dose is 350 to 450 mg depending on which source you use.

[wendy25]

You have to ween yourself off it. If u take 6 it will take 6 weeks

[Hidden in reply to wendy25]

That's a bit too fast. I took six and it took me ten months to wean off.

3 months is the recommended minimum.

[Cocosmum]

I take 2 pramipexole at 7pm and 2 cocodamol at 10 pm. Works for me. How many are you taking?

[Woody4]

This is what drives me crazy about this maddening thing called RLS!! When I wrote the ‘All Help Appreciated’ I was going nuts from several nights of augmenting. Now as I write this, I have had one of the best nights sleep with no symptoms. As I write this I feel great. I have done nothing different than any other day. What gives??

[Woody4]

Should have kept quiet and just enjoyed my one great day because starting in the afternoon things are back with intensity!!

[Marky1017]

I have spent 1.5 years now trying to get off of it. I was able to get my dosage down to .5mg by going cold turkey for 2weeks and using narcotics during that time. After that using narcotics as my main RLS medicine I have it down to .125mg which is almost time to ween off of it. Trying to cut it down without narcotics was literally a circle of hell. I wont get into all the different meds I have tried to help. Narcotics is the only thing that is working for me. Good luck finding a dr to prescribe it though.