Gabapentin

[Camry2020]

Has anyone suffered OCD or compulsion issues with gabapentin. I feel those issues creeping back in now that I'm taking it

[Joolsg]

Were you on Dopamine agonists before gabapentin? OCD/compulsion issues are a serious side effect of DAs but there is some evidence that the Alpha2Delta ligands, if used after you have suffered ICD or Augmentation on the DAs can cause similar issues.For example at least 2 of us on here have experienced Augmentation on pregabalin. There's a 2015 study comparing Pramipexole with pregabalin and Augmentation on pregabalin is mentioned.

So, if it can cause similar side effects to DAs it would follow that some (not all) will experience ICD with pregabalin/gabapentin.

At least that's my hypothesis.

You're not still taking any other meds are you?

[Camry2020 in reply to Joolsg]

Thanks! Great point and I didn't think through my past attempts. Mirapex, Horizant, Neupro patch 6mg,..... and every other drug that's ben on the market for the last 40 years all lead to augmentation. Series of iron infusions lead nowhere. There's no escape from this condition! I've been taking Kratom with some success but have learned The WHO is about to have an international ban placed on it.

[Joolsg in reply to Camry2020]

Have you tried low dose opioids? It seems that those with severe, refractory RLS who have had ICD or augmentation on DAs and a tough withdrawal don't seem to find relief with the alpha2delta ligands. Dr. Buchfuhrer, a US RLS specialist sees hundreds of patients and he was the one who first mentioned the inefficacy of pregabalin and gabapentin to me.

I know there's difficulty getting opioids in the USA but there are several specialist doctors and centres of excellence in the USA where you would be able to get them prescribed at low dose. If you let me know where you are I can send some info from the US RLS foundation.

[Steino in reply to Joolsg]

I am one with severe, refractory RLS off of requip. Took 6 months to get off it. Misery. Nothing else has worked. Am current on a combo of pregabalin and clonazepam, and still wake up every night with symptoms. My doc has prescribed low dose methadone which I will start after a sleep study to rule out sleep apnea first. My hubby is terrified of my taking methadone. However I am typically not an addictive personality. Hopefully this step works. My doc is suggesting a year of this and then back on ropinerol however.

[Joolsg in reply to Steino]

Methadone at low dose seems to work very well for severe refractory RLS after augmentation & tough withdrawal. Dr. Winkelman's opioid study shows it's the most widely prescribed opioid in the USA for RLS.

Requip is a far more serious drug but it's taking the medical profession a long time to realise the devastating side effects of ICD and augmentation.

I hope your sleep test shows you will be able to tolerate it and good luck.

massgeneral.org/rls-registry

[Steino in reply to Joolsg]

Thanks so much for the link to the Mass General registry. Incredible work and ever so important. The initial data is very interesting and reductions in suicides and effectiveness of treatment, etc.

[Joolsg in reply to Steino]

Funded by the US foundation. The only research into effective treatments at the moment. We desperately need more research and more doctors with basic knowledge.

[Hidden]

It must be awful, if you suffered an Impulse Control Disorder (ICD) as a result of previously taking a dopamine agonist (DA), thought you had recovered from it and then find it returning. I'm so sorry.

It is known that DAs cause an ICD. There is a known reason for this and it's because they directly raise dopamine levels and this is also a known feature of addictive narcotics such as opiates or cocaine.

I'm not 100% certain, but as far as I'm aware, gabapentin does not directly raise dopamine levels.

I'm also aware that you mention "compulsion" issues rather than ICD, so it is possible that these may be separate issues.

Again I'm not 100% certain that DAs have ever been found to be a factor in OCD. Compulsive behaviour (rather than impulsive) is also an aspect of OCD.

I'm not sure that gabapentin is a factor in OCD either.

The point I'm trying to make is that I wouldn't automatically assume that the gabapentin is the cause of your issues. The OCD may be entirely separate.

In which case stopping gabapentin or switching to another drug may possibly be of no help.

I am neither a doctor nor do I know sufficient about your health history to give you a definitive answer.

I strongly suggest you therefore seek professional help, not just about your RLS, but also about your mental health issues.

[Hidden]

Some more information for you.

In my travels through scholarly articles on psychological factors in RLS I found the following.

"Impulsivity" is the tendency to carry out actions without thinking of the consequences.

"Compulsivity" is the tendency to carry out the same action repeatedly.

I found at least one study that found both OCD and ADHD are correlated with RLS! ADHD more so.

If you didn't suffer OCD before being diagnosed with RLS, then it is possible that your OCD has developed because of RLS, i.e. NOT because of any drug.

I find it confusing the way in which IMPULSE Control Disorder (ICD) is written about in relation to the use of dopamine agonists (DAs) for RLS.

These articles appear to use the two words, impulsive and compulsive as if they are synonymous. ICD is described as repetitive behaviour rather than thoughtless action.

Perhaps I've missed something!

I never suffered ICD when I took a DA.

However, more recently I do recall sharing experiences with at least one other member that I have sudden impulses. Luckily, I manage not to act on them. Whenever I go to the edge of a high wall, cliff edge etc, I get the urge to jump off.

When driving, I sometimes get the urge to deliberately crash into another car.

This is not complusive, you can only jump off a cliff once!

Recently the petrol lawn mower wouldn't start. I partly dismantled it. Checked spark plug and spark. Checked fuel lines and even dismantled the carburettor and cleaned it. Still wouldn't start.

So I went and bought a new one!

When I got home, my wife had started the old one. His and her lawnmowers!

I believe I am considerably more impulsive than I used to be.

Since I take gabapentin, I think at least some of this is due to gabapentin.

However, this is clearly NOT the same as ICD or OCD.

This confirms perhaps my earlier suggestion that your OCD is not due to gabapentin, or since you've stopped, a DA.

Your OCD may be a part of your RLS. I'd seek professional advice.

Lastly another little snippet, it has been found that gabapentin, when used in conjunction with other medicines (not on its own) can help treat OCD. Conclusion, your OCD is not due to gabapentin.