I just want to thank everyone who replied to my post. It has been so very helpful. I decided to go ahead and try gabapentin. Today is Wednesday so it was last Thursday when I took my last mirapex. I was only on a very low dose, however I started gabapentin on Sunday. I took at first 300mg at 9 pm. At 11 another 300mg. I had a bad night even with Kratom to help. Monday was a bad day from 4 pm onwards but maybe it was because I had a flu Jan. I took again 600 mg at night with tramadol and Kratom as Jools advised. It was a better night. Last night I took 300 then 600 mg. I slept will no leg problem but woke up at 3am so I had some Kratom. I then slept until 9am when the alarm woke me. I feel wonderful. Let's hope it lasts. Thanks so much everyone for helping.
GabapentinI: I just want to thank... - Restless Legs Syn...
GabapentinI
So glad to read your update! I agree that the information and support on this sight is incredible! I’m so grateful for the people who are experiencing RLS and have also done an amazing amount of research! Like you, I’ve had to test out different doses of Gabapentin. I started with 300, increased to 400 and then to 600. Recently I tried split doses of 300 (early evening) and then 600 (2 hrs before bed) and that seems to be working best. I wish you well in this challenging journey!
That is good news Memmy. Thanks for sharing. Uplifting for us 😃
That's good to hear. It's often trial and error. If it continues great, if you have RLS, add the kratom as needed. Bear in mind it'll take 3 weeks for the 1200mg dose to be fully effective. Long may it continue. X
Unfortunately tonight is bad. My legs won't settle. I presume it's the effect of mirapex. I'm determined not to take it again and just hope the gabapentin will work
You may still be suffering withdrawal effects from the mirapex. If I'm correct, you're taking 900mg gabapentin in split doses.
If you've only recently increased to this, it may take 3 weeks for this to become effective.
Note - 900mg is considered the minimum effective dose, but most people need more. So there is scope for you to increase the dose further.
If you need more than 1200mg, it might be better to switch to pregabalin. 200mg pregabalin is equivalent to 1200mg gabapentin.
Stick with it. The withdrawal symptoms are tough but they should settle as the gabapentin takes effect. Don't go back on Mirapex- it just prolongs the agony.As Elffindoe suggests, pregabalin may be more effective if the gaba doesn't help after 3 weeks. You can make a straight switch to 200mg. It's more easily absorbed, hence the lower dose. If you're in the USA, there is also Horizant ( gabapentin enacarbil).
However Horizant is very expensive.
Since it takes 3 weeks to be fully effective, you mght want to wait before increasing the dose or you could increase it but after 3 weeks try decreasing it to see if you can get by with less. In any case I believe it is recommended to increase it every 3 days, not every day.
Thanks Sue
That's great news. 900 mg gabapentin works for me, still get restless legs a bit, but nothing like previously! I take 600 at 6 and 300 at 8..
Lesley
I have ben taking Gabapentin for several years, 300 mgs mornings and the same each evening. I have to top-up with Ropinirole often during the night which I also take regularly by day. I sometimes feel I must rattle when walking! But whatever it takes to live without a constant twitching. Gabapentin has made a huge difference; I didn't realise just how much until the evening I forgot to take it and couldn't understand why I had a night of pacing the floor - then I discovered the dose, still waiting to be swallowed, the next morning.
Good luck.
Sorry I don't quite follow that.
I don't agree that accepting waking after only a few bours is "normal". That's what I endured when I was suffering augmentation. After stopping pramipexole and starting on gabapentin, I started sleeping at least 6 hours.
What you're not considering is that after taking an oral medicine, it take's a while for it to be fully absorbed. For gabapentin this is 2 - 3 hours. After that it starts disappearing from your blood stream. The rate at which this happens is known as its "half life" = the time taken for it to halve. For gabapentin it's 5 to 7 hours.
Thirdly, you have to take enough gabapentin to ensure that the level of it in your blood reaches a "therapeutic" level. This is the lowest level which works for you.
Putting these three things together, if you take just enough to achieve a therapeutic level in 2 to 3 hours and only just, then the level will very soon fall below the therapeutic level. That is, it will wear off. QUICKLY.
However, if you take more than you need to achieve a therapeutic level in 2 to 3 hours, then it takes longer to fall; below the therapeutic level.
Hence taking 300mg may help you sleep 3 hours, but not enough to sleep longer.
Increasing the smount you take will make the effect last longer.
If you take an additional dose at 3am, such a low dose is really not to going to make much difference.
This is partly because your level is already fallen below the therapeutic level and such a small additional amount is not going to have much of an impact on this.
It's also partly becasue it takes up to 3 hours for the second dose to be absorbed anyway. 6am, is much too late.
Putting this in numbers.
If you take 300mg 2 hours before bed, then at bedtime you will have absorbed 240mg (80%).
5 hours later there will only be 120mg left.
Say your therapeutic level is 150mg.
This means that the drug will cease to have any effect after about 3 to 4 hours.
If you take 600mg then you will absorb about 400mg of that (less than 80%)
5 hours later there will be 200mg left, this will still be working because it's still above 150mg.
Think about it!
So I was useless at Maths and I don't really understand what I should take. Last night I took 300mg at 7pm then at 9pm I took 600mg. I went to bed and my legs started so I had 1/2 spoonful of Kratom. Still not response. After another hour I took good old tramadol (50mg) and eventually slept at around 1am. I woke at 4.30 walked around a bit then fell asleep until the alarm at 8.15. Not too bad. So can you advise me about what times I should be taking gabapentin and the amounts. I have no rls now in the evenings and go to bed at around 10pm which is when it starts. If we go out (which is once or twice a week) then I sleep at around 12. I'm still getting over the mirapexin and the withdrawal is probably affecting me. Thanks you are so much more helpful than my doctor who knows nothing about rls.
One consideration is that you won't be absolutely sure how effective the gabapentin is being until you entirely get over withdrawal from mirapexin.
Your routine for taking gabapentin sounds round about OK, but if you go to bed at 10pm, then it's better to take the 600mg at 8pm. It usually takes 2 hours for it to be fully absorbed. I should really say 2 hours before symptoms usually start.
If you take it too late and symptoms start,then once they've started then they're difficult to stop. The gabapentin isn't for stopping them, it's for preventing them.
If you're not sleeping through with this, then one option is to increase the dose of gabapentin.
Simply put, the maths just demonstrate that a higher dose not only means greater effectiveness, it also means it's effective for longer.
If I take the 600 at 8, what time should I take the 300 if my bed time is 10. I read and don't sleep until 12(if my legs allow it)
Really it's the time when your symptoms startr that is the key.
I don't know if this is before or after you go to bed.
The best is to take the gabapentin 2 hours before symptoms usuyally start.
For example, if you go to bed at 10, but your symptoms normally start at 11 then take the gabapentin at 9.
The aim of splitting the dsoe is becasue if you take 300mg, 80% of it will be absorbed but with increasing doses, less is absorbed. So if you take 600mg all at once, NOT 80% is absorbed. If you take 900mg all at once then evcen less is absorbed.
Hence if you take 300mg 80% is absorbed, then wait 2 hours until it's all absorbed then more of the 800 mg witll be absorbed.
So the simple answer is, take the first dose 2 hours before the second dose.
Ok so my symptoms start very soon after I go to bed. So as I understand I should take 300first 2hrs before symptoms start then two hours later take 600mgs. I hope I don't sound too thick. Thanks
Take 600mg 2 hours before you go to bed/symptoms start and 300mg 2 hours before that
E.g.
300mg 6pm
600mg 8pm
Bedtime 10pm.
So I presume I can adjust that if I have a later night
You can but it really depends on when your symptoms usually start.
If they usually start at 10pm, but you go to bed at 11pm then if you take the gabapentin at 9pm, it won't be fully effective until after your symptoms normally start. Once they've started, it's difficult to stop them, and easier to prevent them starting in the first place.
You'll either be impressed by this or think I'm crazy.
I favour the latter myself.
The amount of a drug in the blood decays "inverse exponentially"
There is an equation for this i.e.
Y = A times (1-B) to the power of X.
That is (1-B) times itself X times.
Y is the amount left at any time.
A is the original amount absorbed.
X is the time, in this case, in hours.
B is the "reduction factor".
Based on a half life for gabapentin being 5 hours, I worked out that B = 0.13.
If you take 300mg gabapentin you will absorb 240mg (80%).
After 3 hours, i.e. when you wake, using the equation there will be about 158mg left. This may mean your therapeutic level is about 160mg.
If you take 600mg you may absorb about 450mg (less than (80%).
Using the same equation it will take more than 6 hours for the level to fall below 160mg. I.e. you should sleep more than twice as long.
At least that's what the maths says.
Even if the numbers aren't quite right, I hope you get the point.
I'll have to redefine the equation
Y = A times (1-B) to the power of X.
Y is the amount left at any time.
A is the original amount absorbed.
X is the time, in this case, in hours.
B is the "beer factor".
I take 900 mg Gabapentin at 8:30 and go to sleep at 11 or so. I only have a few twinges when I go to bed but walk it off for just a few min.
Thanks do you sleep all night. Glad to hear it's working for you
I do sleep all night
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