my dopamine levels are not coming back to normal

[Browne1212]

Rls stopped taking ropinirole 3 months ago because of augmentation the good side my RLS has almost stopped and under control no medications been on ropinirole for 10 years but it seems my dopamine levels are not coming back and making me fall a sleep / fatigue /no drive all blood test normal

Any one else gone though this my life seems to have stopped struggling to do just normal day to day things

[Elffindoe]

Hi, all I can do is offer you some thoughts on this.

Ropinirole does not directly raise dopamine levels in the same way that levodopa does. So when you stop taking it, it doesn't necessarily mean the level will either fall or rise.

If withdrawal effects have disappeared then your system should have returned more or less to how it was before you started the ropinirole.

Unless you have test for dopamine levels you can't possibly know that they are low. In fact since low levels opf dopamine make RLS worse, if you do have RLS then you would be having RLS symptoms. Yert you're saying you don't have symptoms.

Overall, you're assuming that your tiredness/fatigue is due to low dopamine levels, but there are many possible explanations.

I don't know what investigations you have had, but perhaps they need to be more thorough before you assume it's defintely low dopamine.

I have been suffering severe fatigue for 14 months now and find it debilitating and it has severely restricted what I can do, so I can appreciate how you feel.

For me it has nothing whatsover to do with RLS or dopamine.

[Birdland]

I took Ropinirole for 16 years. After stopping I have been suffering from severe depression which can effect energy levels. This is known as DAWS, dopamine agonist withdrawal syndrome. It has been debilitating for me. Currently I’m undergoing rTMS, repetitive transcranial magnetic stimulation.

[Joolsg]

More likely to be DAWS- depression & anxiety & malaise after getting off Ropinirole. The dopamine receptors take months to 'reset' but Dr. Buchfuhrer believes they're often permanently damaged by dopamine agonists.Hopefully you should feel a little better soon. Ensure your serum ferritin levels are above 100 as that helps RLS generally.

[Elffindoe]

When you wrote about tiredness/fatigue/no drive then my first thought was this isn't related to your ropinirole withdrawal.

Other members have suggested this may be due to DAWS.

I often find that members on this site, with the best intentions, focus solely on RLS as if every symptom anybody gets is connected to RLS.

It is possible that you may be suffering DAWS, but I still think ypu need to consider it might be something else.

I suggest that you look up descriptions of the symptoms of DAWS and compare them to your own experience to see if there are any differences.

Sometimes it is difficult to distinguish between fatigue and depression, which is a feature of DAWS.

However if it helps, a feature of depression is that your movements, speech and thoughts can slow down. I don't experience this with fatigue. I can move at normal speed, it's just that after a very short spell of activity I can feel exhausted and even out of breath. I never felt that when i've suffered depression.

This link may be of some help

jnnp.bmj.com/content/84/2/130

I note fatigue is the only feature you mention that could be attributed to DAWS. Do you have any other of the symptoms?

DAWS is actually most common in people who suffered an ICD ( Impulse Control Disorder) whilst taking a dopaminergic agent. That is compulsive gambling, shopping, eating or hypersexuality.

Note that there is no treatment for DAWS as such. Not even antidepressants. The only thing that will relieve is to restart the dopamine agonist. Otherwise it's just a matter of time.

This link might also help

mdedge.com/neurology/articl...