Moving form pramipexole to gabapentin

[Catscratchman]

Hi folks, sorry to pick your brains again. After agreeing that I might be augmenting on prami (2 x 0.088mg), my neuro has suggested tapering this off over 2 weeks then starting gaba 300mg and increasing this until effective. Should I take longer to come off the prami and should I start the gaba at the same time to mitigate the possible effects of DAWS? I'm not convinced the neuro is on top of RLS and the GP just does what the neuro suggests; I've got much more faith in this forum!

[Elffindoe]

Hi, having being through the same process a few years ago I suggest you start taking the gabapentin before reducing the pramipexole. It may take a few weeks to start working fully.

Wean off the pramipexole as slow as you can bear. I suggest reducing in steps of half a 0.088mg tab and no more often than once every two weeks.

I think your Dr's suggestion is much too fast.

[Catscratchman in reply to Elffindoe]

Many thanks Elffindoe, that's what I'll do.

[Nikula]

I tried coming off the pramipexole all together before taking the gabapentin but it was awful and I didn't sleep at all for two nights. I had a reaction straight away from the gabapentin and my RlS went haywire. I had huge spasms in my legs and almost seizure like movements. I am back on the pramipexole eventhough I know Augmentation is inevitable.

[Catscratchman in reply to Nikula]

My GP is fine with prescribing the gabapentin but still wanted me to stop the prami first as advised by the neuro. I said I understood but I'll still start the gaba at the same time as reducing the prami!!

[Joolsg in reply to Catscratchman]

Your neurologist clearly knows very little about RLS or Pramipexole sadly. As Elffindoe advises, gabapentin and pregabalin take 3 weeks to be fully effective and Pramipexole withdrawal can be hellish! 2 weeks is far too fast. The US experts who have vast experience recommend a minimum of 3 months to reduce DAs.Hopefully your GP will listen to you.

[Catscratchman in reply to Joolsg]

GPs assume that the neuro is the expert and that their guidance is sacrosanct but without necessarily taking into account the experiences of folk who've actually lived through their advice. My GP is good but clearly didn't want to deviate from the neuro...and I won't mention RLS UK or this forum to him again!

[Joolsg in reply to Catscratchman]

🤣😂Luckily my GP is aware that very few Neurologists are taught about RLS. My MS neurologist has admitted she knows very little. I think the older, old school neuros won't admit their lack of knowledge. However, there is actually a warning on Pramipexole so the neuro SHOULD take account of that. There's been a big legal case against a neurologist in the UK over dopamine agonists.Links attached for your own curiosity.

healthline.com/health/drugs...

bmj.com/content/364/bmj.l434

[Catscratchman in reply to Joolsg]

There's a couple of side-effects in that first link that I wasn't aware of and which I am getting...makes me even keener to get off the pramipexole. Thanks Joolsg.