Advice please talking to the doctor tomorrow, about an alternative to preagabalin as I am having a limited amount of relief ,I don't want any d/agonists so where do I go from here ?also I am going to ask for Mr ferritin levels to be checked , what level should they be ? Thank you in advance !
Ferritin should be at least 100 or more.
Gabapentin is the main alternative to Pregabalin. You can take both at the same time. Titrating down one, and raising the other up. 900 is the optimal dose. After that it becomes less efficient.
Horizant is a better prospect if you are in America.
Good luck.
According to the Mayo Clinic Updated Guidance on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily". The equivalent pregabalin dose would be 1/6 of that. Horizant is a good alternative but it can be very expensive in the US, and it is basically the same type of medicine as pregabalin and gabapentin so if you find they don't work, then it is unlikely Horizant would.
For iron tests get the full panel - Ferritin levels, % Saturation, Total Iron Binding Capacity. Get the exact number results, not just "normal" etc. My Ferritin was 49 with raging RLS - supplementation (Ferrous Bisglycinate Chelate) raised it to 105 within 3 months, and severe RLS went to very intermittent. BTW - docs said normal! Here's a great explanation of iron and test results...
You augmented on Pramipexole several years ago and have since tried up to 400mg pregabalin and clonazepam and tramadol without success.You could be someone for whom the Alpha2Delta ligands don't work. Dr. Buchfuhrer states that this happens after augmentation on Dopamine Agonists.
I'm one of them.
The only remaining class of meds for refractory RLS are low dose opioids. This is set out in the new Mayo algorithm on RLS.
Low dose Oxycontin or Buprenorphine will probably be your next step. Discuss with GP and print off and show the Mayo guidelines.
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