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Restless Legs Syndrome

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pramipexole

auldreekie18 profile image
10 Replies

Hi, Happy New Year to all you wonderful people.

Just cut out my 180 microgram tablet bad muscle pain ,going to see Doc with help to get off the 350 microgram should I start halve a tab or quarter ,taking magnesium and horse chestnut and it helps ,thinking pregabelin if I succeed ,what do you think .god bless.

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auldreekie18
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SueJohnson profile image
SueJohnson

your 180 microgram = .18 mg. You should reduce by no more than .125 mg, so I would cut your tablet in half and wait a couple of weeks before going to 0. Meanwhile you should start taking gabapentin since it takes at least 3 weeks to be effective, although it won't help much until you are off pramipexole. Beginning dose is usually 300 mg gabapentin or 100 mg gabapentin if you are over the age of 65. Once you are off pramipexole increase by 100 mg every few days until you find the dose that controls your symptoms. Take it 1-2 hours before bedtime. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. Typical effective doses are 1200-1800 mg. Most of the side effects of gabapentin or pregabalin will disappear after a few weeks and the few that don't will lessen.

I always suggest one start with gabapentin rather than pregabalin as it can be increased in smaller doses. Once you find the correct dose you can switch to pregabalin if you like or stay on gabapentin. They are basically the same.

auldreekie18 profile image
auldreekie18 in reply to SueJohnson

Hi Sue , already stopped 180 microgram do not want to start it again think I can handle it . What is your views on tramadol and buprenorphine .

SueJohnson profile image
SueJohnson in reply to auldreekie18

Both good.

Moonwalker1967 profile image
Moonwalker1967

I get bad muscle pain as well. Stays with me all day. It's horrible. I don't get a whole night's sleep neither. Symptoms starting earlier in the day know. Will have to phone my GP next week for help. This is a nightmare.

Joolsg profile image
Joolsg in reply to Moonwalker1967

What meds are you currently taking?

Moonwalker1967 profile image
Moonwalker1967 in reply to Joolsg

Pramipexole 0.18 mg every evening only. Not during the day.

Joolsg profile image
Joolsg in reply to Moonwalker1967

That explains the symptoms in the day. That's a classic sign of augmentation. Read the pinned post, the new Mayo algorithm and all the posts on here that mention Pramipexole.Your GP sadly won't know anything about RLS or augmentation as RLS is not taught during training in the UK.

Whatever you do, don't increase the dose or switch to Ropinirole or the Neupro patch as they all cause over stimulation of the D1 dopamine receptors which makes your RLS more intense, earlier in the day and eventually causes RLS in your arms, hands, back and other body parts.

Ensure serum ferritin is above 250 and that you're not on Sedating anti histamines, anti depressants, statins of beta blockers or PPI meds.

The solution is to very slowly reduce Pramipexole over 3 months and start a new med like Pregabalin about 4 weeks before the last dose of Pramipexole.

As you will read in all the articles, Pramipexole and other dopamine agonists are no longer prescribed for RLS because of the very high rate of augmentation of symptoms. Most people on this site joined because their RLS was getting worse and augmentation is the reason. Most of us manage to get off them and onto other meds. Once you're off Pramipexole, the intensity of your RLS will reduce and you won't get ot in the day. Research yourself because the medical profession sadly know very little.

Links attached.

rls.org/treatment/managing-...

mayoclinicproceedings.org/a...

nbmedical.com/kiss/kiss-res...

Moonwalker1967 profile image
Moonwalker1967

Thanks so much for the above. I will go off it and see if I can do without. Unfortunately I was denied a visit to see a neurologist to get help. I live in England, so specialist appointment is only on referrals. Will phone next week and see if I can switch. Again, your help is much appreciated. Hope you get better and get some calm nights.

Joolsg profile image
Joolsg in reply to Moonwalker1967

Withdrawal is very tough and most people need an opioid to deal with the constant symptoms and lack of sleep.First line treatment is now pregabalin ( average dose 200-300mg at night).

My RLS is now gone. I tried pregabalin, gabapentin, tramadol and Oxycontin but still had very severe RLS.

I'm now on 0.4mg Buprenorphine at night and have zero RLS.

Hope you manage to get off Pramipexole and that you find better meds.

Good luck & let us know how you get on.

Moonwalker1967 profile image
Moonwalker1967

Thanks for your message. I have a lot of discipline and managed with little sleep for many years. I will try to reduce to my old tablets first. Pramipexole 0.88 which I got before the dose was put up. Phone my GP next week and stick to my following regime: Prayers, meditation, hot baths and heating pad, 10.000 steps every day, no alcohol and smoking. No cakes and sugary things after 4.00 hot meals and last meal before 6.00 pm. Try not to get suicidal and hang in there. Read somewhere that peanut butter helps, so will try that as well. Will keep you updated. Thanks for your help and support. By the way, I am a cyclist and found cycling helpful.

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