Gabapentin, need more because of PLMD and insomnia

[Maximus01]

Hi everyone, I started the Gabapentin (after trying out Pregabalin for 8 weeks) at 300 mg two hours before bed. Then took 600, now am taking 900 at separate times. In the the morning, my duvet is still kicked down and hanging onto the floor, which tells me that I am still doing the PLMD at night. I am also taking 1 mg lorazepam. Every third night or so, I allow myself an additional Gabapentin in the middle of the night when I wake up, and also an additional 1 mg lorazepam, if I want to have a "normal" day. This is really not a life. I feel emotionally and physically drained when I have to function on 3-4 hrs. As mentioned, I tried Pregabalin first. I find that it is very much the same as Gabapentin. Sorry, just venting.

[SueJohnson]

You probably need more gabapentin. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily" 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.

[WideBody]

I got frustrated with Gabapentin, I had to take 1500 - 1800mg. Basically I had to take it every 2 hours starting at Noon. I eventually moved to Pregablin (Lyrica), 300mg a day. 150mg * 2. Pregabalin was much more consistent and reliable.

Now I am trying to get off my pregabalin. Down to 100mg a night.

[Memmy in reply to WideBody]

May I ask why you are trying to get off pregabalin. It's been very successful for me. I'm also taking 300 but with 50 mg tramadol

[WideBody in reply to Memmy]

Pregabalin, while it does help with RLS and sleep. It also has a mind numbing effect. I feel the world is a bit more alive within pregabalin. The main reason I want to get off pregabalin is that Dipyridamole is so much more effective. So I am increasing Dipyridamole and decreasing pregabalin.

[Memmy in reply to WideBody]

Glad to hear that dipyridamole is working well for you. Do you take anything else with it? Can you let me know how you get on. I'm quite happy with 300mg pregabalin although I do have to take tramadol with it. I'm considering increasing the dose to see if I can stop the tram. When I took a higher dose it made me feel a bit dizzy so I'm waiting a while before I try again. I also take magnesium, vit D, and I keep my ferritin level high

[WideBody in reply to Memmy]

Pregabalin though effective is really a mask. For me a mind numbing mask. The world seems a bit clearer now that I am cutting back on pregabalin. I have been taking 300mg of pregabalin for a couple years. One week after I started Dipyridamole I dropped to 150mg of pregabalin (don’t do that, cold sweats, etc) I am now down to 100mg a night and I plan on 50mg a night at the first of the month. Dipyridamole seems to be more effective for my type of RLS. When I say “my type”, I am talking about hyperarousal, exaggerated response reflex. I jerk and twitch whenever I try to rest. Dipyridamole reduces that greatly. It appears to be working and not a mask. I did have crazy dreams at first, that has calmed down. My sleep scores a definitely improving, I think I even set a record. Good luck on your journey.

[Memmy in reply to WideBody]

That sounds really good. My Rls is that horrible gnawing feeling in my leg never twitching so it may not work for me. Do you have to take anything else with it?

[Bruxelles]

Sorry to hear that. I sympathise with you as I am also permanently drained through lack of sleep - same as you 3-4 hrs a night. I get very irritable and bad tempered too which is totally out of character for « normal » me.At the moment, after years of RLS every night I have periods with it and periods without it- no explanation for this!

The one thing that seems to help is keeping my lags warm. Have you tried that?

Good luck.