Not sure if I understand augmenting

[ESRDRLS]

Can someone explain augmenting from a med for rls. I understand having a med stop working for rls and things getting worse. I just want to know if I am understanding right. Sorry if I misspelled it.

[Kaarina Administrator]

healthunlocked.com/rlsuk/po... This thread was posted by a member of our forum 5 years ago. Does this help you?

[Hidden]

In the context of RLS, augmentation is specific to dopaminergic medications (rotigotine, pramipexole, and ropinirole) and Tramadol.

Augmentation is defined as a worsening of RLS symptoms that occurs after starting one of the above medications to treat RLS. The medication is effective when it's first commenced, but over time symptoms worsen, meaning you need more of the medication to deal with the symptoms. Once augmentation starts, it's recommended to come off or significantly reduce the medication.

Augmentation is often confused with 'tolerance'. Tolerance occurs when a regular user of a drug gradually becomes less responsive to the drug. This can often lead to the person requiring larger amounts of the drug to achieve the same effect.

The key distinction between augmentation and tolerance is that augmentation results in an actual worsening of symptoms, tolerance does not (even though it may FEEL as though that is what is occurring ).

[Kaarina Administrator]

sleepreviewmag.com/sleep-di... This link may help you to know if you are understanding augmentation correctly.

[SueJohnson]

Augmentation refers to being on a dopamine agonist like ropinirole or pramipexole. The signs of augmentation are when you have to keep increasing your dose to get relief, or when your symptoms occur earlier in the day or when they move to other parts of your body (arms, trunk or face) or when the intensity of your symptoms worsen. Up to 70% of people will eventually suffer augmentation on a dopamine agonist according to the Mayo Clinic Updated Algorithm on RLS which believe me you don't want because it can be hell to come off it and the longer you are on it, the harder it will be to come off it. Check out the Mayo Clinic Updated Algorithm on RLS which discusses augmentation and the latest guidelines on RLS treatment.

Https://mayoclinicproceedings.org/a...

[Irmajs]

This will help you understand. I as on Ropinirole for two yrs before my RLS started getting worse. My neurologist kept increasing the dose not realizing it would make it even worse. Before I ever took any meds for RLS I only had it in the evenings and at night. This is when the dopamine levels start to drop causing symptoms. Unable to get any sleep. At my worst on Ropinirole, I had RLS day and night. Scared the crap out of me when I was on a freeway with my grandkids in the car. I couldn’t sit or lay down for more than 10 min at a time without it starting. I was exhausted. When I stopped seeing that Dr and weaned myself off of Ropinirole, I was relieved to see it return to only evenings and nights. Hope this website helps.

rls.org/treatment/managing-...

[Bieler in reply to Irmajs]

To alleviate the symptoms at night, I take tramadol and it has been working (same dose or lower) for several years. I have no side effects. It does not relieve any other pain I may have (torn rotator, sprained wrist etc) it just stops the miserable nerve pain in my legs and arms. I take 50 mg 4 x per day. Godsend!

[SueJohnson in reply to Irmajs]

If your RLS symptoms aren't fully controlled have you thought about taking gabapentin which is now the first line treatment for RLS?