Pregablin query

[Whymelord]

Hi everyone, I was on Pramipexole for a long time then I augmented, I have halved my 0.18mg. I attended the hospital last week and the Doctor discussed RLS with me.she prescribed 75mg.of Pregablin,can anyone please tell me if this is a good move,I'm unsure if it's any better.

[SueJohnson]

It is a very good move. However it takes at least 3 weeks to be effective and won't be completely effective until you are off pramipexole for several weeks. Then you can increase it by 25 mg every few days until you find the dose that works for you. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." This translates to 200 mg to 300 mg of pregabalin. (They are basically the same drug).

[Whymelord in reply to SueJohnson]

Thankyou Suejohnson,do I just stop taking Pramipexole right away and take the pregablin?

[SueJohnson in reply to Whymelord]

No. You need to reduce the pramipexole by .125 mg every couple of weeks. You will suffer and may need to go even slower or by a lessor amount. You may need a low dose opioid temporarily to help with the symptoms. You should go ahead and start the pregabalin.

[Madlegs1]

Yes--she's on the ball. Gabapentin or Pregabalin would be the standard prescription after Pramipexol fails.Sue has given good advice.

Good luck.

[Whymelord in reply to Madlegs1]

Thankyou Madlegs,its really helpful to know I can come on this forum and get advice.

[ircam2112]

Great response from Sue. Too add a little, s I had good success with 225mg Pregabalin at bedtime - my primary diagnosis is PLMD. Just be aware that you do build up a tolerance over time and I believe the range was anywhere from 6 - 12 months. So, it’s best to start on the lowest dose possible that you feel is adequately controlling your symptoms. Best wishes.

[Whymelord in reply to ircam2112]

Thankyou ircam2112 for your reply.

[Bganim1947]

I’ve been on Pregabalin for five years. it’s been the best medication ever (I was on quite a few others including Gabapentin and Ropinerol) for my restless legs. My RLS specialist doctor prescribed that plus an equal dose of tramadol three times a day— 100 mgs of both taken at 8 AM, 3 PM and 10 PM. The key to the combo of tramadol and Pregabalin is taking it at the same time every day without variance. If you skip a dose or two, or a day, you’re going to get a reaction an RLS reaction— it’s not augmentation, it’s simply the body missing its dose. I’ve never experienced an kind of augmentation w/Pregabalin, nor have I had to increase my dosage. Its the best medication combination for restless legs I’ve ever been on and I’ve been on quite a few.

[Whymelord in reply to Bganim1947]

Thankyou Bganim1947 for your reply.Its really good to hear that pregablin works,the doctor didn't suggest anything else along with this but I'm gonna try it ,hopefully it'll work for me.The last doctor I saw was in my local hospital, she is the only one who sounded remotely interested in how desperate I felt,so if I need help I will blooming ring her at the hospital. Thanks again .

[dklohrey]

I was on ropinirole for about 20 years before I had to leave it due to augmentation. There were times when I forgot that I ever had RLS, ropinirole worked so well. I think I was probably spoiled because I have tried both gabapentin at 1200 mg and pregabalin at 300mg and can not achieve the same results. Sometimes if I am lucky, I will get about 2 hours of sleep, wake up for about an hour and go back to sleep for another 4 hours. I do not live too far from Rochester, Mn, where the Mayo Clinic is located. I am debating going there, though my insurance will not cover it. Will let you know the results should I go.

[Whymelord in reply to dklohrey]

Hi dklohrey, just proves that it's trial and error for us all,what works for one may not work for another, I was soo excited when the hospital doc.actually changed my meds from Pramipexole, I'm in the North of Ireland and feel they just don't seem to take RLS as serious as it is.i will try the pregablin, please do let me know how you're visit goes.

[SueJohnson in reply to dklohrey]

The gabapentin and the pregabalin probably didn't work because you were on ropinirole for so long. After many years on a dopamine agonist you may have permanent damage to the dopamine receptors. Or it is possible you needed more gabapentin or pregabalin. The maximum dose for pregabalin is 450 mg. Yes I would go to the Mayo Clinic.