To up or not to up Gabapentin

[Elsie77]

I ve been off Pramipexole for over 4 weeks, had my first sleep all night for years but last night fidgeting and stretching leg for over 3 hours in the early hours. I’m on 500 mg of Gabapentin couple of hours before bed. Should I up the Gabapentin or am I just being impatient and need to wait longer for the Gabapentin to work?

[SueJohnson]

Yes, you can start adding 100 mg every couple of days until you find the dose that works for you. 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. Congratulations on getting off the pramipexole!

[Madlegs1]

Be careful not to take any sort of magnesium within 3 hrs of gabapentin. That might include antacids.Also , gabapentin, of itself won't help with the withdrawal feelings. But should take care of RLS.

Good luck.

[Joolsg]

I agree with Sue. Average dose of gabapentin for RLS is 1500mg at night.

[LotteM]

Elsie, other responders have given very good replies. Do consider that it may still be withdrawal symptoms from the pramipexole. On the other hand, your current gabapentin dose is still quite low, so do as Sue suggested - and if your doctor agrees. It may take another few to many weeks or months before you find a new balance. I hope sooner than later, of course.

[Elsie77]

Many thanks for all the advice. My Dr has shown he knows nothing about RLS so it’s a waste of time asking him.

[ziggypiggy in reply to Elsie77]

I wouldn't stick with a doc like that. But finding a new one is easier said than done. All good advice in the replies above.

[Elsie77]

Our surgery has 5 doctors we can contact, the others have even less knowledge, the only good thing about the Dr I contact is that he will listen to what I say and accept what I ask for if I can j back it up with solid facts. For advice I use this site.

[Nikos64]

I take 1200mg of gabapentin and it barely helps. So, you should ask for more.

[grassgree in reply to Nikos64]

Could I ask you--how long have you been taking gabapentin, and did it work initially? Have you been gradually increasing the dose, or was it ineffective from the start?

[Nikos64 in reply to grassgree]

Certainly. I started taking 600mg Horizant which is gabapentin that is absorbed better early in January this year. Additionally, I was prescribed 600mg of gabapentin. When I started this I was on 100mg of Tramadol. By early March I was off Tramadol and exclusively on the aforementioned medications.

As far as I can tell, 1200mg of gabapentin is not enough for me and was never as effective as Tramadol

I’ll give it another month and ask to be on Tramadol again. 100mg worked perfectly and I was on it for 8y. Unfortunately, because of drug seekers and strict prescribing regulations in Florida, doctors do not like prescribing opiates. It’s a pity these people make it difficult to obtain for those that benefit and do not abuse this medication.

[grassgree in reply to Nikos64]

You are so right! I hope the Horizant starts to work--it can take a while. But it's good to know there is something out there that does work, even if you have to fight for it.

[SueJohnson in reply to Nikos64]

Are you on both 600 mg of horizant and1200 mg of gabapentin?

[Nikos64 in reply to SueJohnson]

Yes on both Horizant and gabapentin both at 600mg

[SueJohnson in reply to Nikos64]

There is no point in increasing the horizant as studies have shown there is no additional benefit above 600 mg. I'm not really familiar with combining the two drugs. If you were just on gabapentin, you could increase it to as much as 3600 mg in divided doses of 600 mg 2 hours apart. I would ask your doctor.

[Elsie77]

Thanks for your advice, I have been prescribed extra if I need it. I hope you find something that helps more.

[Daewood1949]

These replies are so well thought out and informative Elsie. Concerning gabapentin and the other medications you mentioned, do you find that pharmacists/chemists are so much better at advising a person? (than a doctor) I sure do. Most doctors don't really listen to RLS issues. Sue, I was so interested in what you said about how to take gabapentin. I did not know that.Nikos I agree with you too. It makes it hard for the ones really needing help when people abuse medications and make it difficult for actual sufferers of RLS to get some relief