Problematic side effects from Gabapentin?

[FluteE]

I’ve been on pramipexole for years now (lowest dose). I’m dreading the day of augmentation but am wondering what are side effects that would prevent me from taking gabapentin?

[SueJohnson]

I wouldn't worry about side effects. Most of the side effects of gabapentin will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. Of course like all medicines there may be side effects that you can't tolerate, but you won't know about them until you try it. You shouldn't let the fear of them keep you from trying it. You can always slowly stop taking it.

[SueJohnson]

As far as the pramipexole, you are better off to wean yourself off it now as the longer you are on it, the harder it will be and it will be even harder once you suffer from augmentation.

[Joolsg]

The most common side effects are dizziness, double vision, water retention, leg swelling and increased appetite.Not everyone gets them.

I had all the side effects but they did reduce and eventually disappeared after 3 months. However gabapentin and pregabalin didn't work for me but they do seem to help the majority.

Gabapentin and pregabalin won't help the RLS usually until you've been through Pramipexole withdrawal (although I do know a few people who didn't have withdrawal symptoms and they were at full dose of gabapentin before they got off Pramipexole).

[Nightwalker6]

I tried Gabapentin. Dreadful side effects. Splitting headache & irritability, even rage. And depression. Terrible drug.

[Frustrated-RLS]

I have been taking gabapentin for four months after augmenting on ropinirole and months of augmentation and withdrawal misery. I have had no notable side effects from the gabapentin and it has helped me tremendously. I was scared to try another medication but I am so glad I did.

[Dotmowatee]

You might not necessarily augment if you are on the lowest dose of pramipexole. Gabapentin didn't work for me.

[FluteE in reply to Dotmowatee]

I’ve been on that lowest does since I started taking it in 2014. It was increased to the next step up for a short time (a year maybe). Because of this forum, I learned about the sertraline that I had been on for years prior was making it worse. My dr took me off of that with my “advising” lol. Instantly I was able to go back to the lowest dose. Covid after effects made me question whether or not I was augmenting. Some nights are good, others, I’m hurting. 🤷🏼‍♀️

[LotteM]

Flute, if you want to make the transition from pramipexole to gabapentin, do not worry and inform yourself thoroughly, discuss with your doctor, make a decision and a plan. Like Joolsg said, it does not work for everybody but it works for many. There are no guarantees. Also not about lasting side effects. They may occur, or not, and they may disappear or not. For example, I had severe depression on the gabapentin and it didn't settle. And I am not the only one. But that is relatively rare and you will not know until you try.

Building a good gabapentin dose before you start reducing the pramipexole seems like a wise approach, based on our collective experiences. The first thing to think about though, is why you want to switch. Why change something that works? Make sure you do not let your pramipexole dose escalate if it become less effective.

[SueJohnson]

If you decide to come off pramipexole, reduce by a half tablet every 2 weeks or so. If you find that produces too much withdrawal effects, reduce by a quarter of a pill or wait longer before reducing. You will have increased symptoms. You will suffer and may need a low dose opioid temporarily to help out with the symptoms. But in the long run, you will be glad you did. On the gabapentin, beginning dose is usually 300 mg gabapentin or 100 mg if you are over the age of 65. Start it 3 weeks before you are off pramipexole although it won't be fully effective until you are off it for several weeks. After that increase it by 100 mg every couple of days until you find the dose that works for you. 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. Most of the side effects of gabapentin will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." If you take magnesium take it at least 3 hours before taking gabapentin as it will interfere with the absorption of the gabapentin. Also have you had your ferritin checked? If it is below 100 improving it to 100 or more helps 60% of patients and in some will completely eliminate their symptoms. If you haven't had your ferritin checked, ask your doctor for a full iron panel. Stop taking any iron supplements 48 hours before the test and fast after midnight. Have your test in the morning when your ferritin is lowest. When you get the results, ask for your ferritin and transferrin saturation numbers. You want your ferritin to be over 100. If your ferritin is less than 75 then take 325 mg of ferrous sulfate with 100 mg of vitamin C or some orange juice since that helps its absorption. Take it every other day at least 1 hour before a meal or coffee and at least 2 hours after a meal or coffee since iron is absorbed better on an empty stomach and preferably at night. If you have problems with constipation switch to iron bisglycinate. If your ferritin is between 75 and 100 or if your transferrin saturation is below 20, you probably need an iron infusion since iron isn't absorbed as well above 75. If you take magnesium take it at least 2 hours apart since it interferes with the absorption of iron. Don't take tumeric as it interferes with the absorption of iron. It takes several months for the iron tablets or iron infusion to slowly raise your ferritin. Ask for a new blood test after 8 weeks if you have an iron infusion or after 3 months if you are taking iron tablets. Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it as yours obviously isn't at

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

[K2D2 in reply to SueJohnson]

Sue, so if taking 1800 mg and going to bed at 9 pm, dosing might be 600 mg at 3 pm, 600 mg at 6 pm and 600 mg at 8 pm? I think I may not be taking my first dose early enough right now (I start at 6 pm), though it generally works for me.

[SueJohnson in reply to K2D2]

No 600 at 8 pm and 600 at 6 pm is correct, but the 600 at 3 pm should be at 4 pm.

[SueJohnson in reply to K2D2]

And you may find that by taking them 2 hours apart you can reduce your total doseage. If so reduce the 4 pm one. Also if taking them this way is too inconvenient, you could switch to 300 pregabalin which you only have to take 1 time.

[K2D2]

Gabapentin at 1800 mg per night has been a lifesaver for me. The only side effect has been that I can be a bit unsteady on my feet when getting up out of bed and walking. So thankful I have an open minded physician who just wants to help and do what works.

[sylvanwanderer]

I know that some people can, and are helped by it, but I cannot take gabapentin. I took it for a little over a year for myofascial pain and struggled with short-term memory loss caused by the drug. I only found out much later that I had also lost my long-term memory of that time. I essentially lost over a year of my and my children's lives. To say that gabapentin is safe and that everyonone will eventually get over any side effects is false. For some, it is a very dangerous drug.