I have had RLS since I was a child, but it has just been at the level of an occasional nuisance. However, at the age of 85, it has suddenly become a problem, mainly because I have started having violent leg movements in my sleep, which for some reason my wife does not appreciate. I contacted my GP, hoping to get a prescription for diazepam, which has worked for me once before. However, I got the “addiction” story and ended up with a prescription for Ropinirole. Having read the potential side effects, and the problems with stopping the medication, I have no intention of taking it. The cure is worse than the disease in my case. I just want some medication I can take when necessary. Can anyone suggest a course of action for me?
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Shakespeare1564
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I wonder( with the very greatest of respect 😝) just how much longer he expects you to live on. I'm 75 myself.I remember my doctor telling me 8 years ago ,when I complained about being on 75mg of Fentanyl and wanting help to get off it ,and he wondered why I'd be bothered at my age!!!!!!!
Took me 18 months of pure bloody hell, on my own- no help ,except the blue light sites and Matt Finch.
Anyway, rant over and apologies. It's late and I'm tired.
It would be worth taking up the offer of Pramipexol or Ropinerol. I'm not sure of the relative differences-- you are well able to research that-- or someone will come on to help out.
Despite all the fears about the DAs, they are extremely effective for RLS. Used for short term, maybe to get you over a tricky patch, they could work. Just go with the lowest dose possible, and work up until effective.
Most importantly, check your medications to see whether they are causing the rls, or food or drink.
Alcohol, msg processed foods etc
Also statins, antihistamines or antidepressants are all known triggers for RLS.
No, No, No !!! Don't start on ropinirole. It used to be the first line treatment for RLS but no longer is because up to 70% of people will suffer from augmentation which believe me you don't want, and then you have to get off it and that can be hell. First off when you see your doctor ask 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 as that is 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. Improving it to that helps 60% of RLS patients. 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. Above all don't let your doctor prescribe a dopamine agonist like ropinirole (requip) or pramipexole (mirapex). They used to be the first line treatment for RLS, but no longer are because of the danger of augmentation. Instead have him prescribe gabapentin. Beginning dose is usually 300 mg gabapentin or 100 mg if you are over the age of 65. It will take 3 weeks to be fully effective. 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 don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of the gabapentin. 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 at
Grassgree is right about other medications. What medicines and over the counter supplements are you taking? If you list them I can tell you if any make RLS symptoms worse and if so perhaps give you a safe substitute.
Hi. Thank you for being so helpful. My medication has not changed for many years, so I don’t think I can blame that. I think I think that I have just gone through a period where I have done too much and got overtired, and in the last few days I have gone back to normal. The incidence of RLS has always been intermittent, and usually I just have occasional periods where it is an irritating nuisance. This is why I do not want any drug that I have to take every day and thus favour the opioid route. What about codeine?
Understood. You can at least check your ferritin. You should be aware though that RLS can become more frequent as you get older. For many years I only had it maybe once every week or two until I started having it every day. I am 81.
Okay. I am 85 next month….which is why I can’t bring myself to worry too much about getting addicted. Incidentally, you will probably remember codeine being available over the counter in our younger days and for many it was the first choice pain killer. Don’t remember major addiction problems.I am having my blood tested for everything!
If you can persuade him to give you a benzodiazepine, you might want to ask for ativan. The problem with diazepam is it has a long half life of 48 hours and could make you sleepy during the daytime. Also it is one that has gotten a lot of bad press which may also be why the doctor won't prescribe it.
Stress is definitely a factor for me. Any kind of extra activity, even the fun kind, has consistently made it worse over the years. Packing for vacation, the night before a plane flight, that kind of thing. It's a vicious cycle--the RLS keeps you awake, you get more tired, then more stressed, and around and around we go.
Sue is right! Problems with ropinirole can develop in a matter of weeks, and gabapentin is a better choice. Diazepam is addictive and doesn't work for long, and if you've taken it before it may not be effective now. There is a reason why your RLS got suddenly worse, and although the reason may be hard to find, there are things to try. Google your medications followed by RLS and see what you find. There's a lot of info on this forum.
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