Sifrol withdrawal

[Audrina1209]

I have been trying to reduce Sifrol but everytime I reduce dose to 1/4 of 0.125mg tablet, breakthru RLS symptoms happen about midnight for a few hours and I have to end up getting up and having the remainder 1/4 tablet, I have tried reducing that last little bit a number of times with no success, I have also been on gabapentin gradually increasing 100mg dose every approx 4 days. I am now on 1100mg gabapentin do you please have any advice for me my ferritin levels are just over 100. Also my 2nd Neurologist has moved on and now I will have to go on a waiting list for public hospital to get help. I would appreciate any advice thanks

[Madlegs1]

Are you taking magnesium in any form? Perhaps as an indigestion medication?Or what other medications are you on?

[Audrina1209 in reply to Madlegs1]

Yes I am taking magnesium glycinate as Sue suggests..only other meds are BP med Coversyl and thryoid med Estroxsig..thanks for your answer..I have had RLS for years, my late mum had it as well

[SueJohnson]

Are you taking the gabapentin in divided doses? It is not well absorbed above 600 mg so you should take 600 mg 1 to 2 hours before bedtime and 500 mg 4 hours before bedtime. If you are taking magnesium, take it at least 3 hours before the gabapentin. Do not increase it any more until you are off sifrol for several weeks. On reducing sifrol, yes, unfortunately you are going to suffer. Wait until your symptoms have settled before making each reduction even if it takes weeks. You probably need a low dose opioid temporarily to help you. If your new neurologist balks at prescribing an opioid, print out the appropriate section of the Mayo Clinic Updated Algorithm on RLS to show him/her at Https://mayoclinicproceedings.org/a... Since you are on a waiting list, you might want to wait to make the next reduction until you can see a doctor and get an opioid. Are you taking any medicines or over the counter supplements If you list them I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute. If you are uncomfortable listing them here, you can message me.

[SueJohnson]

Meanwhile: some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, estrogen, dehydration, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, masturbation, magnesium glycinate, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, massage including a massage gun and yoga.

[Audrina1209 in reply to SueJohnson]

I have tried all you suggest I wont increase Gabapentin anymore until off Sifrol..I will try my GP again for low dose opiod..she wouldnt give them to me even though I suggested the Mayo paper..I will print it out and if she wont again while I am waiting for Specialist appt I may have to Doctor shop for them...thanks for your advice..I have been staggering the Gabapentin as you suggest for weeks and also take my Magnesium glycinate at least 3 hrs before (when I renember) I believe I just need to get off the Sifrol. I can only drink decaf coffee 2 a day at most.

[Joolsg]

Sadly Audrina, hardly anyone escapes withdrawal. To get off sifrol most people have to go through a week of withdrawal symptoms. It is horrible but once you get through the one or two weeks of withdrawal, the intense RLS settles.I only know of a handful of people who made the switch from dopamine agonists who didn't have withdrawal symptoms.

The gabapentin will then start to help.

It's tough, but accept you have to suffer several really bad nights of constant RLS before it settles.

Ask your GP for short term low dose opioid cover for 2 to 3 weeks to get through withdrawal. 50mg tramadol every 4 hours at night for 2 weeks or if you can get medical cannabis, that really helps withdrawal symptoms.

Stay strong. That last dose is the worst and you can expect 2 weeks of withdrawal but then the RLS settles.

[Audrina1209 in reply to Joolsg]

Thanks Jools..see my reply to Sue

[Jules1953]

That last stage of withdrawal from Pramipexole is the most difficult. I had the same issue once I was at 0.125mgI was originally on 3.00mg Pramipexole and had spent a year or more slowly reducing the dosage.

Taking 5mg oxycodone each night helped me through the horrendous withdrawal period, 0.125mg to zero Pramipexole.

Even after completely weaning off the Pramipexole, it took about 6 months for my brain to adjust.

I now use Temgesic sublingual 200mcg tablets to successfully control my RLS. I place two Temgesic tablets under my tongue each evening. Temgesic is micro dosages of Buprenorphine.

From my experience, and I have suffered with RLS for 51 years, you will require a low dose opioid medication to help you finally get off the Pramipexole. Kind regards Julie McGowan from Western Australia

[Audrina1209 in reply to Jules1953]

Jules..I still need help with getting off Sifrol..I,ve given up the Gabapentin as they were not helping...Sifrol will give me relief after an hour or so or longer...unfortunately my Sifrol use has crept up again...1 x 0.25 at about 4pm and sometimes another 1/2 thru the night...GP wouldnt give me low dose opiod..to help...Hopeful for answers from Specialist whom I see on Tuesday (after waiting for my appointment for 8 months)...I am sleep deprived and now depressed and losing hope in medical profession...can you help me Julie..I notice you are in WA .I am in Tas..thinking I may have to travel interstate for help with this beast

[Jules1953 in reply to Audrina1209]

Hello Audrina, so sorry to hear what you are going through. I have been in the same situation as you are now. It is so terrible that the majority of doctors have no idea how to help their patients suffering with RLS.I will give you my phone number in a personal message. Kind regards Julie