Advice please - should I ask for an opioid to tide me over when I withdraw completely, and, if so, which one? I am down to a quarter of 0.88mg of pramipexole a night. I have been taking Pregabalin for 4 weeks and now on 75 mg nightly and iron every other night.
I went without the pramipexole the night before last and was up most of the night, finally getting some sleep at 8 in the morning. I took a quarter pill again last night because I have commitments during the day so need to function and I slept well.
I have got this far due to the wealth of information and advice on this forum, plus a supportive GP practice , so many thanks to you all
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jumpyjo
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Firstly, well done for reducing this far. I just want to remind you that 75 mg of pregabalin is still a very low dose. You may want to increase to see whether that helps. After you have come off the pramipexole completely, and after a few weeks (to months) you can always try to reduce the pregabalin dose again to find the lowest effective dose for you. I really hope the pregabalin will work well for you.
You have done a great job reducing the pramipexole. Yes a low dose opioid would be a good idea. As to which one, buprenorphine seems to be recommended a lot on this forum, but I have no experience with opioids. I am sure others with more experience will advise you. On the pregabalin usually the advice is to wait until you have been off the pramipexole for a few weeks since it won't be fully effective until then, but you could increase it now if you want to see if it will help. Increase it by 25 mg every 2 days. The usual effective dose once you are off pramipexole for a few weeks according to the Mayo Clinic Updated Algorithm on RLS is 200 to 300 mg. I see you are taking iron. Have you had your ferritin tested? If so what was it and what was your transferritin percentage?
Thanks Sue, yes I had my iron tested - ferritin level 49 -is that the same as transferritin percentage? (to which I was told all was fine, so I informed them of the latest research) and I am now following your advice and taking 400mg every other eve, to be retested in 4 months. Thanks for the info about pregabalin - I did not know that.
Well done for getting this far. You could certainly ask your GP for short term tramadol or codeine to try to help the withdrawals. Some people don't get any withdrawals but the majority will have at least 4 night's with ZERO sleep and constant intense RLS.Ask for Tramadol or codeine for short term use during withdrawal and explain to your doctor that withdrawal from Pramipexole is worse than heroin withdrawal, especially if you've been on it for a long time and at a dose above 2x0.088.
It's hellish but once through the first 4 days after the last dose of Pramipexole, the RLS starts to settle and you can increase the pregabalin to 150mg.
I actually found cannabis to be the most effective help during my withdrawal in 2016. It was then illegal in the UK ( I now have legal, medical cannabis). My adult children got hold of some cannabis cigarettes for me and they were the only thing to give me 30 minutes of sleep after days without.
Stay strong and keep reminding yourself that it WILL settle after about 2 weeks.
I did much the same as you after being on Pramipexole for over 25 years, I reduced very slowly a bit like yourself and about four weeks before the end of my final quarter tablet I moved onto Pregabalin, I started off on 50 mg but after a couple of weeks upped it to 100 mg per day. The doctor said one in the morning and one in the evening but the advice from this forum which I have taken and rely on totally is to take both tablets in the evening I take mine at about 10:30 pm because I’m late going to bed most nights and it seems to work perfectly well for me and I’m quite happy on it. Touchwood.I did not need to take any opiates or additional medication during the change over period. I had been slightly panicked about that because I had read so many horrific reports so I was so pleased not to have suffered as some of the others have.
Based on what you have written, I would not recommend adding in an opioid at this time. If you have reduced your pramipexole this far without it on such a low dose of Lyrica, you have done far better than I did. I required Methadone while I reduced and eventually stopped ropinerole. If Lyrica is not causing you any side effects, I would consult your physician about increasing it. My doctor put me on an initial dose of 100mg-600mg of Lyrica. I only take 200mg because I do experience side effects.
I used 5mg of oxycodone each night to help with with the final stages of weaning off the Pramipexole. This was a lifesaver for me. Kind regards Julie from Western Australia
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