DA Augmentation, foot pain & Opiods.

[FloridaRN]

I'm currently trying to reduce my Pramipexole due to DA Augmentation. Couple of questions, which I'm hoping you can answer, please:

Occasionally, I've noticed that I'm getting severe stabbing pains in my feet and really intense RLS symptoms when I go to bed. Its particularly prevalent if I've walked my puppy late at night. Does anyone have any experience of late night walks and increase in RLS and pain symptoms?

Opiods- does anyone have experience of Buprenorphine? If so, had you been on any other opiods for your RLS symptoms? Would you recommend Buprenorphine? Has it worked for you?

Thank you all so much.

[TheDoDahMan]

Search "Shumbah" who knows much about Bupe. I've been prescribed low-dose (10 mg per day) methadone which has been working superbly for me for 4 years.

[FloridaRN in reply to TheDoDahMan]

Thanks so much! So glad the methadone is working well for you.

[Joolsg]

When withdrawing from Ropinirole I used to get excruciating, sharp, stabbing pains in my toes. I no longer have them.

After Ropinirole I spent 5 years on 25mg Oxycontin and 150mg pregabalin but still had very severe RLS every day and night. I had an iron infusion but it made no difference.

I switched to 0.4mg Buprenorphine in July 2021 and have had zero RLS ever since. It transformed & saved my life. I thank Shumbah for telling me about it on this forum.

[FloridaRN in reply to Joolsg]

I'm so so happy for you. HONESTLY- this fills me with hope. And, you are on Buprenophine with no Naloxone, correct?

I've found someone willing to help me who follows the Mayo Algorithm and will consider prescribing opiods if necessary.

Is there any info you feel i should have to ask him on my first appointment?

[Joolsg in reply to FloridaRN]

Brilliant that you've found a doctor in Florida.

I take Buprenorphine with no naloxone. I know that it's more common to prescribe with naloxone in the USA because of the opioid crisis.

I would ask the specialist if he/she will refer you for IV iron infusions if needed and will prescribe safe anti nausea meds if you develop nausea on Buprenorphine ( very common in the first week).

I know Dr. Buchfuhrer now prefers Buprenorphine because it is very well tolerated.

[FloridaRN in reply to Joolsg]

Thanks so much for this.

Yes, I did have a IV ferritin infusion a couple of years ago but it failed to make any impact on my RLS symptoms. But i think this was due to my augmentation.

[agapepilgrim]

yes. It helps me to wear support socks when I walk.

[restlessstoz]

Hi, You've had some replies about buprenorphine and I'll add mine. I too listened to Shumba and asked my GP if I could try it. It has changed my life! I do get occasional breakthrough which is annoying but my GP doesn't want me to increase the patch dose. I'm on Norspan patches as here in Australia it's too hard to get Temgesic prescribed. I'm happy with the patches but just wish I could increase the strength then I wouldn't need any other support.

I have also been on Fentanyl patches about 13 years ago which were superb and I got no breakthrough at all. However, it wasn't sustainable as I had to keep increasing the dose. It's also far too strong and doesn't have the low addiction quality of Buprenorphine.

I also have been on Targin but was augmenting at the time and it didn't do much. Tramadol has helped but beware of augmentation from Tramadol as it's a possibility.

A couple of people who process the opioids really fast have found buprenorphine to be good in that they get relief from RLS but the medication lasts only a while before the symptoms reappear. I.e. four hours with the oral medication rather than overnight. or 3-4 days with the patches instead of 7.

I didn't have any side effects except that opioids make me alert so for two years I didn't sleep soundly and was semi awake all the time. I was a wreck until I read on here a post which mentioned gabapentin might help and it does. First dreams and sound sleep for two years.

Good luck with your search for a medication to help.

[FloridaRN]

Thanks so much for your feedback and I'm so glad you are doing well.