Gabapentin for RLS

[DonWilliams]

I was diagnosed with RLS around three weeks ago and have now been prescribed Gabapentin by my GP having rejected his initial prescription of Ropinirole.

My RLS symptoms were initially very severe at night but I was generally symptom free during the day. This has now altered and I am now experiencing symptoms both at night and during the day. This is extremely difficult to live with as it is impacting on everything I do on a day to day basis and disturbs my sleep pattern enormously

My GP has prescribed 100mg Gabapentin increasing to 200mg twice a day after a few days. I understand from reading posts on this forum that this is a relatively low doseage.

I am wondering if I should request the dose to be increased. I am also wondering if Gabapentin should be taken in one dose or whether the dose should be spread out over the day.

Any help would be much appreciated as I am just beginning to understand about RLS and about the debilitating symptoms of the condition.

[SueJohnson]

Beginning dose is usually 300 mg gabapentin . Since you need it during the day too, 300 mg twice a day would be reasonable. It will take 3 weeks before it is fully effective. After that increase it by 100 mg every couple of days until you find the dose that works for you. Hopefully you will not need as much during the day as at night. For night, take it 1 to 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 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" at night. 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 atHttps://mayoclinicproceedings.org/a...

[DonWilliams in reply to SueJohnson]

Hi Sue,

Thanks for your knowledgeable and detailed guidance. It is very much appreciated.

[SueJohnson]

You replied to me when I think you meant to reply to DonWilliams.

[Simkin in reply to SueJohnson]

tx Sue.

[Wairahi]

I would first just emphasise a couple of points which Sue Johnson makes: It takes a couple of hours for Gabapentin to reach full strength in the bloodstream, so if your RLS is starting at 2 pm, you will want to take your first dose of Gabapentin at mid-day. 

Remember also that more than 600 mg is not well absorbed all at once, so you will need to wait a couple of hours before a second dose above 600 mg.

Also, there are a number of natural approaches to dealing with RLS which can help you minimise your need for Gabapentin. Yoga stretches are very helpful for some people. CBD oil taken internally is very helpful for some people. Rubbing Sahacharadi oil (get it from your local Asian specialties shop) into the affected muscles is very effective for some people.

[Simkin]

you are on a very very low dose of gabapentin. I would definitely ask for the dosage to be increased.

I am on 1200 dosage!

[DonWilliams in reply to Simkin]

Simkin,

I think you are right as I have not noticed any significant improvement in my symptoms so far?

Most of the posts on the forum refer to doseages well in excess of the 200mg recommended by my GP. I will be speaking to my GP soon but I have to be diplomatic as some GPs will take umbrage if their patients try to tell them what to prescribe.🤔

[Simkin in reply to DonWilliams]

yes I agree but I am lucky as I have a wonderful GP. I actually said to him "I know doctors don't like patients telling them what dosage they think they should have".

" and he replied "oh I don't know we doctors don't have time to read everything". So now we discuss the pros & cons together. But I always ask him what he thinks about my "suggestion"



[Simkin]

you are on very very low dosage. I would definitely ask for the dosage to be increased.

I am on 1200 dosage!