After a recent post from Amrob explaining that they add 0.125mg or 0.25mg Clonazepam to 300 mg Pregabalin when the Pregabalin does not cut ... I do the same with Ropinirole, adding 0.125mg nightly to 300 mg Pregabalin, because I will never get to sleep otherwise .....
I wonder what the thoughts are of our experts on here as to whether to stick to this regime, or "move away at all costs from dopamine agonists, no matter how small the nightly amount" and go down the opioid route.
I would be grateful for any comments. With warm regards to all, Sally
Written by
67Waterman
To view profiles and participate in discussions please or .
Hi there. I'm curious about the decision to add Clonazepam or Pregabalin to Ropinirole. I've been on .5mg of Ropinirole daily for years and it does the trick for the most part (assuming I remember to take it on time!). I'm new to the group and just learning about augmentation. Would Clonazepam or Pregabalin be used to help reduce the dosage of Ropinirole and potentially forestall augmentation?
Just to clarify, the discussion is more about adding clonazepam or ropinirole to pregabalin. Not so much about adding clonazepam or pregabalin to ropinirole. It’s a subtle but important distinction.
A small minority of people take dopamine agonists (‘DAs’) (eg ropinirole, pramipexole etc) - as a monotherapy - successfully for years.
When DAs cease to be effective, or are less reliable, this may be the first sign of augmentation. Other signs may be symptoms spreading to different parts of the body, or starting earlier in the day.
The consensus is, at this point you do not increase the dose. You decrease the dose slowly with the aim of coming off the DA.
The trouble with using another medication to supplement DAs is that you may be masking any augmentation that is occurring. This is not to say that it can’t be done or shouldn’t be done.
Conversely, some people use DAs to top up other medications. Again, this may be an effective approach if the DA is used sparingly or at a very low dose.
Many people on this forum struggle to find medications that are effective. I think most people on here would agree that if something is working for you, there’s no need to ‘fix what ain’t broke’.
Yup . Was taking Ropinirole as front-line medication for RLS from 2007 to beginning of this year. Over the last two years, I found that I was needing to take more and more, and my symptoms were getting worse, and I started to have bad daytime RLS. It was only through this forum that I learnt about augmentation. So went on Gabapentin and then Pregabalin instead of the Ropinirole ... but they were not particularly effective, so I fall back on small amounts of Ropinirole to get me to sleep.
I keep a small quantity of Ropinirole in the cupboard as a form of insurance, I have an absolute dread of being unwell enough not to be able to move around at night and bedbound with full blown RLS/PLMD. .25mg will I know bring complete respite with no immediate side effects as very very occasional use in the past has confirmed.
My understanding (gleaned from this forum and another one) is that if you're able to keep dopamine agonists at a very low dose and aren't experiencing augmentation then this approach is fine.
The only potential problem may be any long-term impact that dopamine agonists have on our receptors. It's really a case of weighing up the known (this combination works for you) and the unknown (long term impacts of DAs).
HI Amrob ... unfortunately I did experience augmentation quite badly (and quite suddenly), which is why I went onto Gabapentin and then Pregabalin. But I am finding quite simply that Pregabalin just does not work as "effectively" as Ropinirole used to. I still have to take that final push of 0.125mg Ropirinole (sometimes on a bad night 0.25mg) to get relief. All very annoying .....
Hi there, I just wanted to say that if you do decide on an opiate don’t take Tramadol. I am currently augmenting on it; it’s the only opioid that can cause augmentation. The chances are lower than with a DA med so I was hoping for the best and now I’m in augmentation hell.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Pregabalin, Buprenorphine question
Pregabalin to Gabapentin rough ride
Ropinirole
Ropinirole
