Restless legs

[patchworker]

Returning here after many years, I find people trying to reduce Pramipexole. Why? It works wonderfully for me. Is there a problem with it?

[ChrisColumbus]

Because the majority on Dopamine Agonists experience augmentation. You're lucky that you are one of those who don't. The UK is backward in continuing to prescribe them as first line meds for RLS

healthunlocked.com/rlsuk/po...

[martino]

I use a 2mg patch and have used it for 5+ years. It works well for me and in a meeting with a neurologist a few days ago we agreed to carry on with it.If it ain’t broke don’t mend it!

[ChrisColumbus in reply to martino]

Indeed. Same for the OP if it continues to work at the same dosage without problems.

[patchworker in reply to ChrisColumbus]

I understand now. I was on Ropinirole several years ago. Is it the same sort of effect as in the film Awakenings?

[ChrisColumbus in reply to patchworker]

Augmentation doesn't just mean that it stops working: it means that initially one has to take more and more to get the same effect, and eventually that however much one takes it actually makes the symptoms worse. It's then very slow and distressing trying to wean oneself off the drug.

But this doesn't happen to everyone on Ropinirole, Pramipexole, and the Rotigotine patch (I've seen the figure of 70% quoted), so if you've been on the same dose for years and it still works, great. If you find you're having to take more and more, you may have problems. Good luck with it!

[Embroiderer in reply to patchworker]

I’ve had the same question re Awakenings, would be interested to hear people’sthoughts.

[patchworker in reply to martino]

I had patches while I was in hospital for esophagectomy years ago, but was put back on Ropinirole when I got home.

[SueJohnson]

Yes you might be one of the lucky ones. Just be aware of the signs of augmentation and if you experience them do not stop taking it. You will have to wean off slowly. If that happens, post back here and we can give you some advice. The signs of augmentation are when you have to keep increasing your dose to get relief, or when your symptoms occur earlier in the day or there is a shorter period of rest or inactivity before symptoms start or when they move to other parts of your body (arms, trunk or face) or when the intensity of your symptoms worsen.

[Joolsg]

Vast majority taking Ropinirole, Pramipexole or the patch experience drug induced worsening of RLS. The drug feeds the disease. 'Pouring gasoline on the flame'. Augmentation.If you can sit comfortably in a cinema or a long plane journey, you don't need to worry.

Just keep an eye on symptoms and if they start to play up, don't increase the dose. That's the time to consider withdrawal.

[Greenleaf360]

All dopamine agonist (pramipexole, mirapex, ropinerole, requip, rotigitone) will give excellent relief of RLS symptoms until augmentation appears. Rule of thumb 7% augment every year. 80% will augment by year 10. Augmentation is upper body symptoms, daytime symptoms, need to increase dose. Once augmentation occurs it only gets worse. Lots of people are i jured as augmentation gets worse, doctors increase dose and fail to inform the patient. The DA are addicting. Quitting can be very difficult. People who are augmenting often suffed loss of impulse control, sex, gambling, shopping are common. The Mayo Clinic Algorithm recentlt demoted the DA to second line and promoted gabapentin to first line. Go to RLS.ORG and search for augmentation.

[Enable]

I've been on 0.18mg pramipexole for about the last 10 years and it still works well for me too. Its only when I read here about augmentation I start to worry about it and wonder whether I should pre empt it and come off even though I have a good quality of life on it. I'm 61, is it inevitable one day I don't know.