Pramipexole and weight gain

[Randidi]

hello

I have restless legs syndrome and I take Pramipexole. I was wondering if this treatment causes weight gain?

I’ve been eating healthy food and exercising 4 times a week and find it hard to lose weight

[SueJohnson]

Yep - it sure can.

[TeddiJ]

Hi. I gained weight on ROP and PRAM and had such a tough time losing weight, so matter what I did. When I went off of them I lost at least 25 lbs. The weight practically fell off. I have used opioids and kratom since, so those also contribute to some weight loss, it seems. If I had known they caused my weight gain though,I would have dumped them so much sooner and things would be so much easier for me now.

[Wairahi]

In my experience, yes, very significant weight gain.

[SueJohnson]

If you decide to come off it because of the weight gain, post back here and we can give you some advise on how to come off it, and what to take instead.

[Randidi in reply to SueJohnson]

yes please, I’m consulting my doctor in 2 weeks but I’d love to know of there are alternatives

[SueJohnson in reply to Randidi]

To come off pramipexole, reduce by .125 mg every 2 weeks or so. You will have increased symptoms. You may need to reduce more slowly or with a smaller amount. Wait until the increased symptoms from each reduction has settled before going to the next one. You will suffer and may need a low dose opioid temporarily to help out with the symptoms especially as you near the end. But in the long run, you will be glad you came off it. Dopamine agonists like ropinirole and pramipexole are no longer the first line treatment for RLS. Gabapentin or pregabalin is. The beginning dose is usually 300 mg gabapentin (75 mg pregabalin). Start it 3 weeks before you are off ropinirole although it won't be fully effective until you are off it for several weeks. After that increase it by 100 mg (25 mg pregabalin) every couple of days until you find the dose that works for you. Take it 1-2 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. (You don't need to split the doses with pregabalin) Most of the side effects of gabapentin or pregabalin 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 (200 to 300 mg pregabalin) daily." If you haven't had your ferritin checked, ask your doctor for a full iron panel. Stop taking any iron supplements 48 hours before the test and fast after midnight. Have your test in the morning. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your ferritin to be over 100 and your transferrin saturation to be between 20 and 45. If your ferritin is less than 100 or your transferrin saturation is not between 20 and 45 post back here and we can give you some advice. 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 as yours obviously isn't or s/he would never have prescribed a dopamine agonist at Https://mayoclinicproceedings.org/a...

[fishinphil1946]

Hi Randidi,

I was put on PRAM and increased to 2.0mg/day. I gained 20 pounds in 2 years and went from snoring and less than 5 apnea events per hour to over 20 per hour (apneas are a cessation of breathing for >10 seconds) during sleep. I gained 50 pounds in 10 years. It took me 32 weeks at a reduction of 0.125mg per 2 weeks to get off PRAM. I am still on 1500mg/day of Gabapentin which can also promote weight gain. Iam losing a few pounds and want to lose the 50 pounds.

I am 76 years old and losing weight is more difficult at my age due to a lack of exercise, slow metabolism, and will power. At your age DON'T GIVE UP! Anyone can be 500 pounds. I am 5'7" and 220 pounds; basketball players are 6'8" and 220 pounds. USA pro football pass receivers are 6'4" and weigh less than 220 pounds. Either I need to be stretched on a rack or lose weight!

My wife checks the scale every morning. I am up every 2 hours during the night and go right to the refrigerator. Now I am walking 30 minutes and go to a gym for weight workouts. However, WILL Power is essential. Tonight, I have to fast for a blood test and I really can do it when motivated. The South Beach Diet is a good guide for a life change. Eat nothing WHITE; too many carbohydrates and sugar. Stay away from the middle of the grocery store (USA). Don't bring home any "treats" because you won't pace yourself. Ask yourself if you are really hungry before you eat. Take time to prepare your meals. Limit eating out. There is nearly nothing I should eat here in south Texas restaurants. Most of the Latino population is very overweight and diabetic. When I workout too hard and sweat a lot, I get dehydrated and my RLS has a bad night.

I feel so bad for all the young people who are overweight; it gets harder with age. Modern medicine is fantastic, but the best RLS advice is on this website. You don't want excessive weight to complicate all the other medical issues that come with the "Golden Years." You can do it! Candy and donuts are NOT a reward for good behavior. They will be a medical problem!

Best Wishes

[SueJohnson in reply to fishinphil1946]

The way I lose weight and has kept me from gaining is to eat small bites and very slowly.