Loprazolam and RLS

[Ephemera]

Does anybody have any experience of taking Loprazolam for RLS/Insomnia. Husband prescribed it today. 4 days into using Buprenorphine patch and Gabapentin and no change in severe RLS. GP thinks this may help with the not sleeping. Thanks for any answers.

[SueJohnson]

The only problem is that it takes 2 hours to reach peak plasma level, so should probably take it 1 to 2 hours before bedtime.

[Joolsg]

If your husband still has severe RLS, and that's what is waking him, loprazolam will just make him incredibly drowsy and when he is awakened by RLS, he will find it difficult to walk about, and the risk of falls increases.The RLS needs to be controlled.

What dose of patch were you given?

As I've previously mentioned, the oral sub lingual pill is more suited to RLS as it gives more coverage in the 10 hours after you take it. RLS is mainly late evening and night.

The patch is more suited to severe, constant pain.

The average dose of Buprenorphine is around 0.5mg but the effective dose for RLS is between 0.5 and 6mg.

Can you talk to or email Dr Dhanjal and discuss a switch to the sub lingual pill and a dose of 0.5 -1mg?

[Ephemera in reply to Joolsg]

Hi, the dose of patch is 0.5mg. We are going to give it more time to get to work. I understand what you are saying about the sleeper. We had that problem with the Z drugs. He is suffering day and night now.

[Joolsg in reply to Ephemera]

I can only see 5 micogram or 10 microgram as 7 day patches on the NHS lists. Or 52.5 micrograms as 4 day patches.5 micrograms an hour x 24 would give 120 micrograms which is 0.12 milligram.

That is the lowest possible dose.

Most people with severe refractory RLS will need between 0.5mg to 1 mg a day. That would be the 20mcg patch. 20 x 24 = 480 micrograms which is 0.48mg, around the average.

I suggest you email the neurologist urgently and ask for 0.4mg Buprenorphine pills and take at night. Most RLS patients do better on the pills than the patch.

If for some reason he refuses the pills, at least he should increase the patch to the 20 microgram patch as that would be nearer to the average dose for RLS.

I know a few people who get relief on 0.2 milligram but most need 0.4milligram or above.

Explain fully that your husband is still up all night.

Sleeping tablets really won't help. They will only be useful for people with actual insomnia as a side effect of meds. They do nothing for uncontrolled RLS.

[Ephemera in reply to Joolsg]

He is also on 1200mg split in 2 at night

[Joolsg in reply to Ephemera]

1200mg of gabapentin? That will help sleep better than sleeping pills.Gabapentin doesn't work for everyone and in your case it hasn't helped much so far, even though it's an average dose.

If Buprenorphine works, it works instantly, but not if the dose is too low. In your case, I think it's too low.