Transitioning off pramipexole

[robertff3401]

I keep reading the absolute hell many people experience transitioning from pramipexole (or some other drug) to gabapentin. The worst seems to be when one is essentially finished with pramipexole but have taken very little gabapentin. My question is this: why can't you transition off pramipexole by reducing the amount you are taking by X amount and replace that at the same time with an equivalent amount of gabapentin. Use the new combination for Y number of days/weeks then reduce the pramipexole by another X increment and replace that with an equivalent amount of gabapentin. Continue this routine for several weeks/months (whichever is appropriate) until all the pramipexole has been removed and you are totally on gabapentin? I transitioned from pramipexole to Sinemet (25mg carbidopa-100 mg levodopa). I used the transition method mentioned above over an 8 week period and had no problem with my RLS at all. BTW I realize transitioning to Sinemet was not a wise choice, but that's what my PCP wanted me to do, AND that was before I began reading HealthUnlocked and learned some valuable information about RLS.

[Joolsg]

You transitioned from one dopaminergic drug to another so your dopamine receptors were still getting a dopamine 'hit'. You wouldn't get any withdrawal symptoms.

When you stop these category of drugs completely, every dopamine receptor in your body screams out for their fix. It's worse than cocaine or heroin withdrawal.

Gabapentin works in a completely different way and therefore doesn't work at all until your body has been through withdrawal completely. So there's no point reaching a full, effective dose until you're off pramipexole.

I do hope you keep an eye on your symptoms because sinemet is not used for chronic RLS because it has the highest rate of augmentation.

[robertff3401 in reply to Joolsg]

Yes, I'm well aware of the augmentation problem with sinemet, but I was almost through the transition from pramipexole to sinemet when I became aware of the fact that I was replacing one dopaminergic drug with another (from reading information on HealthUnlocked. Thanks for your reply.

[SueJohnson]

I agree with Joolsg.

[Biscuitface]

My gp stopped my very high dosage of Pramiprexole 'cold turkey'. I had then to wait 2 weeks before he would start Gabapentin. It was pure torture for months. I have since learnt so much from this group, Joolsg and Sue in particular to whom I shall be forever grateful.

[robertff3401 in reply to Biscuitface]

I dread the day when I have to face that transition to gabapentin. I think I still have a few months of very little rls symptoms before I have to make that decision. Like you, I too am very grateful for the help from Sue and Joolsg. Their input and the excellent summary of all things RLS by the Mayo Clinic have given me more information in the past few months than I had for many years before I disovered HealthUnlocked. Thanks for your input.