Gabapentin & withdrawal from neuro patch

[VJ29]

Hello I am looking for more advice please. So I started to taper down my neuro patch in October/ November time and started to also take gabapentin at that time. I received brilliant advice from this forum. But now I've sort of got stuck what to do next I'm still on about half a patch and taking 1200 of the gabapentin 600mg then 600mg 2 hours later. My symptoms have been terrible for the last couple of weeks starting earlier in the evening and continuing when I go to bed. I eventually manage to get to sleep after massage hot bath etc.. my doctors are pretty useless in their knowledge so before I speak to them can I ask if I should just stop this last half of patch and increase my gabapentin? I'm a bit scared to do that but wondered by prolonging the use of the patch I'm making things worse for myself. Any advice of you lovely people would really help me as I'm on the edge of just starting on the patches again.

[SueJohnson]

I wouldn't quit cold turkey unless you really want to suffer. The gabapentin isn't going to help much until you have been off the patch for several weeks and your symptoms have settled. Instead I would go back up to the last dose that was not that bad. You have probably decreased it too quickly or by too much. It is normally advised to reduce it every two weeks and wait until your symptoms have settled before making the next reduction. Try cutting the patch into smaller pieces. If you have a patch that is larger than 1 mg, ask for a prescription for the 1 mg patch. Also ask your doctor for a low dose opioid to take temporarily. If he won't prescribe it print out the section of the Mayo Clinic Updated Algorithm on RLS on opioids to show him/her. If that doesn't work get kratom which has helped a lot of people or cannabis or THC gummies. Kratom is banned in the UK. But you can buy it from kraatje.eu/contents/en-us/d... and they are discreet. You can also can get it from kratom.co.uk and they deliver in 48 hours. As far as whether to go cold turkey, it depends on your personality. Are you the type who would rather suffer greatly for a short time and get it over with, or take a longer time without that great suffering.

[VJ29 in reply to SueJohnson]

Thank you so much Sue would you keep with the 1200mg of gabapentin if I increase the patch back to 1mg? Also what dose of the kratom should I take or would that be set out for me. Last but not least what strength of the gummies would you recommend. I will ask my doctor for the opioids but not holding out much hope. I take lanzoprozol ,citalopram 20mg dose as well also magnesium citrate. Thanks again Sue.

[SueJohnson in reply to VJ29]

Lanzoprozol is a Proton Pump Inhibitor and can interfere with the absorption of iron. I can't find anything that says they make RLS make RLS worse but several people have said they do. Citalopram is an antidepressant and can make RLS worse for some. Safe antidepressants include trazodone and wellbutrin (zyban). Yes I would stay with the gabapentin. As far as the dose of kratom, or the strength of gummies I will leave that to others to answer.

[Joolsg]

Tough question.As you've got this far, there are 2 options. Reduce by 1/4 patch and ask for codeine, tramadol or oxycodone. Cannabis is also very helpful for withdrawal symptoms.

Alternatively, just drop the last half patch and expect severe withdrawal symptoms for the next 2 weeks. This is the method adopted by Johns Hopkins Clinic.

For many of us, no matter how slowly we withdraw, we will suffer very severe withdrawals between dose drops and after the last dose. It's a rollercoaster.

You are almost there so don't give up.

As Sue says, the gabapentin will not cover the symptoms until you've been off the patch for at least 3 to 4 weeks.

[Loopylegs]

I'm down to half a pramipexole tablet, 0.088mg now, and while my symptoms have started earlier, I've increased my gabapentin and added 60mg of codeine and am delighted to say I've been getting 5 to 6hrs sleep before rls wakes me, then I have it most of the day but I'm active so it doesn't bother me as much, thanks to the great advice on here I'm managing to taper off the DA, but definitely needs to be done really slowly, I tried cold turkey before and could only stick 3 days, this time its tough but definitely bearable! Best of luck!

[VJ29]

Thank you all for your advice . loopylegs I feel your pain but very well done so far. I've nearly given up but will continue on at the moment I'm tempted for cold turkey but I just don't have a window ATM as I have trips away from home planned.

[Merny5]

I would keep cutting the patch. I was up to 9 mg of Neupro and it took me 18 months to come off. My last dose was just a tiny piece of patch, maybe 1/4 of a mg. I had to tape it on because it was so small, it would easily come off. I would say to take your time and see if you can get an opioid to help. I’m sorry for your suffering. Keep us posted!

[VJ29]

Thank you Merny5 can I ask what you take now to relieve your symptoms.