Clonazepam with Gabapentin

[bbullions]

I've been following this forum for years. Thank you for your guidance. Years ago, a doctor prescribed pramipexole. It worked until it didn't. Weaned off and started Gabapentin. It helps somewhat. I take 600 + 600 three hours later, before bed, as suggested here. I recently met with a pulmonologist for sleep apnea. I told him my story. He said try magnesium and prescribed 0.5 MG of Clonazepam before bed, along with the Gabapentin. BTW, my ferritin level is 116. Thoughts?

[SueJohnson]

It should be 600 mg 1 to 2 hours before bed and then 600 mg TWO hours before that. Since that isn't controlling your RLS take 100 mg two hours before that and after a couple of days increase it by 100 mg until you find the dose that works for you. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin daily." but you can increase it up to 3600 mg. Since it can be inconvenient taking each 600 mg 2 hours before, you can switch to pregabalin by dividing the gabapentin dose by 6 as it can be taken all at the same time. Take the magnesium at night but 3 hours before the gabapentin. If you switch to pregabalin you don't need to do this.

The clonazepam may help you sleep but it has a half life of 40 hours so can make you drowsy the next day.

[bbullions in reply to SueJohnson]

Thanks, Sue. I was thinking the Gabapentin plus clonazapam combined would make me groggy the next day. Or dizzy.

[SueJohnson]

Some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, carbs, foods high in sodium, foods that cause inflammation, ice cream, estrogen, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, using a standing desk, listening to music, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.

[Amrob]

I take clonazepam (0.25mg) with pregabalin and it works well. Pregabalin is in the same class of drug as gabapentin.

Why not try a small dose to see how you tolerate it?