Confusion over Mayo Clinic report - Restless Legs Syn...

Restless Legs Syndrome

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Confusion over Mayo Clinic report

wantokporo profile image
20 Replies

I am now looking at probably going off gabapentin as it is likely the cause of nervousness that I was also experiencing on pregabalin. Reading the report, it seems the next recommendation is the nonergot dopamine agonists, or the drugs that cause augmentation. Sue Johnson, etc. seem to disagree about this course of action?

I also discovered mirogabalin, which I had never heard of before, particularly I don't remember hearing about it here. I wonder if there is any prayer it might not cause this side effect, or if anyone has any experience with it.

What to do?

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wantokporo
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20 Replies
Madlegs1 profile image
Madlegs1

Your next step is some form of opioid. Codeine, methadone and going on in ascending order.

wantokporo profile image
wantokporo in reply toMadlegs1

You mean add in a bit of codeine as I am coming off of the gabapentin?

Madlegs1 profile image
Madlegs1 in reply towantokporo

It's an option.

SueJohnson profile image
SueJohnson

Mirogabalin is interesting because it has fewer side effects but it hasn't been approved by the FDA so I doubt if you could get it. It is interesting about the Mayo Clinic report but it also warns about augmentation with this report and as most forum members have discovered opioids are a better choice.

wantokporo profile image
wantokporo in reply toSueJohnson

It seems it might be possible to order through the mail?

wantokporo profile image
wantokporo

Dr. ordered codeine and tylenol and I'll be starting on 1/2 tab. I just read online (Dr. B) that tylenol can exacerbate RLS?!! Is that true? And while I'm here, what dose of codeine usually gives relief? Thanks all.

SueJohnson profile image
SueJohnson in reply towantokporo

Tylenol can't make RLS worse. It is often prescribed with codeine. 30 to 90 mg of the combined dose per the Mayo Algorithm although it also says 60 to 180 mg alone is the usual effective dose.

wantokporo profile image
wantokporo in reply toSueJohnson

I read this in a paper by Dr. B! but it did not jive with my experience as I have taken a lot of tylenol. Thanks.

SueJohnson profile image
SueJohnson in reply towantokporo

I found an article that mentioned tylenol as a trigger and Alka-Seltzer neither of which are and Dr Buchfuhrer was quoted in the article but he didn't mention tylenol.

wantokporo profile image
wantokporo in reply toSueJohnson

I looked back at the article I was referencing and couldn't find his mention of tylenol, which may go to show that you should not do research when you haven't slept.

SueJohnson profile image
SueJohnson in reply towantokporo

LOL !😀

wantokporo profile image
wantokporo

And another concern: it seems that you shouldn't take gabapentin with tylenol #3? My dosages are low so maybe it is okay?

SueJohnson profile image
SueJohnson in reply towantokporo

Unless you suffer from breathlessness on either, it is not a problem.

Jumpey profile image
Jumpey

Definitely opioids. I began with codeine.Good luck.

wantokporo profile image
wantokporo

Thanks, Jumpey. Do you take Tylenol #3? How much codeine works for you?

ringring_ profile image
ringring_

gabapentin and pregabalin are not causing you nervousness, they're anxiolytic not anxiogenic

wantokporo profile image
wantokporo in reply toringring_

More afterthoughts:

A paradoxical drug reaction is when the opposite outcome of a drug occurs, rather than the expected outcome. It can be negative or positive. An example of a negative paradoxical drug reaction is taking a medication to reduce anxiety and the medication instead worsens your symptoms.

If you google "paradoxical drug reaction" you can learn more.

I have had difficulty tolerating many drugs and finally asked a functional doctor what was up with this. She told me about:

Enzymes play a crucial role in the metabolism of drugs within the body. Genetic variations in specific enzymes can contribute to drug intolerance or increased susceptibility to adverse drug reactions. Here are a few enzymes that are known to influence drug metabolism and can potentially cause drug intolerance:

Cytochrome P450 (CYP) Enzymes: The cytochrome P450 enzyme family, particularly the subfamily CYP2D6, CYP2C9, and CYP2C19, is involved in metabolizing a significant number of medications. Genetic variations in these enzymes can affect their activity levels, leading to variations in drug metabolism. Poor or ultra-rapid metabolizers of certain drugs may experience drug intolerance or increased risk of adverse effects.

My mother became psychotic on both valium and fentenyl. I saw more than one doctor question this and watch in horror with even the smallest amounts causing psychosis when she was hospitalized.

wantokporo profile image
wantokporo

Unfortunately you are mistaken, although that is mainly the case. It is also possible to have a paradoxical response to a medication; I have had many.

Raleigh59 profile image
Raleigh59

I’ve had that medicine and it generally calms people’s nervousness so did a doctor actually tell you that gabenpentin has the side effect of nervousness? If that’s a side effect that seems very rare bc the medicine is also used to calm people. I personally take chelated magnesium by country life for my RLS but I own and use Gabapentin for my anxiety / stress.

wantokporo profile image
wantokporo in reply toRaleigh59

A paradoxical drug reaction is when the opposite outcome of a drug occurs, rather than the expected outcome. It can be negative or positive. An example of a negative paradoxical drug reaction is taking a medication to reduce anxiety and the medication instead worsens your symptoms.

If you google "paradoxical drug reaction" you can learn more.

I have had difficulty tolerating many drugs and finally asked a functional doctor what was up with this. She told me about:

Enzymes play a crucial role in the metabolism of drugs within the body. Genetic variations in specific enzymes can contribute to drug intolerance or increased susceptibility to adverse drug reactions. Here are a few enzymes that are known to influence drug metabolism and can potentially cause drug intolerance:

Cytochrome P450 (CYP) Enzymes: The cytochrome P450 enzyme family, particularly the subfamily CYP2D6, CYP2C9, and CYP2C19, is involved in metabolizing a significant number of medications. Genetic variations in these enzymes can affect their activity levels, leading to variations in drug metabolism. Poor or ultra-rapid metabolizers of certain drugs may experience drug intolerance or increased risk of adverse effects.

My mother became psychotic on both valium and fentenyl. I saw more than one doctor question this and watch in horror with even the smallest amounts causing psychosis when she was hospitalized.

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