Confusion over Mayo Clinic report

[wantokporo]

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?

[Madlegs1]

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

[wantokporo in reply to Madlegs1]

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

[Madlegs1 in reply to wantokporo]

It's an option.

[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 in reply to SueJohnson]

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

[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 in reply to wantokporo]

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 in reply to SueJohnson]

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 in reply to wantokporo]

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 in reply to SueJohnson]

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 in reply to wantokporo]

LOL !😀

[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 in reply to wantokporo]

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

[Jumpey]

Definitely opioids. I began with codeine.Good luck.

[wantokporo]

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

[ringring_]

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

[wantokporo in reply to ringring_]

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]

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]

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 in reply to Raleigh59]

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.