Help!

[Loopylegs]

Hello, everyone, I've an appointment to see my doctor tomorrow and would like to know what strength of buprenorphine helps rls? I'm not doing so good, rls back with a vengeance, had to go back on the hrt gel as I found my rls was way worse after stopping it, I'm crawling all over, day and night since I took my last quarter or pramipexole a couple of weeks ago, I refuse point blank to go back on it as I'm only prolonging my misery, but I'm literally falling asleep for half an hour at a time, day & night, can't rest, have to keep moving, codeine not working, I increased gabapentin to 1200mg following all the advice on here, cut out anything food wise that might trigger symptoms, taking my vitamins & minerals etc.. even tried adding clonazepam to the mix but that made my rls worse, going to see if my doctor will give me buprenorphine, fingers crossed she will!

[SueJohnson]

According to the Mayo Clinic Algorithm, the starting dose is .5 mg to 1 mg. The usual effective dose is .5 mg to 6 mg.

[Loopylegs in reply to SueJohnson]

Thanks Sue, much appreciated!

[Joolsg]

As you've just stopped Pramipexole, the gabapentin won't fully cover symptoms for a few weeks. The withdrawal can take ages to settle. If your GP refuses Buprenorphine, don't despair. The RLS may well settle over the next few weeks.If the GP does agree to a trial, start low!

I started on 0.8mg and it stopped RLS completely BUT I vomited and was prostrate with nausea for a week.

So start with 0.2mg ( if the lowest dose pill is 0.4mg, cut in half). Then you can increase by 0.2mg doses until you find the dose that works.

If your GP suggests the patch, point out that many RLS patients complain that it doesn't last the full 5 or 7 days and they get breakthrough RLS and opioid withdrawal RLS for several days a week.

Have Kwells sea sickness pills or medical cannabis on standby in case of nausea.

I take 0.4mg at night. Zero RLS.

[Loopylegs in reply to Joolsg]

Super, I'll ask for the 0.4mg tab & halve it, hopefully I get it! Thanks for the help, I'm hopeful that it settles, just really need sleep.

[Loopylegs in reply to Joolsg]

Also, do you take gabapentin as well or does the buprenorphine help u sleep?

[Joolsg in reply to Loopylegs]

I started on just Buprenorphine which instantly stopped RLS. Zero.However, after 4 weeks I developed opioid induced panic attacks. It happened before on Oxycontin so I was expecting it. Dr Buchfuhrer advised adding a small dose of pregabalin then. I had some left so added 25mg at night and it stopped the panic attacks.

You should be aware that Buprenorphine and gabapentin/pregabalin can cause respiratory depression, so if you stay on gabapentin, reduce the dose to the absolute minimum to allow sleep/anti anxiety. But avoid if you experience any breathing issues.

Some people experience opioid wakefulness, so a small dose of gabapentin may counter that.

[Jumpey in reply to Joolsg]

Any idea what small dose of gabapentin may help with opioid insomnia Jools?

[Joolsg in reply to Jumpey]

I would use the lowest possible dose. 100mg. And see if it reduces insomnia.

[Jumpey in reply to Joolsg]

Cheers.

[Loopylegs]

I had respiratory depression with tramadol at 100mg dose and it interacted with the gabapentin causing sweats, palpitations and dizziness, so I'll be careful with the buprenorphine, if I get it! Thanks for the advice Joolsg

[Shumbah in reply to Loopylegs]

I had respiratory depression on oxy however zero on Buprenorphine, I wonder if it is dose delayed 2 mg Bup verses 20 mg oxy .

[Loopylegs in reply to Shumbah]

Did you find the buprenorphine helped your rls?

[Ticki]

dear Loopylegs , thank God for that medicine it’s what saved my life after many years of nothing ever working. Unfortunately I have to go to the top milligrams, which is 8 mg but it does the trick. I am obviously I am a hard nut to crack, but it’s the best for me and I don’t have any side effects and it gives me my life back.

[Loopylegs in reply to Ticki]

It's wonderful to find something that works! I'm hopeful my doctor will let me try it.