OTC meds

[BarnGir1]

Now that I have started cutting back on Ropinerole, I am using three over the counter meds. My first week was not as difficult as I expected but I know it will get worse before it gets better. I have cut back from 5 mg to 3 mg daily and I am taking Restful Legs ( both AM and PM tablets), Seratame capsules and MAG R&R by Salt Wrap. They are all new to me but after extensive reading, including info from this group, I want to see how it goes. You are a valuable resource.

[SueJohnson]

I am glad the 1st week went well and you have gotten down to 3 mg. I am concerned about the future for you. The normal advice to come off ropinirole is to reduce by .25 mg every 2 weeks or so. You will have increased symptoms. You may need to reduce more slowly or with a smaller amount. Wait until the increased symptoms from each reduction has settled before going to the next one. You will suffer and may need a low dose opioid temporarily to help out with the symptoms especially as you near the end. But in the long run, you will be glad you came off it. So be aware of this and if it gets bad you might want to go back up to the previous dose and follow this advice.

You are probably aware that dopamine agonists like ropinirole are no longer the first line treatment for RLS. Gabapentin or pregabalin is. (Pregabalin is more expensive than gabapentin in the US - It would help if you indicate where you live on your profile so we can make our answers more helpful) The beginning dose is usually 300 mg gabapentin (75 mg pregabalin). Start it 3 weeks before you are off ropinirole although it won't be fully effective until you are off it for several weeks. After that increase it by 100 mg (25 mg pregabalin) every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. (You don't need to split the doses with pregabalin) Most of the side effects of gabapentin or pregabalin will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. If you take magnesium take it at least 3 hours before or after taking gabapentin (it is OK with pregabalin) as it will interfere with the absorption of gabapentin and if you take calcium don't take it within 2 hours for the same reason (not sure about pregabalin). According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin (200 to 300 mg pregabalin) daily." Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it as yours obviously isn't or s/he would never have prescribed a dopamine agonist atHttps://mayoclinicproceedings.org/a...

[SueJohnson]

Meanwhile 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.

[1kferg]

please keep us updated.

[BarnGir1 in reply to 1kferg]

Thanks to Sue and others I have been able to identify and discontinue meds that I did not know exacerbate RLS. Some research actually says that neurologists are sometimes the first to prescribe Requip, as in my case, which makes me more determined to be more resourceful in learning about RLS and monitoring myself. Restful Legs tablets (both AM and PM versions) were highly recommended OTC in my research so I am using them as directed. I have no idea if its effectiveness will continue as I decrease Requip. I found the 12 day scenario without meds on the RLS Foundation site very helpful if somewhat daunting. I have added other things and discontinued several things so it is not easy to say what is working or not, or if it is the current combo. After my earlier iron infusions I was taking an iron supplement short term per the hematologist so I have added that back until I can get new iron levels and see him. In hindsight, I am surprised and disappointed that some of the professionals I have seen over the years are not more aware of RLS and how complicated it can be to treat. After suffering migraine headaches for about as many years as RLS, and experiencing the struggle to find effective treatments, I can only hope that knowledge of and treatment for RLS will soon follow migraine's long awaited breakthroughs. But then there is the expense of the meds themselves, at least in the US. I also have to chastise myself somewhat for not staying on top of RLS and my own patterns like I have migraine. Only when I began to feel desperate was I motivated to do the work it always takes to find helpful resources like this group . Thanks again for the valuable information.