pregabalin clarity needed

[Jukebox55]

hello again,

Please can someone clarify how to take pregabalin. I am off pramipexole, having taken six months to come off it. I started 75mg x2 of pregabalin 3 weeks before being fully off pramipexole. The docs say take it twice a day. I have been trying 8,30 pm and 10,30 pm to be in bed by 11. I have just read on this site (SueJ I think ) that you dont have to split the dose. I have also tried on a couple of occasions taking 150 mg at 10.30. Does pregabalin need to be taken like clockwork? Same time every day? But am still struggling to sleep despite being on holiday in the countryside. Any guidance on best ways to take pregabalin please. Many thanks as always, Les

[Joolsg]

You are struggling because you've only just stopped Pramipexole.Unfortunately, for most people, withdrawal symptoms will continue for several weeks after the last dose of Pramipexole.

Pregabalin only needs to be taken in the evening for RLS, because RLS follows the dopamine cycle. That's why RLS is usually worse in the evenings and during the night.

You can take Pregabalin in one dose as it is fully absorbed, unlike gabapentin which is poorly absorbed above 600mg.

If 150mg takennin one dose at say 10pm doesn't settle your symptoms after 2 weeks, you may need a higher dose. Alternatively you could add a low dose opioid. Sometimes 2 meds at lower dose work better than one med at a higher dose.

The first month or two after Pramipexole can be very difficult as your dopamine receptors start to adjust and settle.

[Jukebox55 in reply to Joolsg]

thank you, i will struggle on!

[SueJohnson]

I agree with Joolsg. If you then need more add 25 mg every couple of days until you find the dose that works for you. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 200 to 300 mg pregabalin daily."

[Jukebox55 in reply to SueJohnson]

thanks, i will need some 25mg tablets… dont fancy cutting the 75s open and counting out the tiny little things!! Thanks again!

[Jukebox55 in reply to Jukebox55]

one more question… how long should i be on gabapentin for? I havent understood if this is just to tide you over the end of taking pramipexole or the way forward ie long term. Your help much appreciated.

[SueJohnson in reply to Jukebox55]

If it works then most people will stay on it for life.

[Elsie77]

I swapped Gabapentin for Pregabalin because of the side effects, there are still some like brain fog and shaky legs first thing in the morning. I have upped my dose to 200 mg, I have experimented on dose times as I was waking in the early hours with aching legs. I currently take 200 at 8.00 pm ( any later and my legs start) then 100mg at 10.00pm. I woke up very briefly at 5 am but then slept till 7.00am.

[Jukebox55 in reply to Elsie77]

thank you… i am glad you have found what works for you.

[Avocadopal]

Hi, I've had restless legs for over fifty years now taking gabapentin, clonazepam etc.I am now taking one Tramadol at lunchtime and three pregabalin at night. This initially worked well but was waking in the night after a few weeks with restless legs. I was advised to increase Pregabalin to 4 x 50 per night. This worked but caused the most horrendous tinnitus. Like standing on a runway and a plane landing, getting louder and louder. Almost unbearable. So I resorted to three x 50 pregabalin which was not brilliant.

I then saw advertised some AIR COMPRESSION LEG MASSAGERS which you put on your legs for 20 mins before sleep. I usually wear them in bed for 20 mins whilst reading.

Have been doing this for one week now with AMAZING results. Only waking up once for loo, but NO RESTLESS LEGS and going back to sleep immediately. A real life changer for me.

Maybe other RlS sufferers should try them. I highly recommend them.

Good luck everyone.