Gabapentine or Pregabalin?

[TheThirdDoctor]

I am wondering whether there is any difference between Gabapentine and Pregabalin in terms of effectiveness. I take 2400 mg Gabapentine per day in 3X800 mg doses, but while I sleep my ok wife cannot sleep because of my movement. I am wondering if there is any other possible treatment that might work better. I have been down the dopamine agonist blind alley. My iron panel results are consistently good. I do take an iron supplement. I also take losartan and co-amilazide to regulate my blood pressure.

[SueJohnson]

First off you are taking your gabapentin wrong. It is not well absorbed above 600 mg. Ifn you were to continue to take 2400 mg you would take 600 mg 1 to 2 hours before bedtime, 600 mg 4 hours before bedtime, 600 mg 6 hours before bedtime and 600 8 hours before bedtime. Since that is ridiculous I suggest you switch to pregabalin which you can take all at one time 1 to 2 hours before bedtime. The equivalent pregabalin dose is 400 mg. You can switch directly. They are equally effective.

You say your iron panel is consistently good. What is your ferritin?

[SueJohnson]

Your losartan is probably OK but your co-amilazide is a diuretic and unforunately all diuretics make RLS worse, but don't stop it unless your doctor says so.

Many 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.

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, eating late at night, estrogen including HRT, 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, fennel, 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, CBD, 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, vibration devices, using a standing desk, listening to music, meditation and yoga.

[TheThirdDoctor in reply to SueJohnson]

Thank you SueJohnson, that's all very helpful. Unfortunately I cannot, under any circumstances stop using a diuretic, I can reduce the losartan, I could possibly change the diuretic, are there any that are better than coamilazide that I could switch to? I have tried hot baths and that didn't help, I take folic acid but I don't think that I am deficient in anything particular. My Ferritin is consistently in the multiple hundreds, I have forgotten the exact figure but it is nowhere near low enough to cause any concern

[SueJohnson in reply to TheThirdDoctor]

Unfortunately I don't know of any that are any better.

[martino]

My wife and I have satisfactorily got round my movement by having zip and link beds. Now my movement rarely disturbs her.

[Munroist]

If you are sleeping then that's a big bonus. My wife doesn't sleep particularly well for other reasons so my additional thrashing is the last straw and we just have just accepted that for both of us different rooms gives the best sleep. Not everyone has the space though. If you are taking 3 x 800mg gabapentin and sleeping well then as it's not absorbed well over 600mg I wonder if you could actually get by with 3 x 600mg? Just a thought.