I have severe RLS and PLMD
I am currently on 250 mg pregabalin , 0.5 clonazepam and 2 mg neupro patch
my neurologist wants to move me off the neupro patches
To help this process he has prescribed me up to 900 mg gabapentin.
Does anyone know if pregabalin 250mg and gabapentin 900mg can be taken together?
Thank you all for your help
They could but that is ridiculous. They are basically the same drug. If he wants to increase what you are taking it would be better to just add 150 mg of pregabalin. But that would mean you would be taking 400 mg which is close to the 450 mg maximum. And it would not help you come off the Neupro. Then by the time you have been off the Neupro for several weeks and your RLS has settled, you would have to slowly reduce the pregabalin to the dose you need. I would suggest you stay where you are and not increase it.
To come off the Neupro patch get the 1 mg patch and cut it into quarters, then reduce by one quarter 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.
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 at Https://mayoclinicproceedings.org/a...
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.
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.
I also think that it is strange to recommend gabapentin on top of pregabalin to withdraw from Neupro. They are the same class of drugs but with different absorption properties. I agree that you should come off the patch, cutting it as advised by SueJohnson.
But pregabalin or gabapentin won't help withdrawal symptoms. So I would stay on 200mg pregabalin until you are through Neupro withdrawal.
A low dose opioid like codeine, tramadol or oxycodone would be better at reducing the severe withdrawal symptoms. Email your neurologist and ask for codeine, tramadol, or oxycodone ( unless you are unable to take opioids).
Medical cannabis is available privately in the UK now. It can be very helpful during dopamine agonist withdrawal. It works out about £3 a day, but you would only need around a one month supply.
Once off the patch, you can then slowly increase pregabalin from 200mg up to the max dose of 450mg.
Jools has given good advice as usual. Just note that clonazepam (a benzodiazepine) shouldn't be combined with opioids should you decide to go down that route. This combination increases the risk of respiratory depression, moreso the older one is.
I have been taking a new salt of gabapentin called gabapentin enacabril which is specific forRLS. i take it at 5 pm and then I take 0.5 mg ropinirole at 8 pm. I’ve tapered from 1.5mg ropinirole and want to eventually get off of it. I still wake up at 2 or 3 usually to go to bathroom and then my sleep is sometimes very light but I’m praising God that my RLS. Is better. I have PLM still and maybe the other aches in my hips and knees are masking the RLS because of the pain there. Not sure. But the Horizant at 5 pm has been a game changer. I’m in USA are you in USA?
Unfortunately Horizant is not available in the UK and Thorp is in the UK.
That's great it is helping you and it will help even more once you are off ropinirole for several weeks.
I hope my plm will get better and how will getting off of ropinirole improve the Horizant. That would be great Thanks for all your input
Because the Horizant is not fully effective until you have been off the ropinirole for several weeks and your symptoms have settled.
I hope I sent the reply to the correct thread
thank you for all of your advice
Gabapentin
Switching from Gabapentin to Pregabalin
