Have nothing left

Rang specialist said I can't live with this , and I can't, I'm in so much distress....he said I'm not prescribing subutex for you and never will, i said well can i increase 2mcg dose to 4mcg ,he said not a good idea with 10mg targin just keep it at 100mcgs. I said the targin is not working my legs are so distressing, im suicidal ,he said, make an apt to see your gp and see what can be done.....he just signed my death certificate, my body can't do it anymore .

[ziggypiggy]

Sorry to hear you were treated so dismissively. Proud of you for telling it like it is. Not all of us can do that.If possible have someone with you at your next appointment that can attest to the emotional and physical distress you are under. Sometimes by the time we get to our appointment all the fight is gone because we are exausted or feel defeated. Having an advocate can do wonders.

I'm sure if you've been on this site long you know all the standard advice. It can be overwhelming as there are so many variables that make RLS worse and we are all unique in how we respond.

Hang tough.

[SueJohnson]

Can you switch doctors?

[Joolsg]

I am speechless. When you refer to 2mcg dose and increasing it to 4mcg, are you taliking about the temgesic you were recently taking?

Your neurologist has prescribed Temgesic AND Targinact to take at the same time???? Is he not aware that temgesic contains Buprenorphine and Buprenorphine can't be taken with other opioids?Carbamazapene should never be prescribed at the same time as temgesic/buprenorphine.

I know you are exhausted, so for now, stop the Targinact and ask to increase the Temgesic to at least 200mcg.

Ask your GP to arrange this.

Stop the targinact as the Buprenorphine is causing mini withdrawals as it displaces Targinact on the opioid receptors.

Ask your GP to increase the dose of temgesic. If the neurologist refuses to listen and do his research, when you feel stronger, file a formal complaint to the Australian organisation that deals with doctors. List the drugs he's prescribed for you and what he has said.

Subutex is another brand of buprenorphine. Temgesic contains buprenorphine hydrochloride and when I have looked at the pharmakinetic details, it is identical to buprenorphine/subutex.

Temgesic should therefore work in exactly the same way as other brands of buprenorphine once you find the right dose. The starting dose for RLS is 500mcg (0.5mg). Average dose is around 1 -1.5mg.

I do well on 400mcg, others need 800mcg.

You experienced electric shock/ jerking legs and you think it was the temgesic, but I'm not so sure. You do seem to have a particularly difficult presentation. Your neurologist thinks it's nerve damage.

Have a long chat with your GP and explain that Targinact cannot be taken with temgesic. Temgesic cannot be taken with carbamazepene.

Beg for 400mcg of temgesic.

I am so, so sorry this is happening and that your doctors are so poor.

Have you considered emailing Dr Buchfuhrer, setting out your curent meds and your symptoms? He may be able to shed light on what is happening.

[e-mail]

[Hidden in reply to Joolsg]

Ok, I will stop the targin...hope I don't get bad withdrawals......I stopped the carb a few days after I started it, couldn't stop vomiting was getting very dehydrated and sick. I will get the gp to write 1-2 tablets on bup script so I can get it refilled earlier, my last script has only take 1 tab a day and the pharmacy won't let me refill until 50 days is up as there is 50 in a box.......I just can't understand why they can prescribe this but not the stronger dose subutex.

[Joolsg in reply to Hidden]

In the UK, subutex and temgesic are the same product. Both contain Buprenorphine hydrochloride and both have identical pharmakinetic properties. They should therefore work the same. Temgesic brand comes in 200mcg pills. That's the only difference I can find.So 2 x 200mcg pills should work the same as 1 x 400mcg subutex.

I have NO idea why your neurologist is so against subutex 400mcg. I have searched the web for hours to see if there's any difference between temgesic and subutex. I can't find any difference!

Switching from targinact to temgesic should not result in withdrawal as temgesic is another opioid.

The only issue will be those electric shock sensations you have been experiencing.

I suspect they're untreated RLS symptoms and if you get the dose of temgesic correct, it should cover the symptoms.

Average dose for RLS is 1 -1.5 mg, but most people do well on either 400mcg or 800mcg.

Start at 200mcg first night, then if it doesn't help, 400mcg.

A few on here need 800mcg.

Will your neurologist and doctor agree to increase Temgesic to 4 x 200mcg pills a day?

Did Dr Buchfuhrer reply to your email?

[Joolsg in reply to Hidden]

numarknet.com/advice-guidan... think I've found the answer to why your neurologist won't prescibe Subutex. The link above states that Subutex is only licensed for opioid addiction substitution.

It's exactly the same product as Temgesic, but some countries will only allow it to be prescribed to heroin addicts wanting to get off heroin.

It's the licence that's the issue.

Temgesic is exactly the same drug, but comes in a lower dose of 200mcg (0.2mg).

[RLSLearner]

I agree you need to take the published papers on use of opiates/buprenorphine to your GP (do you have them?). But there is more. Dipyridamole is definitely worth trying (I might be able to arrange). Transcranial magnetic stimulation - there are a number of clinics that do it, mostly for depression but it has shown benefit in RLS. If you Google TMS you should find a clinic near you. I have not discussed doing TMS for RLS with any of these clinics but will soon.

[Hidden in reply to RLSLearner]

I did take all the paperwork and the pain spec and neuro refused to read them and told me to stop telling them how to do their job.I will stop the targin...hope I don't get bad withdrawals,,,,because the bup would be knocking the targin off the receptor anyway and keeping me in mini withdrawals I would presume......I stopped the carbamazepine a few days after I started it, couldn't stop vomiting was getting very dehydrated and sick. I will get the gp to write 1-2 tablets on bup script so I can get it refilled earlier, my last script has only take 1 tab a day and the pharmacy won't let me refill until 50 days is up as there is 50 in a box.......I just can't understand why they can prescribe this but not the stronger dose subutex.

[Hidden in reply to RLSLearner]

oh and there is no TMS in back water Tasmania....and I can't afford to go the mainland......as this RLS and nerve damage has ruined my working life, I had to resign, have used all our savings for spec apts and scans etc.....life is shit