Gabapentin and sleepless nights

[Kanags]

I have managed to come off ropinarole and now entirely on Gabapentin.

At present on600 mg nightly. Heavy head and hardly any sleep. Is this normal. Need to increase the dosage to 900 but concerned about the sleeplessness.

Is this the experience of others in a similar situation

[SueJohnson]

Congratulations on getting off ropinirole. I know it was hard.

It depends on how long you have been off ropinirole and whether your symptoms have settled from that and also whether you have been on gabapentin for at least 3 weeks. It generally takes 3 weeks for gabapentin to become effective and gabapentin usually helps you sleep so you may not be taking enough yet. After 3 weeks increase it by 100 mg , every couple of days until you find the dose that works for you. Take it 1-2 hours before bedtime as the peak plasma level is 2 hours. 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. Most of the side effects 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 even in a multivitamin, take it at least 3 hours before or after taking gabapentin 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. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin. "

[UsableThought in reply to SueJohnson]

Sue, that's interesting that magnesium supplements can interfere with gabapentin absorption - I hadn't heard that before. Myself, I don't take gabapentin, but rather Horizant. I was curious and so looked up whether there are any reported interactions between Horizant magnesium and/or calcium supplements, but didn't find anything. I suppose that's because Horizant differs in its bioabsorption, being a "prodrug" that only transforms into gabapentin after it has been absorbed. I did find a question on this forum from 7 years ago where someone asked whether any conflict existed between Horizant and either magnesium or iron, but once again, no replies indicated this. Link to that thread is here:

healthunlocked.com/rlsuk/po...

The only thing I've ever heard about needing to be careful with what you eat or drink with Horizant is that it gets absorbed better if you take it with a meal, preferably a meal including a bit of fat such as butter, olive oil, or whatever. Taking it on an empty stomach apparently is a lot less effective. Here too this seems to be different from straight gabapentin. I'd be curious if anyone has heard of other interactions between Horizant and other foods, supplements, etc.

[SueJohnson in reply to UsableThought]

You are correct in all of the above. The only thing I can add is that the bioavailability depends on the fat content of the meal which I interpret to mean the more fat the more bioavailability.

[Kanags in reply to SueJohnson]

Hi Sue,

I have been off ropinarole for about a week. I have no RLS symptoms at present but the lack of sleep is what concerns me. I am on 600 mg Gapapentin and as I do not have any RLS symptoms will not increase the dosage. I will watch the situation .

[67Waterman]

I found that Gabapentin did not work for me at all ... and I definitely was not sleeping (and I was on the highest dosage). I switched to Pregabalin, which you may find better.

[SaltyUK]

I was on Ropinarole for many years until I realised that I was suffering from Augmentation after reading posts on this forum. I asked my GP for Gabapentin and at which was prescribed without any advice about how to stop the Ropinirole and start taking the Gabapentin.

At first I didn’t think that the Gabapentin was working. I had terrible RLS and was getting a maximum of 2hrs sleep per night. But having read more posts here I realised that I hadn’t given it enough time and the dose was too low. I therefore asked my GP to increase my dose

I now take 600mg early evening and another 300mg 1hr before bed and it works wonderfully well for me. My RLS symptoms have gone and I can now get a full nights sleep. I can’t think of any side effects.

[Simkin]

I am on 900mg gabapentin & I get up 2 to 3 times in the night.But I am resigned to the fact that after 30 years of rls my body has got in the habit of night time wandering.

I take the gabapentin with a small dose of buprenorphine and this all makes me very sleepy during the day.

I am retired so I can have a one hour sleep after lunch to keep me going.

But at least the rls has gone.

[Loopylegs]

Well done on getting off ropinerole, it's easy! I'm currently on 600mg of gabapentin too, I also take 2 tylex (zapain, Co codamol, solpadol) basically it's 60mg of codeine with paracetamol and for the past number of months my rls has improved, it kicks in, in the evening around 9ish, I take the gabapentin around 8pm and the codeine at 10.30 ish, I'm getting 7/8hrs uninterrupted sleep, I must also add, my sleep & rls vastly Improved when I stopped eating anything after 7pm in the evening, I might have the odd decaf tea but that's it. Also the longer I'm off the dopamine agonist medication the more I've noticed an improvement too, I rarely wake with rls at the moment and the longer I'm on the gabapentin the less the side affects affect me, I feel like I have gotten my life back. Best of luck to u, I hope this helps, happy Christmas to all the wonderful advisors here, you've all helped me more than any doctor

[Loopylegs in reply to Loopylegs]

Also I take a multivitamin with epa & dha plus magnesium, vit c & iron

[SueJohnson in reply to Loopylegs]

Be sure you take it 3 hours before the gabapentin. I learned this the hard way.

[Loopylegs in reply to SueJohnson]

Absolutely Sue, I take the magnesium in the morning & the iron at night