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Restless Legs Syndrome

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Gabapentin post dopamine treatment (Aripiprazole)

tttlandddd profile image
6 Replies

Hello,

I took Aripiprazole during 12 years, suffered from augmentation symptom (went to 20mg daily which is a big dose).

I think that taking such dose can damage dopamine receptors and lower Gabapentin efficiency, right?

Any of you can send me some links to read more about this? or giving me more details about why and how to handle it for RLS symptoms?

I'm on Gabapentin since 3 weeks (1500mg) and I have few very good nights but the day after I woke up really tired and pains in leg and feet.

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tttlandddd
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ChrisColumbus profile image
ChrisColumbus

You gave up aripiprazole (Abilify) two years ago and your ferritin is over 300.

*Are you currently taking other medications - even things like antihistamines?*

(other than gabapentin, which I note that SueJohnson has given you advice on taking).

When did your RLS start - while on aripiprazole or afterwards?

While most anti psychotics worsen RLS, aripiprazole is atypical and while it can make RLS worse for some there have been reports that it can help in some cases. It is a dopamine receptor partial agonist (DRPA).

The following 2023 study states:

"Aripiprazole has been described in some case reports to be helpful for RLS, though worsening of RLS has also been reported......... Aripiprazole, a DRPA, may represent another option for management of augmentation in RLS given its unique pharmacological profile, but caution is warranted in interpreting these results"

ncbi.nlm.nih.gov/pmc/articl...

tttlandddd profile image
tttlandddd in reply to ChrisColumbus

Yes two years ago and ferritin is over 300.

No others medications appart gabapentin.

I noticed RLS during Aripiprazole withdrawal (right leg and right arm, very painful, almost impossible to sleep during weeks and then got relief thanks to magnesium and omega 3) but when I was on Aripiprazole some people told me that my left thumb was moving a lot during day (did not notice it).

My opinion is that I have dopamine trouble since I'm young, Aripiprazole helped me a lot after a big stress but augmentation happened and 12 years later my dopamine receptors are "damaged" and create large oscillation in dopamine levels.

I'm planning to continue gabapentin at 1500mg for the pain but also adding L-theanine/Bacopa supplements in order to raise gently dopamine levels (I really don't want to take dopamine RLS medecine after Aripiprazole 😅).

ChrisColumbus profile image
ChrisColumbus in reply to tttlandddd

L-theanine can help, but its effects can be short-lived. I don't know about Bacopa.

I had wondered whether it was the withdrawal from aripiprazole that triggered your RLS. The 20mg that you were on was higher than the UK usual of 15mg (but below the 30mg maximum): did you try just reducing the dose rather than withdrawing completely?

But that's done now, so I hope that the gabapentin works for you. If it doesn't perhaps you'll need a low dose opioid. As I don't take any meds for RLS, others e.g.Joolsg or SueJohnson will give you better advice than I can.

tttlandddd profile image
tttlandddd in reply to ChrisColumbus

I reduced aripiprazole during one year, was at 0.5mg daily at the end. I think that I had « small » RLS before and now it’s a big one.

Will see what happens with supplements.

Knittingasweater profile image
Knittingasweater in reply to tttlandddd

Orgasm releases dopamine and eliviates RLS symptoms

Joolsg profile image
Joolsg

There are no definitive research articles stating that dopamine agonists can permanently damage dopamine receptors. However, the top RLS experts in the USA all believe that they cause permanent damage. That would explain why a small percentage suffer DAWS. A state of permanent depression, anxiety, inability to get off dopamine agonists without permanent symptoms.Dr Berkowski has a great website. He does webcasts on YouTube explaining the dangers of dopamine agonists.

He had one patient who experienced anhedonia ( total inability to experience pleasure in ANYTHING).

It can take months or years for the brain to repair/settle.

In your case, as you're sleeping quite well in such a short time after stopping your medication, that's a very good sign.

Be patient, and you will recover.

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