My Rl is nearly under control with gabapentin now , I have an appointment with the arthritis clinic and I’m hoping to start some kind of anti inflammatory medication.
Osteoarthritis in most joints and in lots of pain .
Can you advise which ones are safe to take and will not aggravate rl ?
The prospect of starting any new drug gives me the fear , especially when it’s taken many years to come off dopamine drugs and finally feel under control .
Is it normal to have low mood when stopping pramipexole?
Written by
Rubynessie
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Yes. Dopamine agonists flood your brain with Dopamine, the feelgood hormone. When you stop taking it, you will feel down/depressed for some time.For most of us, it does settle and our mood stabilises. For a small proportion, DAWS occurs and they feel down/depressed for months/years.
Safe mood stabilisers are trazodone and Bupropion, so do discuss with your GP.
Most anti inflammatories used for arthritis should be RLS safe, but do post the name on here and someone will have some experience. Have you tried medical cannabis? It is excellent for arthritis.
Rubyness this is a UK website and most members are in the UK.I am on medical cannabis here in the UK. It is prescribed privately by cannabis clinics. Arthritis will qualify you for medical cannabis. I know at least 3 pe who take it for pain caused by fibromyalgia. It's expensive though. £50 for intitial zoom consultation and then around £3 a day. Try Lyphe or Sapphire Clinic.
Before you consider opioids, does the gabapentin stop the RLS? If so, you could try a switch to pregabalin. It's in the same class of drug as gabapentin, but the side effects can be different for some patients.
First line treatment for RLS is now iron. Either pills or an iron infusion. One day, infusions will be given routinely, before meds are prescribed.
Opioids are prescribed in the UK for RLS if your GP is knowledgeable (highly unlikely as RLS isn't taught) or willing to be educated and to learn the basics of RLS. The younger GPs are more likely to listen than the older ones, who often take offence at patients researching or knowing about their disease.
The best opioids for RLS are methadone or Buprenorphine as they have a long half life of 24/25 hours. However, GPs are unfamiliar with low dose opioid therapy and Buprenorphine is red listed in many prescribing areas. That means GPs cannot prescribe it. Only a neurologist or sleep specialist.
Targinact ( Oxycontin and naloxone for constipation) is licensed for RLS, and your GP can prescribe that. The only problem is that Oxycontin/Targinact do not work for many of us. That's because Oxycontin doesn't last for 12 hours. We then experience mini opioid withdrawals, and the main symptom of opioid withdrawals is increased RLS. But there are many for whom it works well.
I suggest you ask for a 20min face to face with your GP, show him/her links to the Mayo Clinic Algorithm, Massachussetts General Hospital Opioid study, the NICE study on Targinact and the RLS UK website and ask:
1. Full iron panel fasting, morning blood tests. Raise serum ferritin above 200ųg/L.
2. A trial of 0.4mg Buprenorphine.
3. If Buprenorphine is red listed, or HP refuses, a trial of 20mg Targinact and take 5mg pills every 6 hours.
Opioids can cause anxiety, depression and sweats and constipation.
I know I have told you this before but If you decide to come off gabapentin you need to do so very slowly to avoid withdrawal effects. Reduce by100 - 200 mg every 2 weeks. If you do so you will have no withdrawal effects.
The first thing to do about inflammation is to remove the causes then you can address vitamin deficiencies and add foods that fight oxidative stress and inflammation. Inflammation is part of the natural healing process so you don't want to stop it artificially.
Mainly it’s osteoarthritis that’s causing it . In all of my joints now , the pain is bearable through yoga and swimming and cold water exposure helps too .
I had serious inflammation. Constant excruciating pain. I made a dramatic change in diet. No dairy, no gluten and absolutely NO sugar. 29 days later and I am pain free after years of suffering. The diet change is so great and doable. NO sugar- NO pain. Most of my previous diet had been “inflammatory.” Food makes a difference in our health.
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Query re Oxycodone new guidlines re pain- restless legs and Amytriptaline experiences.
