PREGABALIN

[Keith1231]

Hello dear friends;

I said to my GP via email that 175mg of Pregabalin wasn't working and suggested 300mg was the optimum dose. My GP has prescribed 300mg. I thought that was rather a big jump from 175mg. What do you think? Thank you. Keith

[Amrob]

Your doctor should have suggested increasing slowly (in 25mg increments) so that you find the optimal dose for YOU. Staying as low as possible gives you room to move should you need to increase your dose down the track. It may be that you need 300mg, but you may also do fine on 225mg.

As someone who has been on pregabalin for approx 10 years, i can't recommend strongly enough to stay on the lowest dose possible. This reduces the side effects that are more noticeable at higher doses. Anecdotally, people say that they tolerate higher doses for a period, and then all of a sudden they can't. This has also been my experience.

[Keith1231 in reply to Amrob]

I have spoken to my GP who has issued and increase of 25mg of Pregabalin every 3 days to a point where it suits my condition better. And removed the initial 300mg prescription. Thanks.

[davchar23 in reply to Keith1231]

Dear Keith.

I was prescribed pregabalin by a consultant neurologist for my severe RLS and at one time I went close to the max dose which I seem to remember was 600mg per day. There was no improvement to my DA (rotigotine) augmentation and I experienced some bad side effects (mainly balance control). I have since that point very gradually (over a period of several months) got my Pregabalin dose down to 25mg/day where it just supports my use of opioids to successfully block my RLS. Pregabalin does help many persons ... but just be careful with increased doses.

Have you been on DAs and have augmented?

Kind regards

Davchar

[707twitcher in reply to davchar23]

Just curious about the need for pregabalin “to support my use of opioids”? I’ve been off DAs for 3 months and am just using buprenorphine. I’ve tried starting pregabalin twice, and both times my RLS acted up. What does the pregabalin do for you that your opioids don’t?

[Keith1231 in reply to 707twitcher]

I have never used opioids for my RLS. I was told that Pregabalin was the next step after coming off Pramipexole. I don't have RLS anymore its just I don't sleep that well.

[Munroist in reply to Keith1231]

I'm slightly confused. If you don't have RLS any more then why are you looking at taking or increasing pregabalin? I'd have thought there were better options for not sleeping.

[Keith1231 in reply to Munroist]

I think by stopping the Pregabalin the RLS would return. The reason behind the increase in dose is I think RLS is causing me to wake up. It's severity has gone but a niggaling amount, that I am not conciously aware of, remains.

[Munroist in reply to Keith1231]

Ok I understand, thanks, in which case the very small increments are the right thing

[Keith1231 in reply to Munroist]

Thank you.

[707twitcher in reply to Keith1231]

My reply was to Davchar - he’s the one who mentioned pregabalin to support opioid use….

[davchar23 in reply to 707twitcher]

Dear 707twitcher,

I found when Iwas taking buprenorphine tablets that there were instances during the day where RLS "broke through" but if I supplemented the opioid with a small dose of pregabalin then the "barrier" remained. I seem to remember that Joolsg gave me this hint about a mix of opioid and calcium channel blocker (ie pre or penta etc).

I have now changed to buprenorphine weekly patches and I suspect i do not now need to use pregabalin as the patches provide a steady cover as opposed to the tablets. i am therefore hoping to eliminate the pregabalin completely but in very small reduction steps ie 12.5 mg per day per week;

Kind regards

Davchar

[707twitcher in reply to davchar23]

Thanks. I just switched to patches also. How long are your lasting? My first one didn't last a full 7 days. I switched it at exactly 7 days, but had some RLS that night, so I'm guessing it died between 12 - 24 hours earlier. So I'll switch the current one at 6 days. I gather 5-6 days is typical...

[davchar23 in reply to 707twitcher]

Two points to note here from my point of view:-

1) The patches DO NOT start to work immediately. Some people on this site have said it tales 12-24 hours before a new patch is operate and perhaps that is why you thought your first patch lasted 7 days . I suspect it was less.

2) I find difficult to actually decide when a patch has "finished" but i suspect in my case it is operative for between 5-6 days.

I hope this helps

Dav Char

[Keith1231 in reply to 707twitcher]

Thank you.

[Keith1231 in reply to 707twitcher]

Thank you.

[LotteM in reply to 707twitcher]

Hi 707twitcher, just saw this reply of yours about the no of days of effectiveness of buprenorphine patches. Mine do not always last the 7 days too, although generally they do. To make sure I have coverage, I keep the old patch on for a few extra days as I suspect it still contains and yield ‘some’ buprenorphine. That works very well. I always put the new patch on first thing in the morning on the day it is due (8th day, for me each Saturday).

[Keith1231 in reply to davchar23]

Thank you.

[bluffpt in reply to Amrob]

Hi, can you say more about what the side effects are/were please?

[Amrob in reply to bluffpt]

Reduced cognitive functioning, blunting of emotions, blurred vision, extreme daytime fatigue...the joys are innumerable!!

[coldfeet7]

I asked for an increase from 75mg (three 25mg) to 100mg and the Dr said they can't do it as four 25mg per day. It has to be a single capsule. I found that odd and disappointing.

At first 100mg left me pretty sleep on waking but I am adjusting. A jump from 150 to 300 seems huge.

[Keith1231 in reply to coldfeet7]

Thank you.

[Baz33]

I was taking 200mg but it was too strong so dropped to 150 which is no longer touching the symptoms, so I'm upto 300mg and its working.

[Keith1231]

Thank you.