Augmentation on multiple DAs?

[707twitcher]

Just curious - if one augments on a DA like pramipexole, what happens if you switch to a different DA? Is augmentation likely to occur fairly quickly? Will the new DA even work or will it pick up right where you were on the old one - in augmentation?

[Madlegs1]

It will continue the augmentation straight away. Unless ,of course you are put on a hugely increased dose.

In which case you might just get a few weeks holiday, before being consigned to the worst hell pit you could imagine.🥵👹☠️🔥🧟‍♀️🚨🚑🩺🩻🆘🆘🆘🆘🆘🆘🆘🆘🆘🆘

Avoid having this done to you at any cost.

[SueJohnson in reply to Madlegs1]

My laugh for the day: before being consigned to the worst hell pit you could imagine

[SueJohnson]

You might get a little time on the new DA but you will augment again pretty quickly.

[Joolsg]

It may relieve the symptoms for weeks, months or in a few cases, years. But it WILL cause augmentation again.It's nonsense for neurologists to think switching to Neupro will avoid augmentation. They are presumably relying on Oertels 2011 study, and Trenkwalder's 2017 study, both of which have been refuted by updated reports and knowledge.

I think the top doctors in the USA are correct. Everyone will augment on every DA. It's simply a matter of when, not if.

[RiversW in reply to Joolsg]

However, that's exactly what happened when I went to what many in the states would regard as a top RLS doctor. I was augmenting on Pramipexole, though I didn't understand what that meant at the time, when this doctor switched me to the Neupro patch. The severity of my RLS symptoms lessened for a few months. But then, bang!, worse that ever. However, he is the same doctor who lead me to Buprenorphine which has been a game changer. I have no idea why he just didn't skip a step and go straight from Pramipexole to Buprenorphine. It would have saved me a lot of suffering. Rivers

[Joolsg in reply to RiversW]

😔

[Mongolia2020]

I tried that and augmented again. After augmenting and going on a drug holiday from dopamine agonists 5 times, I decided to get off them and never go back on them. Neither gabapentin or Pregabalin worked for me, but codeine (an opioid) did. But the dose I needed to control symptoms gave me unacceptable side effects. I got to the stage I was absolutely desperate and could not see myself making another birthday ( I am 61 and have had RLS since childhood).

I am now on methadone. It has taken 2 months to titrate up to a dose that is now giving me almost 6 hours sleep every night (6.25 mg). I had to go slowly because side effects were awful until my body got used to it. Sleep is still very broken and I get up twice in the night and do 30 squats then get back into bed. I anticipate one last step up in dose - to 7.5 mg, and believe that will give me as close to a normal nights sleep as possible while maintaining a low level of side effects.

I did not want to go on methadone - it was a last resort, but after trying almost everything else that I have heard of, I have come to believe it may be the only thing that will work for me.

But if you do go on methadone, it is VERY important to increase your dose VERY SLOWLY. I saw my dr every 10 days for first 6 weeks and he monitored me very closely. Main problem I have to deal with now is constipation.

I hope this helps someone.

[PianoRunner]

I augmented on Pramipezole and then was prescribed Ropinerole. It worked for a while, but I'm now augmenting on that. Time for me to eliminate the DA's. Wishing you peace and calm.