Hi, I’ve recently come off of 1.75mg ropinerole after suffering augmentation. I came off slowly and finished 3 weeks ago, now on gabapentin 900mg . Still up 3 to 4 times a night so need to increase but due to my work, I sometimes don’t finish until 10 pm , I would find it easier to take just one dose instead of splitting during the evening. For this reason I’ve asked Dr for pregabalin. He’s told me to come off gaba slowly then take 75mg of prega then increase to 150mg which should be enough??? I tried to explain that if 900 gaba isn’t enough then equivalent prega probably won’t be enough I don’t think he was listening.
Can I go straight from one to the other without tapering?
Thanks in advance for any advice
Written by
DaveBike
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Yes - you don't need to taper. You can switch directly to pregabalin and then increase by 25 mg every couple of days until you find the dose that controls your RLS.
You can show him the Mayo Updated Algorithm on RLS that shows that the usual effective dose is 1200 to 1800 mg of gabapentin. And you already know the conversion to pregabalin is to divide the gabapentin by 6.
You can switch directly. I am on 1500 mg of gabapentin which controls my RLS and sometimes especially if I am going out for the evening I switch to 250 pregabalin.
Whats more if you don't switch directly you have to withdraw from the first one very slowly or you will have withdrawal effects.
Congrats on getting off the ropinerol! That is a big accomplishment! I know because I got off of pramipexole after augmenting (and suffering) for years. I now take 300 mg pregabalin but ALSO 7.5mg methadone. I was on 500 mg pregabalin for a while but I was so groggy in the morning and it took me 90 minutes to feel awake. Before that I was a morning person for my whole life. I also gained 15 pounds. It didn’t work 100% so I added methadone. It took me a while to be willing to take methadone It felt so extreme and I was worried about stigma of taking a medication that is associated with drug addicts. It seems silly to me tow but it was an issue (in my mind) until I felt so desperate that I didn’t care anymore.
The combo, for me, is amazing. I started with 5 mg methadone but over the past 1-2 years figured out that lowering the pregabalin to 300 and upping the methadone to 7.5 mg is the magic combination for me. I lost the gained weight and am much better in the morning. 95% of nights I have zero RLS. On the occasional night I have mild RLS I take a tiny bit more of the pregabalin or methadone and it goes away. I hope you can find a solution that works for you and get your doctor to better understand RLS (or get a new doctor).
I went from gabapentin to Pregabalin without any problem. As Sue said, you don’t need any tapering or gradual change. I didn’t have any problems switching in one day. Good luck.
Hi All, I'm currently taking 2800mg of Gabapentin in 3 divided doses, 800mg at 2pm 800mg at 4pm and 1200mg at 6pm. Im still getting some RLS symptoms when I go to bed and early evening however once I get off to sleep I seem to sleep without any further symptoms for the best part of the night, should I increase my Gaba further ? and what would you recommend on the dosing schedule? OR should I try a switch to Pregabalin and see how that goes? or can you take a combination of both? with the pregabalin being the last evening dose and potentially a little higher dose to hopefully settle my RLS before going to bed, any advice here would be greatly appreciated, thanks to all in advance.
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