Augmenting

[Apples70]

Hi allBeen on rigotine 3mg for a few weeks, I've seen people mention augmenting ( think that's what you call it). Can someone tell me what this is please as it sounds from posts on here, it's not great.

Thanks

[ChrisColumbus]

Dopamine agonists - pramipexole, ropinirole and rotigotine - work well at first, but over time lead to worsening of RLS symptoms known as augmentation - symptoms get worse, start earlier, can spread to other parts of the body - and there's a risk of development of impulse control disorders.

This is still not widely recognised by UK doctors, although NICE guidelines were revised in February.

Dopamine agonists are no longer considered first line treatment for RLS by experts: gabapentin or pregabalin are instead.

I see from replies you made to a post 9 months ago that you're already on gabapentin for back pain and that SueJohnson gave you advice on augmentation, gabapentin doses and timing, ferritin levels and not to start on the patch at the time.

Did you make the changes to gabapentin that she suggested, and find out your ferritin levels? If you get your gabapentin doses and your iron levels right you will not need the dopamine agonist.

As you apparently started using the rotigotine patch anyway, DO NOT suddenly stop. You need guidance from Sue or Joolsg on weaning off the patch.

[SueJohnson]

The signs of augmentation are when you have to keep increasing your dose to get relief, or when your symptoms occur earlier in the day or there is a shorter period of rest or inactivity before symptoms start or when they move to other parts of your body (arms, trunk or face) or when the intensity of your symptoms worsen.

When that happens you need to come off it because it will only get worse. Doctors will tell you that you are not as likely to get augmentation on the patch, but it will soon happen again.

You can do the reduction in one of 2 ways. Using a 1 mg rotigotine patch cut it into sixths. The easiest way is to draw lines on it. This will equal the .25 mg reduction since 1 mg of rotigotine = 1.5 mg ropinirole,. Or you can switch to ropinirole. Multiply the dose of rotigotine you are taking by 1.5 to get the correct amount. Since you can get ropinirole in .25 tablets this is the easier way to reduce.

As Chris said - see my reply to your post 9 months ago. Go to your profile to find it.

[Apples70 in reply to SueJohnson]

Thank you Sue, I will consider your recommendation.

[Apples70]

Thank you for your recommendation Desert Oasis, I will look at taking my Baclofen in the morning. Yes, my RLS started really early which is a worry if I'm honest.