Gabapentin Update

[Rameau]

I have been taking 400-500mg of Gabapentin for the last few months - usually an hour, or an hour and a half before bed. This has largely eliminated or significantly reduced my RLS symptoms until about 2 hours before bed. However, since temperatures have started to rise the heat trigger that usually signals the start of my RLS has returned - particularly so after going to bed.

I spoke to my GP practice this morning who said I could take another 100mg if I needed to (it is almost as if it is rationed!). I hope to speak to a doctor again later in the week and persuade him to raise the dose by as much as I need to and reduce symptoms to the extent that I can get a few more hours sleep.

Has anyone else notice a worsening of symptoms when the temperature rises?

Many thanks

[SueJohnson]

Your doctor is ridiculous. This is the usual advice:

Beginning dose is usually 300 mg gabapentin It will take 3 weeks before it is fully effective which you have already passed. After that increase it by 100 mg every couple of days until you find the dose that works for you.

If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. (You don't need to split the doses with pregabalin)

According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin (200 to 300 mg pregabalin)."

If you take magnesium even in a multivitamin, don't take it within 3 hours of taking gabapentin as it will interfere with the absorption of gabapentin and don't take calcium within 2 hours for the same reason . Show the appropriate section of the Mayo Clinic Updated Algorithm on RLS to your doctor Https://mayoclinicproceedings.org/a...

Even the Nice Guidelines I am told says you can take up to 2700 mg. (I am in the US so can't access them)

[Rameau in reply to SueJohnson]

Thanks Sue. It seems absurd to me too.

NICE prescribing info includes the following:

Initial dose: 300 mg if the person is under 65 years old and 100 mg if the person is over 65 years old.

Titration: maximum recommended dose for RLS is 2700 mg.

[Bernaldi in reply to Rameau]

I took 2400 to 3600 back when I had to take gp (which was when I was in mold exposure.) I think doctors are being "monitored from above" more than they used to be, and of course there is still the God Syndrome out there en masse.

[Joolsg]

I agree with SueJohnson. Is this a qualified UK GP???Print off the link to RLS-UK website so he can learn how to treat RLS and the average effective dose of gabapentin.

rls-uk.org/medical-treatments

cks.nice.org.uk/topics/rest....

I should point out that NICE guidance is pretty rubbish as it says max UK recommended dose is 2700mg but tells GP to prescribe 3 times a day. That's nonsense. You take it at night only.

But show the GP the guidance so he will prescribe more and then take it correctly, at night only, in split 600mg doses 2 hours apart.

[FLAME43]

Totally what I wondered, as i have had excessive attacks, and it was hot days here in Southend on Sea UK (in fact i think it was a heatwave