Requip + Gabapentin ?

[BarnGir1]

This group has offered excellent advise to me before as I transition from Requip. A year ago, I was on 1/2 mg requip every 12 hours which worked until recently. Now my dr. has increased my gaba to 400 mg. at bedtime while still on requip. I recently heard a presentation on augmentation from Dr. B. who said some people may need to stay on requip and add other drugs to help. At 75 my dr. is reluctant to add too much gaba and wants me to stay on this combo. Some nights I get 2 hours of sleep and some nights I sleep 5 or 6. Anyone else still taking requip after adding gaba? If so, any problems with higher doses of gaba at 75, with or without requip? Thanks so much for any advice. BarnGir1

[SueJohnson]

You can take both but the gabapentin won't help much while you are on requip.

400 mg is a very low dose. I take 1500 mg and I am 83 and expect to keep taking it the rest of my life, so your doctor is worrying needlessly. Did you ever go to Vanderbilt. I know you were worrying about leaving your husband but after the first visit you could probably do telehealth.

You really need a low dose opioid but if you don't live in Tennessee Vanderbilt won't give you a prescription. Or can you get cannabis?

What state and city do you live in. You really need a new doctor. At least show her the Mayo Clinic Updated Algorithm on RLS at Https://mayoclinicproceedings.org/a... where it shows opioids are useful and that the normal effective dose once you are off requip is 1200 to 1800 mg and they don't say anything about being too old to take those amounts.

It is great that you are down to .5 from 5 mg requip. You just need to keep going. If it is getting too hard to reduce further you can get an inexpensive jewelry scale on Amazon ($11) that measures down to .01 gram and shave off a bit of the tablet and measure it. Then reduce by that amount every 2 weeks.

[BarnGir1 in reply to SueJohnson]

Thanks, Sue. I have been doing a lot of research, and re-reading of these posts, to come up with a suggestion for my (new) dr. when I see him tomorrow for a third visit since he is very willing to listen to me and work with me. He did listen to the augmentation presentation by Dr. Buchfuhrer which may be why he wanted me to stay on this combo for a while longer. Do you think it would be helpful to try gabapentin in place of the .5 requip in the morning and continue with requip .5 at 6 pm and gaba at bedtiime to continue to get off requip? As you can probably tell, I am reluctant to try opiods until I see if I can handle RLS with gabapentin and NO requip, knowing that I can increase the gaba. We live in very rural Kentucky, about 3 hours north of Nashville. Before Covid, I saw a neurologist at Vandy for migraine (I knew I had RLS but it had not yet started causing me any problems). I could make the trip alone (my husband has been doing very well but can't travel much) but this dr. has made such a difference in my migraines (within about 18 months) that I want to give him a chance since I just started working with him on my RLS. I had made the drop to total 1 mg requip a year or so ago myself based on what you, Joolsg and Chris Columbus said and it worked very well until recently when I started telling this dr. about the RLS. BarnGir1

[SueJohnson in reply to BarnGir1]

The suggestion for the opioid was to use it temporarily to help you get off the requip.

I am confused when you said to try to take the gabapentin in the morning (in place of the requip) and then you mention continuing with the gabapentin at bedtime. Are you taking 400 mg gabapentin both morning and evening or suggesting splitting it and taking 200 in the AM and 200 in the PM?

[BarnGir1 in reply to SueJohnson]

I was thinking of splitting it am and pm, at least short term, trying to get of requip completely. Then if needed., I could increase either but especially nighttime.

[SueJohnson in reply to BarnGir1]

To answer your question then - No cutting the requip by .5 by eliminating the morning one is too much of a reduction. You can try reducing it by .25 or half of the .5 tablet. And I would keep the gabapentin in the evening 1 to 2 hours before bedtime.

[BarnGir1 in reply to SueJohnson]

Thanks. Had a good visit with current doc. He just wanted to ease my gaba up gradually based on my age and other meds I am taking. He diagnosed idiopathic neuropathy and thinks gabapentin with make a big difference as I increase it.

[BarnGir1]

Forgive my poor memory but why does it take so long to completely get off Requip?

[SueJohnson in reply to BarnGir1]

Because otherwise you will suffer tremendously.

[BarnGir1 in reply to SueJohnson]

LOL! I was looking for a medical reason but this will do! Thanks for all you do, Sue!