Advice on pregablin augmentation

[Aaaules]

I finally saw a neurologist after years of having RLS. He said the only drug that he was allowed to prescribe for rls was Pregablin. My gp had already tried me on a variety of meds so this was fine. It’s worked pretty well for the last 5 years.

My RLS was already full spasms when I saw the neurologist. Now I think I have classic augmentation, but I’m scared to come off in case I’m so much worse. I already can’t sit, let alone lie down and sleep at night.

My gps seem unable or unwilling to discuss it. Last time I tried to reduce my pregablin, they just kept messing my prescription up, I get severe withdrawal and those symptoms start within an hour of being late taking it.

I’m stunned at the variety of meds everyone is on, different things seem to work for some and not for others.

I basically feel this condition is managed by yourself, unless you live in Liverpool. I feel isolated and poorly understood.

[SueJohnson]

You can't augment on pregabalin. You may need more. Try increasing it for one night.

Or you changed something - eating a different food, taking a new medicine or a new OTC drug, or changing something in your lifestyle.

Some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, artificial sweeteners, carbs, foods high in sodium, foods that cause inflammation, foods high in glutamate, ice cream, eating late at night, oestrogen (estrogen) including HRT, dehydration, electrolyte imbalance, melatonin, Monosodium Glutamate (MSG), collagen supplements, eating late at night, stress and vigorous exercise.

Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennell, low oxalate diet, a low-inflammatory diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, applying a topical magnesium lotion or spray, doing a magnesium salts soak (epsom salts), vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, playing and listening to music, creative hobbies, meditation and yoga.

Many medicines and OTC supplements can make RLS worse. If you are taking any I may be able to provide a safe alternative.

Have you had your ferritin checked? If so, what was it? This is the first thing your doctor should have done. Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not when you see your doctor ask for a full iron panel. Stop taking any iron supplements including in a multivitamin 48 hours before the test, avoid a heavy meat meal the night before and fast after midnight and have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. You want your transferrin saturation to be over 20% but less than 45% and your ferritin to be at least 100. If they are not, post them here and we can give you some advice.

[Madlegs1 in reply to SueJohnson]

Sue says it all.

Basically - Pregabalin does not cause augmentation.

Two possibilities -- you have mistaken the medication --

Or-- you have taken a trigger-- as Sue has said.