Have you found Rotigotine patches 4mgs helpful

[Tramp66]

I have been using prescribed Rotigotine patches for a few years now up to 4mgs, have peeps found them helpful?

[Madlegs1]

They are very effective, but we would advise people to avoid Dopamine Agonists ( Pramipexol, Rotigotine, Neupro and suchlike , because of the inevitably of experiencing Augmentation.

You have 2 options, as I see it--

Stay on the patch until augmentation sets in -- the dose needs to be increased and the RLS gets worse.

Or get off it now-- slowly and by very small doses, and get a new medication such as Pregabalin or Gabapentin.

Talk with your doctor.

And follow up Sue Johnson's answers to many posts on this site.

Good luck.

[Tramp66 in reply to Madlegs1]

Thank you. I've been on meds before patches & currently on Pregabablin have been for years an suffer terrible side affects, hoping to come off them soon.

[SueJohnson]

No, no no! You so not want to use the patch. You said previously that you suffer terribly from RLS. I assume that means the patch is not controlling your RLS. Even if it is you are using more than the maximum amount which is 3 mg. You are suffering augmentation and need to get off it. 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.

You can do the reduction in one of 2 ways. Using a 1 mg Neupro (Rotigotine) patch cut it into sixths. The easiest way is to draw lines on it. This will equal the .25 mg reduction that is advised since 1 mg of Neupro = 1.5 mg ropinirole. Or you can switch to ropinirole. Multiply the dose of Neupro you are taking by 1.5 to get the correct amount which would be 6 mg of ropinirole. Since you can get ropinirole in .25 tablets this is the easier way to reduce.

Then reduce by this amount (.25 mg) every 2 weeks. You will have increased symptoms. You may need to reduce more slowly or with a smaller amount or you may be able to reduce more quickly. Wait until the increased symptoms from each reduction has settled before going to the next one. You will suffer and may need a low dose opioid temporarily to help out with the symptoms especially as you near the end. Some have used kratom or cannabis temporarily to help. But in the long run, you will be glad you came off it.

Ropinirole, Neupro and pramipexole are no longer the first-line treatment for RLS, gabapentin or pregabalin are. They used to be the first-line treatment which is why so many doctors prescribed it but they are not uptodate on the current treatment recommendations.

You would start gabapentin or pregabalin 3 weeks before you are off Neupro. After the withdrawal symptoms have settled once you are off Neupro then you can start increasing the gabapentin or pregabalin as I described to you on your last post.

[Tramp66 in reply to SueJohnson]

Thank you. I've also been o Pregabalin for years & Gabapentin prior to that

[SueJohnson in reply to Tramp66]

Was this before you went on the patch? How much did you take? What was your experience with them and why did you stop taking them?

[Tramp66]

Yes it was before. Gabapentin was for my back pain/sciatica this was changed to Pregabaline for anxiety disorder I am still taking them.

[SueJohnson in reply to Tramp66]

Did they help your RLS before you were on Neupro? How much did you take?

The pregabalin won't help while you are on Neupro.

[Tramp66]

No they didn't until the dose was increased but so was the Neupros. I started off on 100mgs Twice a day then 100mgs mane & 150mgs nocte then 150mgs mane & nocte then 200mgs mane 150mgs nocte then 300mgs mane & nocte but the side affects were getting to bad so currently on 200mgs mane & 300mgs nocte.