Which countries other than the US prescribe opioids for refractory RLS?

[MrCrow]

Title says it. I am from India and treatments for RLS are limited to DAs and gabapentinoids.

[RiceyRiceRice]

I live in Germany and opioids are definitely prescribed for RLS here. Both by GPs and neurologists.

Overall there is no hysteria here towards opioids or other medications like gabapentin or pregabalin.

[MrCrow in reply to RiceyRiceRice]

That's great news! I hope I get work there soon. In India unfortunately, they are very tightly regulated.

[Joolsg]

It very much depends on the individual doctors.Those that are up to date on research will know about opioids for RLS at low dose and will be familiar with the Mayo Clinic Algorithm, the new AASM guidance and Dr Winkelman's opioid study.

There will also be an issue of Big Pharma involvement. Dopamine agonists create billions in profit. Dopamine agonists pharmaceutical companies are very much aware that these drugs cause severe augmentation and ICD. But they don't want to lose the billions in profits.

Many neurologists are STILL insisting on prescribing them to RLS patients, despite the overwhelming evidence against them.

Either they are too busy to read the research and evidence, or too wedded to old beliefs.

And perhaps there is financial incentive in some countries to keep prescribing dopamine agonists?

Most opioids are cheap and generic versions are available. They don't make as much money for big pharma.

So- a combination of ignorance, negligence and possibly corruption/financial incentives in some countries.

And that will include the UK and the USA.

[MrCrow in reply to Joolsg]

I heard some rather distressing news from another member here that a top doctor in India who knows about augmentation and is in touch with Diego Garcia refuse to prescribe opioids for the condition to their mother who is currently on 1mg pramipex. Getting opioids prescribed is apparently very difficult in India. I am trying to immigrate to a place where this isn't an issue.

[Joolsg in reply to MrCrow]

It's depressing and infuriating.1mg Pramipexole- the poor woman will be climbing the walls.

I would video the severe augmentation and sleepless nights and send to the doctors.

I totally understand the opioid crisis and the fear of addiction and abuse.

But the studies are disproving this for RLS.

One day........