Neupro with opinoids

[MARISEGATIEN]

Hello,Wednesday, I'm going to see a new Neurologist Alex Desauthel in the city of Montréal, QC, Canada. On the past, Pregabalin , Lyrica, Requip didn't help. For now only Neupro help. Should I accept to continue on Neupro with opinoids? Also my sympthoms are worse on Summers Seasons, I don't understand why. I have benefits with reduced carbohydrates, but still have problems with RLS. I also lost 15 pounds, but didn't help.

[Madlegs1]

A lot of questions there!

Do you take antihistamines in summer? If so that could be a trigger at that time.

You need to be getting off the Neupro, very slowly and by tiny amounts,- see Sue Johnson's replies to many posts on this site,.

What opioids are you on??

Type and dose?? Timing?

Hope to hear from you soon.

I'll let Sue take over from here!😝💚

[Joolsg]

Neupro patch will cause augmentation. It's simply a matter of when.So follow RLS-UK withdrawal schedule under 'useful resources'.

Opioids will reduce the withdrawals and can be taken long term to treat severe, refractory RLS.

What opioid are you taking and what dose?

Hopefully the doctor you are seeing will be familiar with the Mayo Clinic Algorithm and the new guidance from the American Academy of Sleep Medicine.

[SueJohnson]

No you don't want to continue with the neupro. I gave you this info before but will give it to you again in case you forgot as you weren't going to reduce it then.

You can do the reduction in one of 2 ways. Using a 1 mg Neupro 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. Since you can get ropinirole in .25 tablets this is the easier way to reduce. Then reduce by this amount 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 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.

If your can get an opioid and can continue it even after you are off the Neupro that would be great but I thought your doctor wouldn't prescribe one. Perhaps that is why you are seeing a neurologist. As I mentioned before I would recommend buprenorphine or methadone as they are long lasting. Most of the others last only 4 to 6 hours and need to be taken that often or you will have mini withdrawals. If you are prescribed one of the others be sure you are given enough to take them that often

Did you ever have your ferritin tested?

[MARISEGATIEN in reply to SueJohnson]

Thank you. I will show your answer to the neurologist and I will see what he will tell me about that. This neurologist accept to prescribe opinoid with other Drugs. I have a question. I'm new in this group and I don't know your background. Are you neurologist? Also if Neupro can cause permanent damage?

[SueJohnson in reply to MARISEGATIEN]

No I am not a doctor, I went through what many others did. I augmented on ropinirole and was then put on gabapentin and my symptoms are now completely controlled. I am retired and decided to learn everything I could about RLS and pay it forward by helping others. Most of my advice comes from the Mayo Clinic Updated Algorithm on RLS and the rest from my research and my own experience.

Staying on Neupro will mean in time you will have to take more and more to control your symptoms past the maximum amount of 3 mg which you are already taking . And after awhile it will damage your dopamine receptors so that iron won't work.

[Amelanchier]

Hello Marisegatien

My RLS is also worse in the summer months but I don’t know why. Perhaps to do with the different circadian rhythm associated with longer daylight hours? This year I even suspected tomatoes as I grow them and east quite a lot in the summer and I’ve recently learned that they can be a trigger in some people. I’ve stopped eating them and I think it might have helped but it s certainly no cure! With RLS the words of that well known song often come to mind

🎼🎶. There are more questions than answers……🎶🎵. 😊

I hope you get some answers when you attend the neurologist tomorrow .