I have been on Gabapentin for just over a year 1200mg x3 per day, breakfast, lunch and tea. The last two months have been hell at night time. Almost like the gabapentin is causing the RLS. I’ve seriously been awake all night every night walking the floors and raiding the fridge to try and distract the discomfort. I have gained weight and I’m conscious of other medical issues this may cause - possible diabetes and high cholesterol. My doc has now switched me to pregablin. I’ve read that people have found relief with this med, however, I’ve also read weight gain as a side effect. I’m worried for the extra health complications. Has anyone else experienced this and is there a med that can be taken to counter the weight gain? I understand a healthy diet and exercise is important but just thought a bit of extra help would be supportive? Although if I start to sleep at night, the ‘munchies’ will disappear and this may help?
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Twitchyfeet
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I have been on pregabalin for almost 2 years now. I began with 75 mg per night - and remained on that dose for a year. I did gain weight, but I have no idea whether it was because of the drug or simply my lifestyle - which was quite sedentary.About a year ago I developed chronic back pain and my dose increased, first to 150 mg, then to 300 mg. Perhaps because I was aware of the side effect of weight gain or because I changed my diet and became way more active, I have actually lost weight. I do find that it is quite a difficult to do (basically a Mediterranean diet). Other side effects, such as feeling 'spaced out' disappeared within a week or two, and I will sometimes have breakthrough rls, but it is usually manageable.
I use 100 - 300 micrograms of clonidine (aka Catapress), to aid with sleep. It is non habit forming and fairly effective.
That said, all of us have different reactions to things.
Were you taking the gabapentin specifically for RLS? If so it’s best to take them all in evening rather than breakfast lunch dinner. The recommendation is max 600mg every 2 hours, 2 hours before bed. So for example 600mg at 6pm then 600mg at 8pm.
Re the Pregabalin, you should also take this all at once 1-2 hours before bedtime, not spaced out (as your GP may advise). I’m on 450mg and for me it’s so much better than the gabapentin. Yes there is some weight gain but my life is pretty sedentary and not eating well due to tiredness from the RLS/insomnia so I think we have to pick our battles.
As Islay9 said and I said a few weeks ago you don't need gabapentin other than at night because one only has RLS at night. Doctors will prescribe it that way because it used to be only prescribed for neuropathy. And gabapentin doses need to be 2 hours apart for maximum effect. A few weeks ago you said you were taking 300 mg 3 times a day for a total of 900. So did you mean 400 mg 3 times a day for a total of 1200 mg? If so the equivalent amount of pregabalin is 200 mg. Any less and you will have withdrawal symptoms. Take all of it 1 to 2 hours before bedtime. As to weight gain you will soon find out. It's usually because of increased hunger. There is no medicine to counteract that. If it happens and you want to come off it you need to do so very slowly to avoid withdrawal effects. Reduce by 25 mg every 2 weeks. If you do so you will have very few or no withdrawal effects. If you do have any, slow down even further, In very very rare cases you still might have withdrawal effects.
Often once you come off it you will slowly lose the weight you gained. You will then need something else to control your RLS, usually an opioid. If that happens post back here and we can give you some advice.
According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 200 mg to 300 mg of pregabalin." However since you were only taking 400 mg of gabapentin at night which is equivalent to only 67 mg of pregabalin you might find that you don't need as much as 200 mg but start with that much to avoid withdrawal symptoms and if it controls your RLS reduce as I advised you until you find the lowest amount that controls your RLS. If it doesn't add 25 mg every couple of days until you find the dose that does control it.
This is why I stopped taking pregabalin i gained 2 stone in 6 months.I'm now currently cutting out paroxetine (slowly) I'm down from 20 mg to 10 now, I also take 80 mg of iron every other night, vitamin d, magnesium.
My rls has significantly improved but it's taken about 3-5 months although worth it.
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