clarification on procedures for getting off pramipexole

[Yorkie111]

I just want to make sure I am reading the procedure for going off pramipexole and onto pregablin correctly. I started taking pregablin along with my pramipexole and will do this for about 4 weeks. At that point I will start reducing the pramipexole while still taking pregablin. I just want to make sure I don’t start reducing pramipexole as soon as I start taking the pregablin.

Thanks

[SueJohnson]

You should start reducing the pramipexole. You don't need to start the pregabalin until you are 3 weeks away from being off pramipexole.

[Yorkie111 in reply to SueJohnson]

Thanks. Glad I asked!

[Yorkie111 in reply to SueJohnson]

Sue, why wouldn’t it work to be on both pregablin and pramipexole for a couple of months and then start cutting back on the pramipexole?

Thanks

[SueJohnson in reply to Yorkie111]

As Joolsg said, it would be a waste of pregabalin as it won't really help until you are off pramipexole and your withdrawal symptoms have settled. Plus you are just putting off reducing the pramipexole.

[karjbee in reply to SueJohnson]

There doesn’t seem to be from the literature the exact timing of wean down wean up. The bigger problem is just stopping it cold turkey and starting something else. I have changed psych drugs a lot and the new drug is started at a very low dose and the existing drug is very slowly weaned for a smooth transition. I’ve looked a lot in the research and the biggest issue is weaning off to fast. I attended the RLS research summit last week. The suggestion is to wean a lot more slowly then previously thought. And of course a lot of success with low dose opioids to help with withdrawal symptoms. Seems to take a lot of finesse and patience in weaning off drugs affecting the mind. But my take away was the slower the better and different for every person.

[SueJohnson in reply to karjbee]

Agreed! That is why although my usual advice is to reduce by 25 mg for ropinirole or 1/2 of a .125 (.088) tablet every 2 weeks I also say 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.

[karjbee in reply to SueJohnson]

thank you, I am afraid to have symptoms again, when right now I am not. Seems like upsetting the apple cart so to speak. However I know its going to happen, so I am going to persevere! AND I have a doctor now who is working with me rather then against. I anticipated having the same issue with this doctor. I was going to pay the $500 consultation fee for Dr Buchfurer, but now I don't have to! The support groups on RLS foundation have been excellent if anybody is looking to share in our journeys. They are all virtual which is perfect.

[Joolsg]

A waste of pregabalin really. Pregabalin may slightly help with sedation but it's not very helpful at stopping severe withdrawals at every dose reduction.So it's better to get down to the last 0.125 pill before you add pregabalin.

Low dose opioids help to reduce the severity of RLS at each dose reduction if taken for 3 or 4 nights.