I’ve been taking gabapentin for RLS for it seems for ever! I was taking 4 x 300 mg spread over the course of the evening. I ended up taking another 300mg in the early hours of the morning as it seemed that it wasn’t really working that well. I have also been taking 2 x codydramol plus 2 x ibuprofen often at 2/3am. My sleep pattern now is absolutely dreadful.
I saw my GP last week as I wanted to change my medication. I said that I would not take dopamine agonists due to what I have read on here.
She’s started me on 1 x Pregabalin 50mg tablets in the evening. This one tablet did not work at all and so I increased it to 2 x 50mg after 3 days.
Can anybody please tell me what dosage I should be taking and how? Should I take them all together or split the dose.
I’m seeing my GP again next week.
Many thanks!!
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Dreamofsleep
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The reason the gabapentin didn't work is because you were taking it wrong. You should have taken 600 mg 1 to 2 hours before bed and 600 mg 2 hours before that.
So you could go back and take gabapentin that way or you can take the 200 pregabalin all at 1 time 1 to 2 hours before bed.
If you go back to gabapentin if you take magnesium, even in a multivitamin, don't take it within 3 hours of the gabapentin as it reduces the absorption of the gabapentin. If you take calcium don't take it nor calcium-rich foods within 2 hours for the same reason. This does not apply to pregabalin.
If you find the 200 mg doesn't work, you can increase it by 25 mg. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 200 to 300 mg pregabalin)."
Have you had your ferritin checked? If so what was it? This is the first thing that should be done for RLS. Improving your ferritin to 100 or more helps 60% of people with RLS and in some cases completely eliminates their symptoms. If not ask your doctor for a full iron panel. Stop taking any iron supplements including in a multivitamin 48 hours before the test, don't eat a heavy meat meal the night before and fast after midnight. Have your test in the morning before 9 am if possible. When you get the results, ask for your ferritin and transferrin saturation (TSAT) numbers. If your ferritin is less than 100 or your transferrin saturation is less than 20% ask for an iron infusion to quickly bring it up as this will help your withdrawal. If you can't get an infusion, let us know and we can advise you further.
Some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, artificial sweeteners, carbs, foods high in sodium, foods that cause inflammation, foods high in glutamate, ice cream, eating late at night, oestrogen (estrogen) including HRT, dehydration, electrolyte imbalance, melatonin, Monosodium Glutamate (MSG), collagen supplements, low potassium. eating late at night, stress and vigorous exercise.
Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennell, low oxalate diet, a low-inflammatory diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, applying a topical magnesium lotion or spray, doing a magnesium salts soak (epsom salts), vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, playing and listening to music, creative hobbies, meditation and yoga.
Many medicines and OTC supplements can make RLS worse. If you are taking any I may be able to provide a safe alternative.
I found gabapentin didn’t work for me. But I’m having much better results with the pregabalin. I’m on 450mg although I feel I may have increased too fast and therefore ended up on a high dose. But it’s definitely working for deep sleep.
I also take dihydrocodeine which absolutely switches off the legs. It doesn’t last all night though. I started at 30mg and now on 60mgMR which seems to be working well so far.
Follow sues advice increase the pregabalin until effective. Maybe you can ask for dihydrocodeine instead of codydramol?
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Day 3 of Pregabalin
Switching from Gabapentin to Pregabalin
Pregabalin Dose Timing
Returning to Gabapentin
transition from pramipexole to gabapentin 
