gabapentin

[Daisysparkle]

Hi. About 7 months ago I was on 1mg of Ropinirole but got augmentation so came off it and started on Gabapentin. I’m on 1800mg but still wake up between 2-4am. I then take 1or 2 15mg Codeine and then fall asleep in about 30 minutes. Ive been taking ferrous sulfate for about 5 months now. The Dr said to go back and she can increase the Gabapentin. I’m just after some advice to how much Gabapentin I will need and what times to take them. Thank you.

[SueJohnson]

I assume you are taking 600 mg of gabapentin 1 to 2 hours before bedtime, 600 mg 2 hours before that and 600 mg 2 hours before that. If not, try that.

If so, trying to increase the gabapentin is ridiculous because you would need to take the increased amount 6 hours before the dose you take 1 to 2 hours before bedtime. Instead switch to pregabalin which can be taken all in 1 dose. The equivalent to 1800 is 300 mg and you can switch directly. After that increase by 25 mg every couple of days until your RLS is controlled. If you get to 450 mg and see no improvement it means your dopamine receptors have been damaged by the ropinirole and you will need to switch to a stronger opioid like buprenorphine or methadone.

If you see some improvement but still have RLS you can increase it in the same fashion up to 600 mg,

If you need to come off it because it is not helping reduce by 25 mg every 2 weeks to avoid withdrawal symptoms.

[Daisysparkle in reply to SueJohnson]

Thank you. I’m going to try the 600gm every 2 hours again as ive been forgetting to take them on time. I will set a reminder on my phone and see how I go first 😊

[Ironmanhan in reply to Daisysparkle]

Hi I’m following your post as had similar thank you x

[Joolsg]

What is waking you? Is it RLS?If so, you could follow SueJohnson advice & switch to pregabalin but take it in 2 doses so you take 150mg 2 hours before bed and 150mg just as you are ready to fall asleep. That might extend the cover to 2am.

If pregabalin doesn't work - you may need to switch to an opioid.

[Daisysparkle]

Hi. I’m not sure what wakes me as I had 2 nights where I didn’t wake and then last night was really bad and I needed to take codeine. I’m having good nights and bad 🤷‍♀️. I’m going to start being stricter taking my tablets on time and see what happens. Thanks

[707twitcher]

I'm no expert on codeine, but isn't it possible that you are experiencing mini-withdrawal symptoms every night as the codeine likely only lasts 4 hours or so? Insomnia can be a withdrawal symptom. It's also a general opioid side effect, so the codeine may be your problem. Seek advice before trying to stop it - probably need a slow taper so the withdrawal doesn't get worse. Hopefully increased gaba or pregab dosage (or just better management of the dose timing) stops the RLS so that you can do without the codeine.

[Daisysparkle in reply to 707twitcher]

Hi. I’m going to be strict on taking the gabapentin on set times and see what happens. If I do take Codeine in the night I try to just take one 15mg but that only lasts about 2hrs. Last night was the worst I have been since taking gabapentin. I’m also going to start doing a diary again to see if there’s a pattern.

[Daisysparkle]

Hi. I was strict and took the Gabapentin on time. Still woke up 3.20am with restless legs. Took 2 co-codamols instead of codeine. Took till 4.15am to try and get back sleep and was awake at 6.45am with restless legs. Also, I have put on a bit of weight since started gabapentin 🤔.

[707twitcher]

I'm curious what others' experience is with gaba/pregab re how long it lasts. I haven't seen other posts that indicate its effective life may only be 6 hours or so. Other comments have focused on how much dosage it takes to control RLS, not for how long. Given that those taking more than 1800mg of gaba will be taking first dose as early as 2pm or so, I had assumed that it's effective for well over 12 hours. I'm in the process of ramping up my gaba dose in an attempt to wean off buprenorphine, so knowing how long it lasts seems pretty important.

[SueJohnson in reply to 707twitcher]

Over 1800 mg , one switches to pregabalin which can be taken all at one time since it would be ridiculous to take it that early.

I take 1500 mg and it lasts all night.

[purple-flowers]

I was on gabapentin for over a year. I’m afraid it didn’t work for me. I took 600 mg T 4pm and 600 at 7pm. I am now on oxycodone 5 mg in the morning and 10 mg at night and miracle of miracles it works! Previously I was on Pramipexole for years then ropinerole. Codeine didn’t help at all. Pregabalin made my ankles swell alarmingly. I have found the oxycodone to be the answer. Good luck,!