Here goes nothing...

[madhttr]

Saw my primary care doctor today and will eliminate the last 0.0625 mg of Pramipexole tonight (down from 0.5 mg 6 months ago). I have started Gabapentin and increased over a couple of months to 800 mg (two doses two hours apart) which has helped with restless legs in the evening and to some extent afterward. I am often able to fall asleep initially, but my wife notices the leg spasms about every thirty seconds and I awake myself frequently until about 2 am; then I can sleep until 5-6 am. Oral iron has increased my ferritin from a low of 44 ųg a year ago to 125 ųg now. Ready to be done with this poison and see what happens next.

[SueJohnson]

Your symptoms could either be from withdrawal of pramipexole or a side effect of gabapentin. The only way you will know is after you have been off pramipexole for several weeks. By then they should get be better and hopefully gone or it may take longer. I would not increase my gabapentin during this time.

If it is not better you might want to try switching to pregabalin. Although it is basically the same drug except you don't need to divide the doses, and the side effects are basically the same, some people find that the side effects that bother them on one don't bother them on the other. Divide the gabapentin amount by 6 to get the correct dose.

If you still have it after switching, then reduce the pregabalin slowly to avoid withdrawal symptoms by 25 mg every 2 weeks.

Then you will need a low dose opioid. 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.

If it turns out to be the pramipexole, you need to take the gabapentin the right way. Take it 1-2 hours before bedtime as the peak plasma level is 2 hours. Increase it by 100 mg every couple of days until you find the dose that controls your symptoms. If you need more than 600 mg take the extra 4 hours before bedtime as it is not as well absorbed above 600 mg. If you need more than 1200 mg, take the extra 6 hours before bedtime. (You don't need to divide the doses on pregabalin)

[Joolsg]

See the withdrawal schedule on RLS-UK. It will show you what to expect.The next 2 weeks will now be the toughest. It will be bad. But stick with it.

You have to get all that dopamine out of your system and allow your brain to settle.

After 2 weeks, every night will be a little better than the night before.

Well done.