Withdrawal from Pramipexole

[Longess01]

This is carrying on from a previous post from me and wasn't sure if it still shows.Don't know if I've messed up! Was impatient and decided to try and reduce from 3 x 0.088mg quicker. I got it down to 1 and 1/2 tablets and tonight as it's getting harder I decided drop down to 1 tablet and to start on gabapentin. The gp has only given me 3 x 100g a night.

Well the last 2 nights I've been up on and off with worse than ever symptoms. Along with the usual restlessness tonight my legs are aching really bad and during the day as well. I'm getting a couple of hours sleep a night.

How do people cope with this and is this normal? Makes me just think stuff it I'm going to go back to Pramipexole but I really want to get off it.

[SueJohnson]

Yes it is normal.

Take your time. Wait until your latest withdrawal symptoms settle before reducing to 1 tablet. The withdrawal symptoms do get worse the closer you are to being off it. But hang in there. You can do it as so many others have! You will be so glad when you are off it.

300 mg is the starting dose of gabapentin and it won't be effective until you are off the pramipexole and your RLS withdrawal symptoms have gone away and you are back to how your RLS was before you ever took any medicine.

After that increase it by 100 mg every couple of days until you find the dose that works for you. Take it 1 to 2 hours before bedtime as the peak plasma level is 2 hours. 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.

Most of the side effects will disappear after a few weeks and the few that don't will usually lessen. Those that remain are usually worth it for the elimination of the RLS symptoms. According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 1200 to 1800 mg of gabapentin . You may need to print this out to show your doctor.

If you take magnesium even in a multivitamin, don't take it within 3 hours of taking gabapentin (it is OK with pregabalin) as it will interfere with the absorption of gabapentin and don't take calcium nor antacids within 2 hours for the same reason (not sure about pregabalin).

Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it at Https://mayoclinicproceedings.org/a...

[madhttr]

don’t go back but take it slower. Maybe just back to 1 1/2 pills for a bit longer. I tapered off over six months and it was not fun but tolerable. The gapapentin won’t work until you’re off pramipexole. Hang in there you can do it!

[Longess01 in reply to madhttr]

Thanks guys I appreciate the advice. My fault really just impatient and panicked when I was struggling and thought the sooner I start gabapentin the sooner I would feel better. I'll go back to what I was originally advised and will do a further week at 1 1/2 then 2 weeks at each 1/2 tablet reduction. Then I can start on gabapentin when I'm 3 weeks from being completely off them is that right?

[SueJohnson in reply to Longess01]

right

[madhttr]

I started gabapentin early also and maybe it helped a little? More likely it just takes time for your brain to reset from the effects of pramipexole and that overshadows any gain from the gabapentin. I’m four weeks off pramipexole and the gabapentin seems to be slowly improving. It’s worth the hassle to be done with pramipexole.

[707twitcher]

Have you asked about getting buprenorphine or methadone during your withdrawal from pramipexole? I know it's harder to find a doctor who will prescribe it in UK, but bup did wonders for me and many others. It facilitated the prami withdrawal fairly easily, and it remains the med I need for ongoing RLS relief.