I would appreciate comments on the medication I am now taking for RLS - see below

I have recently changed from Mirapexine to Gabapentine which I supplement with a 3mg neupro patch. At first the specialist that I saw prescribed 100mg tablets three times a day but this was clearly not enough and I had a terrible time, made worse by the fact that I was on holiday in South Africa. Just before I left the UK I persuaded the doctor to increase the Gabapentine to 200mg and then I saw another doctor in SA. That meeting proved very interesting for several reasons but to cut a long storey short she agreed to prescribe additional Gabapentine such that I now tale 300mg three times a day. Because I was still suffering badly from lack of sleep and having to wander around all evening I decided to cut 3mg patches in half and apply these with a whole patch.. Since then I have enjoyed much more sleep and have even slept through the night - I even slept on the plane home which is a first for me. Any comments on the new formulation - ie 300mg Gabapentine three times a day together with four and a half mg Neupro patches?

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  • Gapapentin at that dose is still low from reading on other support groups so that seems fine to me... I am on 3mg Neupro Patch and is not working, i am adding up to a 1/2 of a 0.088 Pramipexole tab to get me through the night. The highest dose for the patch is 3mg, i could have done the same as you have and cut a patch to make it 4 and 1/2 mg, but the problem with that is it will probably only work for a while. I used to cut the patches so i could up the dose slowly to reduce side effects...ie...1mg then 1 and1/2 patch and so on.

    By me adding the little bit of pramipexole to the patch, is of course just adding more dopamine, but i know that its not the answer, as my body gets used to the extra bit of dopamine it will want more... I am almost sure that is what will happen to you by adding the extra patch... its called augmentation, which i am sure you have seen has been spoken about alot on this site..

  • Usually, I am finding out, that a combination of meds works waaaaay better than just one. Lots of people take Gabapentin. 300 mgs daily is the lowest dose, and I would be surprised if tha was enough. So, you have upped it once, and see how that works. Max dose can go to 3600 mgs, so that ives you an idea how low 300 mgs is. :) Let me say, it is 3600 mgs in the US, and I think it is the same in the UK. Have no idea about South Africa. I am glad she is working with you on that.

  • I agree with you there nightdancer regarding a combination of meds, I take 600mg Gabapentin, with 0.08mg pramipexole and Ropinerole 0.25. If I feel it shuddering towards me I can 'top up' with 0.18 Pramipexole. It usually work most nights, but sometimes I think augmentation is not far away. I can use Amatrypteline as well or Citalopram if needed.

    One problem I have at the moment is lack of sleep. which doesn't help! I tried Zolpadin but that did nothing, my latest prescription is for Tamazepam 10mg. I tried 20mg at first, but that was awful. I slept too long and felt drowsy all day. I have now gone to 10mg, and that seem s to work at the moment.

    I also take Citalopram, Zapain, Omeprazole . Dicloflex and Dihydrocodiene 60mg slow release.

    These are my Pain Killing Regime for osteo and rheumatoid arthritis,

    You would think with all that, I shouldn't have any problems with RLS!! Don't believe it, I still get it!!!!!!

  • In Canada we can take up to 2800 mg of gabapentin a day. We have been told the side affects are few and large doses are ok. My mother was on 3000 mg day for shingles.

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