How effective is Dopamine agents for RLS?

My name is Reji Joseph and I am writing to you on behalf of my mother.

My mother is a school teacher and she is currently 56 years old.

She has been suffering from Restless legs syndrome since the last four years.

Her height is 1.5 meters and she weighs 110 pounds.(50 Kilograms)

It all began five years back, with a small accident at her workplace, where she tripped as fell down hurting her LEFT knee in the process.

She was diagnosed with Ligament tear and she developed some inflammation in her knee cap due to that fall.

She underwent a key-hole knee surgery and the pain initially receded a little.

However, due to the surgery, she was actually giving more support to her body from her left leg and over a period of time (6 months), she started feeling pain in her right knee also. The symptoms this time were exactly similar to the ones mentioned in your website. This needle-pin pricking like pain has been occurring to her since the last four years (six months after her operation). Currently, she has the same needle-prickling like pain in both her legs (from her knee to her toes) and she is deprived of a sound sleep at least four days a week.

We would like to try out the medication "Dopamine agonists" like Ropinirole (Requip), Pramipexole (Mirapex), Pergolide (Permax) and Rotigotine.

Please advice your recommendations and if possible, please do give your inferences.

7 Replies

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  • Hi Reji, I'm sorry to hear that your mother has this infuriating condition. When I was diagnosed, my GP didn't know anything much about RLS but I did some research and found that the "dopamine agonists" are an effective treatment. It may also be worth your mother asking to get her serum ferritin levels checked via a blood test. This is in connection with the way our bodies store iron. I believe that these levels should be around 50-100 for people with RLS.

    I started on Ropinirole at 0.25mg and gradually had to increase the dose until I got to 3.5mg. The max you can take is 4mg. I then tried introducing Gabapentin, which is an anti-epileptic/anti-convulsant, because I get periodic limb movement disorder which stops me sleeping. This wasn't so effective though and in the end my doctor suggested that I see a neurologist who - oh joy - knew about RLS and PLMD! He has now put me back on 1mg of Ropinirole and introduced a small dose of Clonazepam (a traditional sleeping aid), which has been working perfectly. I take both drugs at 9.15pm and get into bed at about 10.30 and am asleep within minutes - it's sheer bliss!

    I would suggest that your mother goes to her GP and explains her symptoms just to ensure that she is indeed suffering from RLS. The GP should give her a blood test to confirm this (or at least to rule out anything else). If the GP doesn't know about the condition, your mother might like to ask to be referred to a neurologist who hopefully will be able to help.

    Lastly, I find that alcohol and anything containing salt or sugar will make the condition worse.

    Hope that helps.

    Angie

  • The 4 official criteria for helping to confirm

    a restless legs syndrome diagnosis

    These criteria were established by the National Institutes of Health in a workshop with members of the International Restless Legs Syndrome Study Group.

    The four criteria are:

    You have a strong and often overwhelming urge to move your legs. This urge is usually accompanied by the various unpleasant restless leg syndrome symptoms or sensations I mentioned above.

    The urge to move or the symptoms of restless leg syndrome are triggered or worsen when you're inactive and resting...either lying down, sleeping, or just sitting.

    Your restless leg syndrome sensations are relieved, either partly or totally, with movements. Activities such as stretching, walking, riding an exercise bike, or shaking the legs. This relief continues as long as the movement continues.

    Your restless leg syndrome symptoms and urge to move are worse at night. Also, they are either gone in the morning or are very slight

    The above is how RLS is diagnosed as there isnt a test which can be done.

    Mostly, to get relief at night, it means getting up and walking up and down, jumping legs which seem to have a mind of there own when trying to drop off to sleep, it can also effect other parts of the body, arms, shoulders, torso, for some people.

  • doapmine meds work for some people, and they are the first ones to try. Permax, no. It was removed from the US market years ago, because it is an ergot derived dopamine agonist, and can cause severe heart defects,. Nobody should be taking Permax, if it is actaully vailable. Ropinerole and Mirapexin are the first line of treatment. Keep in mind to read ALL side effects. Important, since

    Mirapex is now getting stronger warings, even though it and Ropinerole are non ergot dopamine agonists. rxlist.com is the most detailed web site when it come sto describing all aspects of any meds. It is my med Biblw. also for the "treatment Bible" go to rlshelp.org go to the treatment page, read that, and make sure you scroll down to see the list of "Drugs and foods to

    Avoid" That is as important. many many meds can cause RLS to get worse, like off the charts.

    Hi, I am Donna, from the US< and am 56 also. :)

  • Just remember that what works for one RLSer does not necessarily work of the next RLSer. It is all trail and error, with other meds to try of the dopamne meds do not do it. About a third of the people i know can take these mes with no isse, but the rest of them ( and me) have to go to other meds to get relief. Really, read that list of Drugs and foods to avoid". Lots of over the counter med ( like sleep meds), antidepressants ( some classes) anything with the ingredient diphenhydramine will most likely have an RLSer crawling on the ceiling.

  • Benedryl causes my legs to chase a cold spot in the bed

    worse than anything on this planet so far...Alcohol

    comes in a close second...

    I feel for your dear mother...I had my knee replaced not long ago (I am 46)

    because I fell out of an attic and landed straight on it.. any injury to

    the knee will cause great pain and pressure in anyway that it's rested

    or touching the bed..

    Nightdancer pointed you in the right direction..I refer to that list every

    single time I am changing a medicine.

    With this many people on this site, If someone hears something, it will

    be known to all..Lots of ears and eyes are on the lookout for better

    breaking treatments. I could never solve my RLS issues without this

    group so hang in there...keep reading.

  • I have developed RLS over the past few months and am nearly going crazy. I am so tired and cannot sleep. In fact after our evening meal, I can't even sit and watch TV without leaping up and down all the time.

    Is there no cure for this maddening disease.

  • Hi, there is no cure for RLS, all we can do if it is keeping us a wake all night, is to use the medications for RLS... Check that any meds you maybe taking could be causing your RLS.

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