PREGABALIN v PRAMIPEXOLE

[BENGAL1000]

I am trying to find out what the difference is between Pregabalin and Pramipexole. Obviously I have Googled, but I have not come up with a satisfactory answer. So I was wondering if any of you guys could indeed shine a light on it for me.

[Joolsg]

Pramipexole is a Dopamine Agonist, pregabalin is an alpha@delta ligand. Completely different category of drugs.

Dopamine agonists imitate the actions of dopamine when brain levels are low and are commonly used as first line treatment for RLS.

Alpha2delta ligands are anti seizure meds used off licence for RLS.

Dopamine agonists are no longer first choice for RLS amongst experts because of the risk of Augmentation.

[Hidden]

As Jools says Pramipexole stimulates dopamine receptors, hence increasing the activity of brain cells using dopamine as their neurotransmitter.

These cells calm down motor nerves.

Alpha 2 delta ligands block the action of a neurotransmitter called glutamate. Glutamate cells make motor nerves more excitable, so blocking them has a calming effect.

Pregabalin can also be used to treat nerve pain and epilepsy. Not prami.

Pramipexole is effective for RLS symptoms and is also quite effective fir associated PLMS as well. However, it can cause insomnia, - early waking.

Pregabalin is effective for RLS, but not as good for PLMS. It can promote sleep and reduce anxiety.

Because of raising dopamine levels in the brain, prami can cause an Impulse Control Disorder, various kinds of "addiction".

[timosky43]

Those are really good descriptions by Joolsg and Manerva. I can only speak about pramipexole, which I have used for about 5 years. It was prescribed for me to replace Sinemet (carbidopa/levodopa) for RLS when augmentation occurred with the Sinemet. The good news for me was that it worked well to completely dampen the RLS symptoms. The bad news for me was that when I tried to eliminate it, I was introduced to the phenomenon known as DAWS or Dopamine Agonist Withdrawal Syndrome. The prescribing doctor didn't happen to mention that. In summary, one description I read says that it's like stopping a heroin habit, cold turkey. With the help of LDN (Low Dose Naltrexone), I've been able to reduce my dosage by 50% in small steps, but the last time I tried a further reduction, it didn't go well. I recommend that you research both medications until you know more about them than any physician and that you contact as many of us that you can who have actually used each medication so you have as much first-hand feedback as possible.

[HilsK]

Yes I wish I had had the knowledge that Jools and Minerva write 12 months ago ..

Interesting .. this question though Bengall. I have been on Pramipexole for 22 years for RLS . The doctors just ramped up the dose as the symptoms of RLS worsened. The inevitable happened, which I was never warned about ... and my body went into severe augmentation due to the drug.

I have now been put onto Pregabalin started at 25mg and being increased by 25g every week to enable me to withdraw from Pramipexole over a few months. The Pregablin MUST work differently from Pramipexole as it has alleviated some of the severe symptoms of Augmentation. I have just had the 1st night's sleep in my bed for 7 months .. and pain free at that.

Wishing you well