Restless legs - augmentation - dosis af medicine and iron ?

[Gibbel]

Now I'm back for advice. It is simply lucky to be able to find help here when you live in a small country where treating restless legs syndrome is not a top priority among doctors.

my first question: I see that the iron product I have started to take contains 50 mg of iron added as the iron chelate (ferrochel) - and as recommended by Joe, I take 2 of these every other night. Is it enough ?

Next question: I am trying to taper off pramipexole to switch to pregabalin. My neurologist said: You can just switch over (from 0.7 mg pramipexole to 75 - 150 mg pregabalin). My GP not quite as consistent - try a little at a time. And if too many augmentation symptoms, I got a prescription for contalgin depottbl. a`5 mg, of which I could take 1 together with pramipexole (now down to 0.450). At the same time take pregabalin 75 mg - 150 mg.

My problem is that I don't get any sleep because of restlessness and pain when I try to go down a little more with pramipexole. 1 tbsp. contalgin depot a`5 mg makes neither off nor on. But if I take 10 mg, I actually get 3 + 2 hours of sleep per night. Is 10 mg contalgin depotbl. over what is called "small dose opiod"? Or - will I have problems getting that dosage down again?? I am very confused about it all!!

Gibble

[SueJohnson]

I already gave you advice of reducing pramipexole. Just switching over would be a horrible idea,

That is still a low dose.

yes on the iron

[SueJohnson]

My apologies - you need 3 of the ferrochel. Although as I mentioned before since it can interact with blood thinners you need to discuss the right balance with your doctor. At the very least take them a few hours apart.

[Gibbel in reply to SueJohnson]

Forgive me for having to take it in with big spoons But I just wanted to be absolutely sure because I have been given such different instructions. I follow your recommendation and thank you 100 times for your help. Also regarding dosage of iron !!

[Joolsg]

Your neurologist is incorrect. There are 2 methods of reducing Pramipexole. The fast route, for fit, otherwise healthy, younger patients, where you reduce over 3 weeks while increasing pregabalin. However, this is brutal for most and will involve severe RLS and little sleep.The slow route is recommended by most top RLS experts and involves a very slow reduction over at least 6 months, and starting pregabalin in the last month.

Contalgin isn't commonly known in UK and USA, but it seems to be morphine pills. That should help the severe withdrawals.

If you are struggling, slow down the withdrawal.

[Gibbel in reply to Joolsg]

I am so grateful for all the advice I get from you and from Sue ! The neurologist I saw had perhaps expected that I would come in leaning on a walker? Looked at me - quickly assessed that I did not look involved enough for either slow tapering or the help of opioids. "NO, no . you're not there at all !" Didn't ask about night sleep or symptoms at all. The only positive was that he prescribed the full panel of iron - blood tests. Never had it taken before - despite many years of treatment with pramipexole from a general practitioner.

Can see on medicine packaging that Contalgin is yes - MORPHIN.