Introducing myself

Whether new to RLS/WED or new to the site, we welcome you and invite you to share your history and experiences with RLS/WED, introduce yourself, and ask questions. Successful treatment starts with a solid understanding of this disease.
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Joined: Thu Oct 28, 2004 6:37 am
Location: Los Angeles

Re: Introducing myself

Postby ViewsAskew » Thu Nov 29, 2018 8:33 am

Excellent to hear.

My experience was similar to Steve's. I augmented on one, also on the other.

I cannot high is your serum ferritin? I found that key for me to not augment as quickly, allowing me to use pramipexole for longer times before I had to stop it.
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

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Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

Re: Introducing myself

Postby badnights » Sun Dec 02, 2018 4:03 am

Based on my imperfect understanding of a subject that even researchers in the field don't understand (so for whatever it's worth!) I tend to think a long-acting DA just masks whatever dysfunction the DA is causing, for longer than a short-acting DA would. I don't know if my nebulous negativity is useful to you in making this choice; the information you need to make it just doesn't exist.
Beth - Wishing you a restful sleep tonight
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

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Location: Palo Alto, California

Re: Introducing myself

Postby stjohnh » Sun Dec 02, 2018 2:51 pm

Well, here's my theory of DA's and augmentation: As time goes on at a particular dose of a DA, the dopamine receptors get less and less responsive to the DA, requiring higher doses to achieve the same symptom control (the dose increase requirement is a well known aspect of DA treatment of RLS). At some point the DA receptors become completely saturated, making increasing doses ineffective and causing severe side effects (augmentation). Keeping the DA dose low, such that the patient has a spell each day of mild RLS symptoms, helps to keep the receptors from losing too much sensitivity. Short acting DAs cause a spike in the blood level with each dose, that spike is what saturates the receptors, leading to sensitivity loss and ultimately augmentation. Long acting DAs have less of that problem because the med is released slowly into the blood stream, avoiding the high blood level spikes that short acting DAs have, leading to the observation that long acting DAs have fewer problems with augmentation, but the augmentation risk is still there.

It is well known that saturation of some brain receptors causes VERY serious side effects in some cases- think the deaths and brain damage that occurred in France a couple of years ago with an accidental overdose during the study of an experimental pain medication.

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