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New to group old acquaintance of RLS

Posted: Wed May 15, 2019 9:20 pm
by graycedee
I am a 65 y.o. Woman. I have had RLS for about 20 years. I was well controlled on Mirapex for many years and last fall I went through the absolute torture of augmentation and DA withdrawal . I was very stable on 200-300mg of gaba pentin and tramadol twice daily. In the past 2 weeks I have increased my tramadol dose with RLS breakthroughs. I was placed on 2.5 mg of methadone and there,is no other way to put it- slept horribly and feel like sh**. Also had RLS around 5 am to boot. I finally took a tramadol and some gaba pentin not caring wether I died. Any suggestions? :?:

Re: New to group old acquaintance of RLS

Posted: Sat May 18, 2019 4:38 am
by badnights
Hi graycedee
So sorry to hear you're having these all-too-common problems. Methadone can have an alerting effect (all teh opioids can) on people with WED/RLS. You might try taking it earlier in the day, so that the alerting effect has worn off by bedtime. It has a long half-life so the symptom-relieving effect would still be active.

But it could also be that something in your life has changed recently to cause the increase in symptoms.The first thing that comes to mind is the tramadol - it's uncommon but not unheard of to augment on it. Maybe the increase in symptoms was augmentation? not as likely if it was sudden as opposed to gradual, I guess. I'm not sure if withdrawal from augmented tramadol is similar to DA withdrawal, - someone else here might know??
but if it is, you would have to wait it out, as you know from your previous experiences, and not use tramdol at all meantime.

There are other things than tramadol augmentation, though. Did you change your diet just before the worsened symptoms started? Did you start or stop taking a seemingly unrelated medication or supplement? Do you drink coffee later in the day than usual? ( you might try quitting coffee completely if you do drink it).

You might also want to try taking iron supplements, if you're not in danger of iron overload. If your ferritin level is below 100, you might want to try to get it higher by taking oral iron wiht vitamin C, preferably on an empty stomach.

I hope one of these ideas helps!

Re: New to group old acquaintance of RLS

Posted: Sat May 18, 2019 6:46 pm
by ViewsAskew
Beth's post was excellent!

Re: New to group old acquaintance of RLS

Posted: Tue May 21, 2019 2:07 am
by graycedee
Thank you for your kind reply. I ended up taking 2 tramadol during the day six hours apart and the methadone at night. That worked beautifully. Tomorrow I will start on 2.5. methadone in the am and pm and drop the tramadol at the suggestion of my provider. I do believe that I was starting to augment on the tramadol but 2.5mg of methadone was not enough.

Re: New to group old acquaintance of RLS

Posted: Tue May 21, 2019 5:32 am
by badnights
Nice! I hope it works. Feels great to get a good night's sleep after so many bad ones, doesn't it? :)