RLS meds making me sick after weight loss surgery

[janw75]

Hello everyone! I have had RLS for about 8 years now. I have been on Requip for 8 years also, I started on 1mg, I am now on 2mg.

In September 2019 I had Gastric Bypass surgery. For about 2 weeks I was taking the Requip just fine, but then it started making me sick. Every night it now makes me extremely nauseous and groggy. My RLS symptoms usually start around 6 in the evening. I used to take the Requip around that time and then my legs would get better and I would go about my night. But now I can't take it until I know I'm going to be near my bed and bathroom.

My gastric bypass surgeon told me to take Tums before the Requip, but that didn't work. He says it's going to get better but I'm not sure.

Just wondering if anyone had this problem and what helped? Or any suggestions?

janw75

[tagalongbuddy]

I wonder if a lower dose of Requip would be better for you right now---->>>until you are feeling better since the bypass surgery

[badnights]

Maybe the nausea will get better but it's a terrible thing to have to wait out. I agree you should attempt to lower the dose, and my agreement is not just because of the nausea. Have you heard of augmentation?

Augmentation is a worsening of WED/RLS caused by the dopamine-type medications. It happens sooner or later in almost everyone who takes them. The dopamine-type meds include Sinemet/levo-carbidopa (which becomes dopamine in the body), and the dopamine agonists: Requip/ropinirole, Mirapex/pramipexole, and Neupro/rotigotine, all of which activate the dopamine receptors, fooling them into thinking dopamine is attached to them so those receptors go on to do the things they would do as if dopamine was attached. Too much info on the meds, probably! They all cause augmentation eventually. Probably it has something to do with the fact that we're not actually low on dopamine - most studies find plenty of dopamine in our brains, so it probably some critical task of cellular metabolism that dopamine is involved in is dysfunctional.

You have augmentation if, compared to before you started the Requip, your symptoms have increased in intensity, spread to your arms or other parts, now start 2-4 hr earlier in the day, and /or start sooner when you sit or lie down. If one or two of these is true, you probably have augmentation.

It's hard to compare to before meds when that was a long time ago, but try. (TRy before you take your meds and start feeling sick.) Many doctors assume augmentation is just natural progression of the disease, but it doesn't actually progress very fast in most people. whereas augmentation progresses alarmingly fast in some of us. People augmenting reach heights of agony never experienced by those who don't. Their doctors typically aren't aware that the worsening is iatrogenic (caused by the medication that is supposed to be helping), so the doctors just increase the dose, which increases the severity of the augmenation. It's a nasty cycle, and hard to bust out of because (1) you have to learn about augmentation, (2), you have to train your doctor or find a new one, and (3), you have to stop the dopamine-type medication that is causing you to augment, and that involves a further worsening of your disease.

I am not helping you with your nausea, other than try to lower the dose, which will help the nausea AND prepare you for quitting ropinirole.

Interestingly, originally just levodopa was given to people (for Parkinson's). It turns into dopamine in the brain and in the peripheral nervous system (the nerves outside the brain and spinal cord). However, dopamine acting on the peripheral nervous system caused nausea and vomiting. Also, it was needed in the brain, and did no good if it was used up in the periphery. So they added carbidopa to the formulation, which prevented its conversion to dopamine until it got into the brain, hence preventing the nausea and allowing more of the medication to work where it was needed.

I can't see how that relates to you, except to verify that there are dopamine receptors in the gut, and since we have plenty of dopamine, no wonder taking dopamine messes you up./
I'm having symptoms so I cant sit still

[janw75]

Thanks for the replies! I tried quitting the requip cold turkey and have had some very sleepless nights. But my doctor just prescribed mirapex for me yesterday. I took it and it did not make me sick at my stomach. It didn't make my legs completely quit hurting but did help enough that I got some sleep. Crossing my fingers this will work and not make things worse.
Thanks!

[Icantsleep]

Unless you've had a lengthy break between requip and mirapex, your augmentation will merely continue.

You shouldnt really ever go back to a Dopamine agonist after augmentation unless all other options have been exhausted

Mirapex may, for some unknown reason to me, may help very temporarily with nausea.
It is certainly not the long term answer if you are in fact augmenting

[Icantsleep]

I'm sorry I wasnt more helpful

I only told you what you cant do and didn't suggest options .
To be honest and clear, I'm certainly not a doctor .
I could suggest you try a low dose opiate in place of your dopamine agonist , but I shouldn't be the one to direct you .

I hope you can find some relief somehow

I truly hope you feel better