wabbit wrote:Ann,
I am currently taking Mirapex. In August it will be a year and I am aware of the possibility of augumentation and heart failure. What names of opioids work for use for WED. I would like to have an idea of what mediciations work for WED in case I have to eventually change. So far Mirapex is working well. Whatever I take will be up to my neurologist due to the epilepsy.
It's really tough for many of us. The dopamine agonists fail in enough cases that we have to have alternatives. In Polar Bear's signature, there is a link to a document that has a treatment algorithm and shows the progression to try.
The best book you can buy - that details ALL meds used - is The Clinical Management of Restless Legs Syndrome, by Hening, Buchfuhrer (the Dr B we mention) and Lee. It's being rewritten, but not sure when it's due to come out. Amazon usually has used copies at a reasonable price.
In it, they outline all opioids, from codeine through morphine. They rank them - low, moderate and high potency. You use different ones based on the reason you use them. To treat augmentation, you usually need a high potency, such as methadone. To treat regular moderate symptoms, you might be able to use a moderate opioid, such as tramadol or hydrocodone. For severe symptoms, you are almost always looking at the high potency ones. Most doctors that will use them have favorites. A lot of doctors like methadone because it is long lasting, well-studied, safe for pregnancy, and so on.
These are not without concerns! If you have other breathing disorders, they may be contraindicated. They can cause dependence (usually do). And, in rare cases, they can cause addiction. We've heard of very few addiction cases, thankfully. I got dependent on tramadol VERY quickly, but took methadone for a few years and stopped it cold turkey, so you never know what will happen when you stop. They can cause lethargy and daytime fatigue. For some of us, they energize us instead of putting us to sleep (boy, I don't like that!).