Hello,
I am 34 and have had RLS for all of my life. It started as a little kid. I would awake to find my pillow and sheets in another zipcode from where I was sleeping.
It was not until after college that RLS started to effect my sleep. I tnow controls my whole life.
My symptoms start at about 3pm. I take 6 mg og Requip a day. 1 at 3pm, 1 at 6 or 7pm, and 4 at bedtime. If I do not take the meds before I start to feel the "fidgets" coming on, then it can take up to 3 hours before there is any effect by the Requip.
My question has always been to Doctors is when is it enough? Will I have to keep taking more and more medication? I started 2 years a go with 2 mg and now I am at 6mg.
Another note, my entire family has RLS. 4 of us are on medication for it!
Increasing Doses of Requip
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ViewsAskew
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Hey KMAC, my whole family has it too! Genetics are wonderful 
.
Here's my take - remember this is just one sleep-deprived person's view and may be twisted and distored by my current mental state. ALL of the dopamine agonists can cause rebound, augmentation and tolerance, albeit some less than others. You appear to be experiencing tolerance - your body got used to a dose so now you need more. You may also be experiencing augmentation - symptoms starting earlier in the day or are more severe than before.
Both of these are often 'solved' by the docs upping the dosage. Based on my experience and the experiences of others on these boards, I think this is the wrong approach. I think it makes things lots worse.
So, here's my take as of today and my current knowledge. First, less is more. Second, anyone who gets tolerance, augmentation, or rebound should immediately take a drug holiday. During that time, they should use something either an equivalent drug (Mirapex for Requip or Ultram for Percodan) or a completely different type. (I'm not sure which is better - many people have success the first way, but I haven't). The doctor needs to make sure dosing is correct because there is not a one to one correlation - for example, people need 2 to 4 times the amount of Requip as they do of Mirapex. After two weeks, they should go back to the original dose of the original drug. Drug holidays should occur every few months or at the first signs of tolerance, augmentation, or rebound. I'd also postulate that anyone that experiences significant augmentation or rebound within days or a few weeks of starting a DA should immediately stop it and try another or switch to a completely different class of drugs. I know many docs would not agree with me on that, though.
People who use drug holidsay usually have much greater success in keeping doses low and in keeping the meds effective.
In my humble opinion, I'd immediately contact my doctor if I were you. I'd tell him/her that I wanted to take a drug holiday and see what happens. I truly believe that you it will only continue to escalate until you have additional problems that may not be easily resolved.
I also believe in drug cocktails. Many of use take more than one thing rather than relying on large doses of one med. That's also something to consider.
Of course, it wouldn't be a post from me without my admonition to read as much as you can and to get as informed as you can. Doctors don't always like patients that try to participate in their own treatment, but I strongly believe you must. You are the only one who knows your body, who can advocate for you, who knows what quality of life you need and want. The only way you can do that is to get as educated as you can. There are some great links to wonderful info in this thread. Please consider starting your search there.
http://beta.restlesslegs.org/phpBB2/viewtopic.php?t=549
Welcome
Ann
.
Here's my take - remember this is just one sleep-deprived person's view and may be twisted and distored by my current mental state. ALL of the dopamine agonists can cause rebound, augmentation and tolerance, albeit some less than others. You appear to be experiencing tolerance - your body got used to a dose so now you need more. You may also be experiencing augmentation - symptoms starting earlier in the day or are more severe than before.
Both of these are often 'solved' by the docs upping the dosage. Based on my experience and the experiences of others on these boards, I think this is the wrong approach. I think it makes things lots worse.
So, here's my take as of today and my current knowledge. First, less is more. Second, anyone who gets tolerance, augmentation, or rebound should immediately take a drug holiday. During that time, they should use something either an equivalent drug (Mirapex for Requip or Ultram for Percodan) or a completely different type. (I'm not sure which is better - many people have success the first way, but I haven't). The doctor needs to make sure dosing is correct because there is not a one to one correlation - for example, people need 2 to 4 times the amount of Requip as they do of Mirapex. After two weeks, they should go back to the original dose of the original drug. Drug holidays should occur every few months or at the first signs of tolerance, augmentation, or rebound. I'd also postulate that anyone that experiences significant augmentation or rebound within days or a few weeks of starting a DA should immediately stop it and try another or switch to a completely different class of drugs. I know many docs would not agree with me on that, though.
People who use drug holidsay usually have much greater success in keeping doses low and in keeping the meds effective.
In my humble opinion, I'd immediately contact my doctor if I were you. I'd tell him/her that I wanted to take a drug holiday and see what happens. I truly believe that you it will only continue to escalate until you have additional problems that may not be easily resolved.
I also believe in drug cocktails. Many of use take more than one thing rather than relying on large doses of one med. That's also something to consider.
Of course, it wouldn't be a post from me without my admonition to read as much as you can and to get as informed as you can. Doctors don't always like patients that try to participate in their own treatment, but I strongly believe you must. You are the only one who knows your body, who can advocate for you, who knows what quality of life you need and want. The only way you can do that is to get as educated as you can. There are some great links to wonderful info in this thread. Please consider starting your search there.
http://beta.restlesslegs.org/phpBB2/viewtopic.php?t=549
Welcome
Ann
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KMAC
Hi Ann,
Thank you for your reply. I do not beleive that I can take a drug holiday. Last summer I went away on vacation an forgot my meds. After 48 hours of wanting to rip my skin off I went to the ER where I was given Valium and other sedation drugs and then my friend Requip.
If I were to take a holiday, I will need enough drugs to put down a cow or I might go nuts!
Thank you for your reply. I do not beleive that I can take a drug holiday. Last summer I went away on vacation an forgot my meds. After 48 hours of wanting to rip my skin off I went to the ER where I was given Valium and other sedation drugs and then my friend Requip.
If I were to take a holiday, I will need enough drugs to put down a cow or I might go nuts!