Augmentation with pramipexole now on ropinirole

[Julieod]

I was on the maximum dose of pramipexole and had augmentation so my doctor started me on the lowest dose of ropinirole. I have had 5 nights of agony almost no sleep I have increased the dose from 0,25mg to 1mg but still hardly sleeping. I cant get to see the doctor for 6 weeks and am going mad any suggestions? I live in Australia and mentioned the fact that low dose opioids are tried in US but he says no to that

[Polar Bear]

The DAs such as pramipexole and ropinerole are no longer considered the first line for treatment. Neither is changing from P to R a great idea. At 1mg of R you are on what the experts would consider the max daily dose. You need to come off the R, weaning very slowly, and will need an alternative medication. Gabapentin or Pregabalin may help but is unlikely to be sufficient to cover the worsened symptoms of weaning off the R. This is when a sympathetic doctor who will prescribe a short course of an opioid is a blessing.

I wonder how experienced your doctor is in the treatment of rls.
You will definitely need help to wean off the R.
Can you get an emergency appointment.

Take a look at the Mayo Clinic Algorithm regarding treatment, show this to your doctor. Highlight the relevant parts.
In the meantime have you tried very hot or icy cold water on your legs. I find that 15/20 minutes of putting my lower legs in a bucket of icy water will calm them for a time.
Have you had your ferritin serum checked. This needs to be up at 100 regardless of 20 being considered as normal.

[Granny1204]

Hello, I read with great interest your post about augmentation using pramipexole. I am in the same situation, also living in Australia with doctors very uncomfortable using any opiod treatment. Like you, I am going crazy with the effects, and feel like jumping off a bridge because It is soooo uncomfortable and unbearable. I would love to hear if there is a hospital that can help with the detoxing of the pramipexole out of my system. And what would be a long term replacement once I removed the pramipexole from my system. This drug is causing me to have constant day time sleepiness whereby I can't drive for more than 30 minutes without falling asleep, so I. hardly drive. The sleepiness occurs constantly and is very embarrassing if I am in a discussion with someone and just nod off. Also light headiness and dizziness. So obviously I need to find a better solution to my situation than this drug. I would be so grateful to hear from others experiencing this. Kindly, Michelle

[RestlessNan]

I am not finding anY further posts from you. How are you now 3 months later