Requip and Legs

[micked]

Has anyone ever experienced augmentation from Requip? At first, I had no restless legs, but I was wide awake at night. I added Klonopin to the Requip and it seemed as it worked. I have started experience my leg problems late afternoon and earlier in the evening. The last 2 nights have also been very bad. I can only relate this to the Requip, so am wondering if anyone has had adverse effects when using Requip.

[SquirmingSusan]

Yes, many of us have had augmentation from Requip. You can do a search of the forum - there is a lot that has been written.

My advice is to call your doctor and get off the Requip as soon as possible. You may need opiods to get you through the first few weeks. It can be rough.

Susan

[Polar Bear]

I have been taking requip for about 5 months now. I am definitely getting better sleep at night, by taking 1mg around 7 pm and then 1 mg at about 10 pm. (I do have valium as a back-up but rarely use it)

However I do get antzy early afternoon, tho usually only in work at my desk. this happened before I started requip anyway.

Watching tv in the evening also isn't great. But because I get sort of decent sleep at night albeit I wake up several times but can get back to sleep again I don't want to not have the requip. Also the jumpy legs in the evening can be handled better than when in bed trying to sleep.

Does anyone think this is augmentation, I doubt it cos I did have it in the afternoons before requip. Tho it is perhaps a little 'more' now.

Or maybe my prescribed dose of 2mg requip could be taken at say, 1mg at 1pm and then again 1 mg at 9 pm. Or would this be too far apart for the 2nd dose to be active before the first dose is wearing off.

Thanks for your thoughts.

Betty

[micked]

I am going to get off the Requip and go back to just Klonopin. After reading replies, it must be the Requip. Thanks for answering. It has been hours everynight the last week, like before I ever started with Klonopin

[jbcole]

I have been taking Requip for over 5 years now & I completely understand where you are coming from. I started on just a small dose of Requip before bed each nite & now am taking Requip & Klonopin in the AM, again at Noon and then at bed.

[micked]

So if you get off the Requip, what do you take next? i just layed down at 4Pm and my legs went nutz. Can't stand this

[badnights]

Don't tell me you've been augmenting since 2007?

What have you tried so far, besides Requip? There's another drug in the same class as Requip, called pramipxole/Mirapex, that your doctor might suggest you try next. The only trick there, that you HAVE to be aware of, is that you have to get all the Requip out of your body before you start the Mirapex. Your doctor might not know this. Here's why: there's a withdrawal associated with stopping Requip, and it consists of worsened symptoms for a few days to a few weeks. If you start taking Mirapex while your symptoms are still worsened by withdrawal, you'll end up on a higher dose than you need. That will shorten the time before you augment on Mirapex (because yes, you can augment on Mirapex too, but you won't necessarily). So you need something to get you through the withdrawal, and that should be two weeks or so of a relatively potent opioid like oxycodone. THEN start taking the Mirapex, increasing the dose if you need to but not more than your doctor allows, until it works.

Before you do any of that, get a blood ferritin test. It's not proven as to cause versus effect, but there's a proven association between low ferritin levels and risk of augmentation, also severity of RLS/WED symptoms. Low ferritin for WED patients is <100 ng/mL, not the 20 ng which is sufficient for non-RLS patients.

So help yourself, bring some info to your doctor, bring info on
augmentation
withdrawal from dopamine agonists for RLS/WED patients (treat with opioid)
ferritin levels in RLS/WED.

A lot of that info is in this pamphlet http://www.rls.org/Document.Doc?&id=2112, you could just print it and highlight the relevant parts and take it to your doctor, and ask him what he thinks. As for the withdrawal, print this for your doctor, it's a quote from a book by a couple of the physicians who contributed to the Mayo algorithm and the RLSF bulletin for treating RLS:

"Severe augmentation invariably causes such distress that people are desperate for relief. Increasing medications further provides little relief and may ultimately intensify symptoms. Stopping the drug will eventually relieve the augmentation, but this may take some time - leaving the patient in great distress. The time it takes for the effects of augmentation to wear off can be quite variable, lasting several days to weeks. Opiods can be used short term to control the intense RLS symptoms in these cases. There are other options for therapy once the effects of augmentation have resolved. Another dopamine agonist may not reproduce augmentation ....."
From: Buchfuhrer, Hening, and Kushida, 2007. Restless Legs Syndrome. American Academy of Neurology Press, Quality of Life Guides, Demos Medical Publishing, New York, p. 106.