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Opioids as treatment

Posted: Fri Jun 11, 2004 4:29 pm
by tashton
I have taken lorazepam which is a benzodiazapine for about a year and the dosage quit working. I have tried Mirapex and Sinemet but the dopamine agonsts make me to sick to tolerate. What about opioids for treating RLS? Anybody out there that have tried them with good results?

Welcome, tashton!

Posted: Tue Jun 15, 2004 8:12 pm
by jumpyowl
Good question! I am copying this from my own post to Ruby, as it is relevant to your question:

There are four primary approaches in medicating RLS:

1. Sedative/hypnotic medications benxodiazepines and non benzodiazepines

2. Dopamine agonists

3. Anticonvulsives

4. Analgesics (opioids)


I have read and seen many cases where the anti-Parkinsons and antiepileptic medications not only did not help but actually made things worse. And these were the very people who eventually received help from opioids. Just like in your case tashton.

I myself get relief with hydrocodone 2x (10mg/235 mg) once or twice a day and an occasional klonopin/clonazepam at night.

I have also used Neurontin and Topamax both anticonvulsants. They, especially the neurontin resulted in augmentation.

Flurazepam or Lorazepam from group #1 I also found helpful. (My wife likes Lorazepam but does not like Flurazepam.)

I hesitate to go too strong on this because I need more experience on my own.

As for myself, I would like to try Mirapex from #2, especially since anticonvulsants do not help consistently. I would not be surprised that if it did not help me. I would really like to take it for diagnostic purposes. This RLS is a thousand handled devil with one or at most two faces. It is also interactive depending on which medication you take. :roll:

The trouble with #2 and #3 is of course that they were developed for different neurogenic diseases. They are powerful drugs and RLS is clearly an off-label use (suggested on the basis of trial and error). 8)

Tashton, how much lorazepam are you taking? Do you have pain with your RLS? I used it as a sleep aid off and on for twenty years from 0.5 mg once at night and up to 4-6 mg also once only at night. Usually took several days to wean off of it. The withdrawal effect was similar to perasthesia. :roll: I do not take it any more since I was diagnosed with RLS/PLMD.

Posted: Wed Aug 11, 2004 10:06 pm
by tashton
Sorry I am slow in responding. I take 2 mg. of Lorazepam nightly. Just returned from the doctor and I am going to try alternating that every other day with 100 mg Ultram. Hope it works and keeps the tolerance level so that the dosage will continue to work. Doctor thinks it could do the trick if the Ultram will control the RLS.