Stay on Current Therapies or No?

Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.
MJDK
Posts: 4
Joined: Sun Feb 24, 2019 8:33 pm

Stay on Current Therapies or No?

Postby MJDK » Sun Feb 24, 2019 9:49 pm

Almost a year ago I was at my wit's end, trying to find medication(s) that would stop my RLS and allow me to sleep. I found the answer on this discussion board, and it has worked very well for me in stopping the RLS, but I continue to have difficultly sleeping. I had some emotional traumas early last year - my Mom passed, and I had emergency small bowel obstruction surgery less than 2 months later. In the process of coming to grip with the anxiety and depression, my doctor prescribed xanax and ambien to help with sleep issues and anxiety. I also started taking .25 mg of Requip along with 2.5 mg of hydrocodone together about 6 pm, before the RLS sets in. This combo - of .25 requip and 2.5 mg of hydrocodone daily, seems to completely eliminate the RLS all night long. So, I've been taking those two drugs about 6 pm, and before going to bed about 10 or 11, I take either 5 mg of Ambien or .25 or .5 mg of xanax.

Usually the .5 mg of xanax keeps me asleep all night, but the Ambien never does. So, when I was in a "don't care" frame of mind, I would just take whatever it took to get rid of the RLS AND sleep all night.

Recently - I'd say for the past several months - my medication schedule looks something like this:

6 PM - requip and hydrocodone
10 PM - xanax or ambien
2 or 3 PM - another ambien or xanax

I am becoming increasingly concerned about dependency. Yesterday I decided to try to wean myself off the hydrocodone, xanax, and ambien. It did not go well.

at 6 PM I took the regular dose of requip (.25 mg) and 1.6 mg of hydrocodone
I took nothing at bedtime and stayed awake until midnight, when I finally took 3.75 mg of ambien. Laid awake until 2 AM when RLS flared up - - - - with a vengeance, so I took 5 mg of hydrocodone and finally fell to sleep about 3 AM.

I've read extensively about Requip, Ambien, Xanax and Hydrocodone dependency. I know, compared to many on the discussion boards, that my doses are minimal and seeming to control my symptoms pretty well, but I am still concerned about taking these drugs every night for months, indeed, nearly a year now.

My question is - - - - if these 4 drugs are working ---- should I just keep on until they aren't working? I don't know. I am concerned.

Thank you very much for your responses.

stjohnh
Posts: 911
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Stay on Current Therapies or No?

Postby stjohnh » Sun Feb 24, 2019 11:09 pm

MJDK, Welcome to the RLS community. You will find many people with problems just like yours, and no lack of empathy from people who have "been there, done that" when it comes to RLS problems and treatments.

Short answer: stay on current meds.

If at some time in the future your RLS starts causing more problems it is important that you NOT increase the Requip. Of the meds you take, the Requip is most likely to cause problems (augmentation) in the future. Keeping the dose low, not increasing it, and keeping your iron levels up (ferritin at least 75) are the best ways of avoiding this complication.

If you just want to improve the sleeping problem, your best bet is to change the xanax/ambien to gabapentin and/or medical marijuana. Both help folks with RLS sleep better, and usually work better than the standard sleeping/anxiety pills.

If you truly want off the meds, the likely reasonable alternative is IV Iron infusions. RLS is caused by BID (Brain Iron Deficiency). The meds you and most people take address the effects of RLS (jumpy legs and insomnia), they don't address the underlying problem (BID). Iron treatment is the only one that does. Unfortunately, most people cannot get their brain iron up enough with oral iron, they will need IV Iron to overcome the abnormal blood iron -> brain iron transport present in people with RLS.
Blessings,
Holland

MJDK
Posts: 4
Joined: Sun Feb 24, 2019 8:33 pm

Re: Stay on Current Therapies or No?

Postby MJDK » Mon Feb 25, 2019 1:15 am

Thank you for your recommendation. I also forgot to mention that I suffer from severe foot and leg cramps, but 400 mg of mg glycinate after dinner seems to help. If taking gabapentin to help sleep, would I also take the lowest possible dose and only at night?

stjohnh
Posts: 911
Joined: Sun Feb 14, 2016 3:13 pm
Location: Palo Alto, California

Re: Stay on Current Therapies or No?

Postby stjohnh » Mon Feb 25, 2019 1:19 am

Gabapentin doesn't have a really long duration of action. You may need to take a dose before bed and another smaller dose at 2-3AM. Lots of people feel zonked out the next day on gabapentin, and taking 2 smaller doses at night is better than one larger dose at bedtime. And yes, all medicines should be taken at the lowest possible doses.

Gabapentin dosing is somewhat different from many medicines in that the effective dose range is VERY high, some people needing low doses to have any effect, others needing MUCH more to have any effect at all. Discuss this with your doctor, you will need a prescription.
Blessings,
Holland


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