Reducing Pregabalin and Methadone dosage

[bwendt]

Hi,

I have learned so much and found solace here when I was hurting and felt alone. Thank you to everyone for their support.

My current predicament:

Took DA for dozen or so years, suffered thru DA augmentation, gabapentin gave me brain fog and depression and finally DR B. helped me find a combination of pregabalin and methadone that worked pretty good. Not 100% but at this point I am not expecting perfection.

Currently I take 400 mg of pregabalin and 12.5 mg of methadone. I deal with the side effects (some dizziness, loss of balance, dry mouth, etc) pretty well but they are challenging.

One month ago for another medical issue I had to go on a strict diet. No refined sugar, NO CAFFEINE at all, no red meat, no OTC drugs....yes a mainly "RLS trigger free diet". (I had done this before for RLS but slipped over the years as my depression flared up.)

Well currently (28 days and running) my RLS symptoms have reduced 80 -90 %! Yes I can sleep from 11:00 to 6:00 getting up once for bathroom and a walk about. Along with very few RLS symptoms during the day, my symptoms have significantly improved on the same meds but the new diet.

So....should I stay the course on the meds or could/should I reduce the meds, stay on the diet and see if I can have the same quality of life. I do hate all the meds. Of course I plan to stay on the diet. I eat almost the same foods everyday and will continue to until at least I figure out what is going on. I keep a detailed log so should notice any changes.

Has anyone reduced their meds before? How did it go? How soon did you notice your symptoms flare back up? How did you decide what med and what dosage to reduce first? How many days did you give for the meds to find their new equilibrium?

Appreciate any help. bill

[ViewsAskew]

I am in the process of reducing right now. I had an iron infusion - it usually takes 8-10 weeks at minimum for me to see changes, but usually around 6 weeks I test it by reducing methadone and adding pramipexole. I reduce 2.5 mg per 10 days. With the long half life, it takes awhile to notice you reduced it and to tell if you can handle the reduction.

If at any point the symptoms roar back, I know I went too far, too fast. That would be last night, lol. I spent most of the night pacing, wandering, stretching, and REALLY wishing I could get back to sleep. About the time I did (8 AM), the gardener crew spent a couple hours close by and I gave up.

I was fine with the first 2.5 reduction and I know it's early, so I'll go back to that dose for about two weeks, then test again.

Per which to reduce, I always reduce the opioid first because it's the hardest to get and the one the medical professionals worry about the most. Dr. B is always very happy if I can get it to the 10 mg range - between tolerance and lower ferritin, I can get up to 30 to 35 mg. Adding pramipexole and increasing the ferritin (safe for me after an infusion) allows me to reduce it dramatically.

For me, changing food has never helped - am very envious of that. So, not sure if/when you'll notice any increase in symptoms. Beth has some experience with that - she will pop in to share her experience, I imagine.

[bwendt]

Ann,
Thank you for your reply. In previous attempts to clean up my diet I never saw the dramatic reduction in my symptoms I saw this time. RLS - always changing on me. I will edit this with my updates as I try to reduce my methadone.

Thank you again....bill

[ViewsAskew]

Ann,
Thank you for your reply. In previous attempts to clean up my diet I never saw the dramatic reduction in my symptoms I saw this time. RLS - always changing on me. I will edit this with my updates as I try to reduce my methadone.

Thank you again....bill

Hmmm - that may be the impetus I need to try again. I've done SO many elimination diets (for other reasons) and they have never impacted my movement issues one bit. But, hearing that they hadn't for you before, either, could be that I just haven't hit the right combo. I'll go get a cookie and think it over (JK!!!).