Pramipexole to pregabalin

[dlourens]

I was on pramipexole for several years, most recently at 0.5mg. Because of augmentation, over the past two weeks, I've weaned off the pramipexole (completely off for two days) and am now taking 225mg of pregabalin in the evening. I did get an iron test that showed ferritin well over 100 ng/mL, so the doctor did not recommend any additional iron (rightfully so I guess).

I continue to have very bad symptoms, getting maybe 4 hours of sleep (sitting in the hot tub has provided some relief). My doctor would not prescribe any opioids for me at this point.

For anyone who has followed a similar path as me, when should I expect to see an improvement? At this point, symptoms are about as bad as they have ever been, and I don't know whether the pregabalin is just ineffective, or if I'm still experiencing withdrawal symptoms from the pramipexole. I know that we're all different, but is there a general timeline for what I'm doing so I know what to expect? I want to give the pregabalin a fair shake, but I don't know how long I can cope with these very bad symptoms. Thanks so much for your help.

[Rustsmith]

I was fortunate to be able to switch directly from 0.75mg pramipexole to methadone, but I can report that the normal timeline for pramipepxole withdrawal is that it takes six to seven days before you start your journey back to whatever is normal for you and you won't reach that point for about 3 or 4 weeks. Unfortunately, pregabalin isn't strong enough to cover the early symptoms of pramipexole withdrawal, so you cannot conclude anything about whether it is helping or not for at least another week. Hopefully it will help you get some sleep next week.

Now for the bad news, the worst part of the pramipexole withdrawal timeline is generally around day 4. It would be a good idea of give any remaining pills that you have to someone to hide from you because it will become tough enough that you will want to take one just to get some relief. But doing so just puts you back to day 1. If you have an opioid pill left from a past surgery, save it for then to try to get a little bit of relief and sleep. If not, soaking in a tub of very hot water will bring a bit of relief, but you will need to do that several times a night. And be careful while walking around on days 4 to 6, because you will be susceptible to falling due to microsleeps. Many of us have awakened as we were about half way to the floor.

[sarahpatto]

I was taking 75 mg of pregabalin for about 3 months. Maybe this is not long enough to give it a fair shake but I noticed no abatement of my RLS symptoms and was reluctant to keep taking it. I tapered off and stopped it and sypmtoms are about the same. During this time I also had an iron infusion from a friendly if not terribly knowledgable hematologist. I was hopeful that it would make an instant difference but it has not. Still having bad nights about 4x per week.