Klonopin
Can't wait to sleep!-
Walking After Midnight
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ViewsAskew
- Moderator
- Posts: 16583
- Joined: Thu Oct 28, 2004 6:37 am
- Location: Los Angeles
The algorithm definitely looks complicated. But, it does makes sense after you get the hang of it. I'll give you the simplified formula as I understand it.
For all RLS, start here with lifestyle stuff:
cut out caffeine and alcohol and nicotine; see if any foods are a trigger and stop consuming them; add b-complex, calcium, magnesium to diet; get causes of secondary RLS under better control if possible; increase ferritin if under 50; find the "right" amount of exercise (just enough will reduce it, too much will increase it, none may increase it); keep your skin hydrated (dry skin is itchy and can set off an RLS attack); wear clothes that don't bind or cause RLS; discontinue drugs that may be worsening RLS (antidepressants, antihistamines, etc,); keep your mind busy during attacks; use hot/cold baths, stretching, etc. to deal with attacks; keep good sleep hygiene (note: I added a few things to their list)
If these don't do enough, read the following questions. If you answer no to the first question, continue to the next question. When you can answer yes to a question, then try a listed solution.
Does your RLS interfere with your sleep, work, and/or quality of life less than five days a week? If so, then try:
-Sinemet (doesn't usually augment if not taken daily, and works fast)
-a low-potency opioid or tramadol
-a short-acting agent such as triazolam, zolpiem, zaleplon for sleep-onset insomnia caused by RLS
-an intermediate-acting agent, such as temazepam for RLS that awakens the patient later in the night
Daily RLS: Does your RLS interfere with your life daily? If so, try:
-Mirapex or Requip (DA - dopamine agonist)
-Neurontin, especially if your RLS has a pain component
-low-potency opioids or tramadol
Do you have augmentation that was not controlled with an earlier dose of the drug, or that has required yet another earlier dose? If so, then:
-if you have only tried one DA, try another
-if you had augmentation on two DAs, do not try another and choose either an opioid or gabapentin
Have you tried one of the items from the daily RLS list but it never worked or the side effects were intolerable? If so, then:
-if you have only tried gabapentin or a low-does opioid, try a DA
-if you have tried only one DA, try another
Have you tried at least one DA and your RLS is either worsened or the medication is not working as well as it used to? If so, then:
-add a second class of medication such as gabepentin or tramadol
-try a different DA if you have only tried one
-stop the DA for a couple of weeks and then try it again at the original dose (note: this is not in the algorithm, however many people have great results and several RLS researchers recommend it)
-switch to a high-potency opioid or tramadol
OK - how was that, Randy??? I hope it made sense. There are some more points, but this is really most of what it says.
Ann
For all RLS, start here with lifestyle stuff:
cut out caffeine and alcohol and nicotine; see if any foods are a trigger and stop consuming them; add b-complex, calcium, magnesium to diet; get causes of secondary RLS under better control if possible; increase ferritin if under 50; find the "right" amount of exercise (just enough will reduce it, too much will increase it, none may increase it); keep your skin hydrated (dry skin is itchy and can set off an RLS attack); wear clothes that don't bind or cause RLS; discontinue drugs that may be worsening RLS (antidepressants, antihistamines, etc,); keep your mind busy during attacks; use hot/cold baths, stretching, etc. to deal with attacks; keep good sleep hygiene (note: I added a few things to their list)
If these don't do enough, read the following questions. If you answer no to the first question, continue to the next question. When you can answer yes to a question, then try a listed solution.
Does your RLS interfere with your sleep, work, and/or quality of life less than five days a week? If so, then try:
-Sinemet (doesn't usually augment if not taken daily, and works fast)
-a low-potency opioid or tramadol
-a short-acting agent such as triazolam, zolpiem, zaleplon for sleep-onset insomnia caused by RLS
-an intermediate-acting agent, such as temazepam for RLS that awakens the patient later in the night
Daily RLS: Does your RLS interfere with your life daily? If so, try:
-Mirapex or Requip (DA - dopamine agonist)
-Neurontin, especially if your RLS has a pain component
-low-potency opioids or tramadol
Do you have augmentation that was not controlled with an earlier dose of the drug, or that has required yet another earlier dose? If so, then:
-if you have only tried one DA, try another
-if you had augmentation on two DAs, do not try another and choose either an opioid or gabapentin
Have you tried one of the items from the daily RLS list but it never worked or the side effects were intolerable? If so, then:
-if you have only tried gabapentin or a low-does opioid, try a DA
-if you have tried only one DA, try another
Have you tried at least one DA and your RLS is either worsened or the medication is not working as well as it used to? If so, then:
-add a second class of medication such as gabepentin or tramadol
-try a different DA if you have only tried one
-stop the DA for a couple of weeks and then try it again at the original dose (note: this is not in the algorithm, however many people have great results and several RLS researchers recommend it)
-switch to a high-potency opioid or tramadol
OK - how was that, Randy??? I hope it made sense. There are some more points, but this is really most of what it says.
Ann
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
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ViewsAskew
- Moderator
- Posts: 16583
- Joined: Thu Oct 28, 2004 6:37 am
- Location: Los Angeles
Em, there is a good link somewhere on here to a message board that deals entirely with benzo addiction. They make our board look tiny, indeed. I used it when I needed to stop and they were quite helpful. They really advocate a method, called the Tashton method (in fact, search on Yahoo or Google for that, and you'll find the board). I asked your doctor about it and he didn't think it had merit. But, the people on the board really think it works. I don't know if mine would have gone easier or faster if I had used it. What I did worked OK.
You may not have any problems; as I understand it from the literature on the benzo board, about 50% of people do not. The other 50? It can be hard. I was sick from day 1 - well, not quite - it started on day 3 and got worse. It really was pretty hard, but I seem sensitive to this class of drugs to begin with.
Start by decreasing it with whatever the doctor says. If you notice you have any effects, just lower the amount you are decreasing it by. I decreased by tenths. Josh will know more, but a pharmacy can make a suspension liquid for you if needed - I just don't know how you go about it. There are also klonopin wafers you can get your script in - these are much easier to cut up into many pieces.
You may not have any problems; as I understand it from the literature on the benzo board, about 50% of people do not. The other 50? It can be hard. I was sick from day 1 - well, not quite - it started on day 3 and got worse. It really was pretty hard, but I seem sensitive to this class of drugs to begin with.
Start by decreasing it with whatever the doctor says. If you notice you have any effects, just lower the amount you are decreasing it by. I decreased by tenths. Josh will know more, but a pharmacy can make a suspension liquid for you if needed - I just don't know how you go about it. There are also klonopin wafers you can get your script in - these are much easier to cut up into many pieces.
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.