Dopamine Agonists and Augmentation

psychick · Post by **psychick** » Mon Oct 01, 2007 9:30 pm

So my doctor told me today that the dopamine agonists, like the ReQuip I was given to take...does not cause augmentation. Only the drugs that include leva dopa like Sinemet. Now I know I've read everywhere that dopamine agonists can and do cause augmentation...and I'm pretty sure that what's happening to me after the 4-6 hour half-life of Requip wears off is augmentation (drastically increased PLMS/RLS). But doc says it ain't so. He is taking me off the ReQuip...and then says, oh just quit your Lexapro. No suggested alternative to cope with my anxiety and dysthymia...until I pointed out that I might need something. I'm pretty much done with this doctor I think.

I'm going in to see my GP tomorrow for a recommendation to another dr and a second opinion.

Post by **ViewsAskew** » Mon Oct 01, 2007 10:07 pm

Being done with this doc sounds like a good idea. As you know, all DAs, not just Sinemet (carbo/levo combo) can cause augmentation. Albeit at lower rates, but still at least 30%. Over time, it maybe closer to 50-60%, but no one is keeping track.

Good luck with the doctor search. . .

gardengirl · Post by **gardengirl** » Thu Oct 04, 2007 5:19 am

I agree. It is better to find a doc that is interested in your concerns and observations. Changing from Lexapro (which is working for your anxiety, right?) may not improve your augmentation. Requip may not be the right drug for you. There are so many different classes of drugs to try. Don't get discouraged. Keep on posting. Look for a new doctor. This is an awesome sight for support and help!!

ctravel12 · Post by **ctravel12** » Thu Oct 04, 2007 11:20 pm

hi pyschick I know when I took requip last year I augmented real bad. I agree that you should find a new dr. Myself personally my legs were not that bad until I took requip. I know that others can take it and there is no problem and that is wonderful.

Please keep us posted on seeing a new dr and the second opinion.

psychick · Post by **psychick** » Tue Oct 09, 2007 11:35 am

Thanks for the support. I found a neurologist through my general practitioner and I saw him yesterday for the first time. He seems more interested in me and my case in general and I found that he actually seemed to listen to me.

He's put me on a trial of Mirapex, with admonitions to stop taking it if I experience the same symptoms as the ReQuip. I took it for the first time last night at the lowest dose (.125) and slept until about 5 hours after I took it, at which time I popped awake, blink blink, and found myself unable to get back to sleep. This is what happened on the ReQuip...but I'm going to give it a few more days and see if it improves or worsens. Like you all, he warned me that there are no pat answers and trial and error lies ahead. Sigh.

I'm really thankful that this group is here and that I don't feel alone with this.

chefws · Post by **chefws** » Tue Oct 09, 2007 12:51 pm

I would caution you with the Mirapex. I went the same route, and as the dose was upped, my insomnia got worse. I was upped to 1mg, which ended me up in the hospital. My body had enough, and the stress of not sleeping only a couple of hours for weeks took it's toll.
If you feel like it is causing insomnia, tell your neuro that it is not working for you. Insomnia is listed as one of the side effects.
Good luck!

gardengirl · Post by **gardengirl** » Tue Oct 09, 2007 4:51 pm

Hi again,
Have you gone to the RLS home page and read the 2005 Medical Bulletin under "Publications and brochures" under "Medical and Scientific info"? I found it really helpful....especially the section on treatment. Since I have the refractory kind of RLS I am on Neurontin and a small amount of Klonopin. My former doctor where I used to live had added a small amount of Gabitril to increase stage 3 and 4 sleep. That was even better. I guess what I am thinking is that there are many classes and combinations of drugs, since everyone is so different. I read(many times) the book"Sleep Thief" when it first came out. It was as if the book was written for me. I also would like to read "Restless Legs Syndrome: Coping with Your Sleepless Nights."
I am really glad you found a good doc who will listen. Do lots of reading and research. Congratulations for listening to yourself!! With Kind Regards, Gardengirl

psychick · Post by **psychick** » Thu Oct 11, 2007 1:59 pm

Thanks for your feedback Chefrs and garden girl.

Here's where I'm at:
So my new neurologist prescribed a new med for my sleep d/o on Monday...it's not ranking very high with me so far:
Monday night: 4 hours of sleep - RLS -Severe
Tuesday night: 8 hours of sleep - RLS - Mild
Wednesday night: 0 hours of sleep - RLS - who the f*** cares, I got No sleep last night!

Looking for feedback - should I continue till the upped dose and see if it improves, or just take it one or two more nights and quit if the insomnia continues? (keep in mind that I had to stop the ReQuip due to the insomnia side effects).

KBear · Post by **KBear** » Thu Oct 11, 2007 3:03 pm

What's the new med?

ctravel12 · Post by **ctravel12** » Thu Oct 11, 2007 4:47 pm

Hi Psychick I am so sorry for what you are going through but would ask the same question that Kathy is - what is the new med? I really hope that you find the right meds to help with the rls and sleep.

Keep us posted on how you are doing.

psychick · Post by **psychick** » Thu Oct 11, 2007 5:06 pm

sorry it's in the oct 9th post - Mirapex is the new med

KBear · Post by **KBear** » Thu Oct 11, 2007 6:26 pm

Sorry my bad based on your Oct 11th post I thought there was ANOTHER new med. :roll:

I am adding your experiences to my list of reasons why I don't want to go the route of Requip and Mirapex. It seems that your response to the Mirapex so far has been mixed. You may want to give it a couple more days.

jen13 · Post by **jen13** » Fri Oct 12, 2007 1:42 am

Hi Kathy - I argee with you. A little over a year ago my doc gave me Mirapex. It only made me feel a little "loopy" and my legs felt worse. I stopped taking it and won't try it again. Just recently I started taking Tramadol (generic for Ultram)...only when needed and Clonazepam. That's it for me.
Take Care,
Jen

Post by **ViewsAskew** » Fri Oct 12, 2007 6:06 am

If it were me. . .I'd have to call and say I wanted off the Mirapex. Sure, if it does resolve the RLS you can try and find something to counter the sleeplessness. . .but that's not what I'd want to do unless I didn't have alternatives.

Of course, that would mean that you'd have to enter that horrible period where you try one thing after another. That's not always fun, either.

Pairodocs · Post by **Pairodocs** » Sun Oct 14, 2007 4:57 pm

Hi Psychick,
I can sympathize with you, I had nearly an identical situation with the same side effects. I hope the new doctor works for you. My PC had such good luck with Requip in other patients, he didn't believe that I could possibly be augmenting. It took 4 months to convince him.

It's great that RLS Foundation has made educating doctors a high priority. Even if we have to try one drug after another to find our personal solution, it would be nice to not have the simultaneous stress and upheaval of changing doctors to find a "rls knowledgable" one as well.

My sister in law is a nurse specializing in diabetes and it was the same long trek for that disease, so many doctors 20 years ago didn't even ask about blood sugar or consider diabetes in relation to the patient's other problems. With the internet, more research and more patient advocacy, it shouldn't take that long for RLS.

Restless Legs Syndrome (RLS) Discussion Board

Dopamine Agonists and Augmentation

Dopamine Agonists and Augmentation

dopamine agonists and augmentation

dopamine Agonist and Augmentation

augmentation and DA's