Gabapentin Caused Severe RLS Symptons

[issuesman50]

I have been on Requip for several years, but started having some augmentation. My DR recommended switching to Gabapentin. However, taking the gabapentin actually made my RLS worse and, in fact, I experienced the most severe symptoms ever when I started taking that drug. Have others had a similar bad experience with Gabapentin? How can the same drug that is apparently very effective in treating RLS in some have a completely opposite effect in others?

[ViewsAskew]

it may not be the gabapentin. When we augment, stopping the drug creates the WORST symptoms ever. I mean, the WORST! These can last for 2-4 weeks, sometimes longer.

Some of the doctors suggest that the only way to handle severe augmentation is through the use of an opioid. Methadone is very commonly used. After 2-4 weeks, you can back off the opioid and see if the symptoms have lessened. Then you can try the gabapentin.

Have you had your serum ferritin tested recently?

Welcome, by the way. Sorry you're having so many difficulties.

[badnights]

How sad but oh so typical that your doctor didn't know of the agony caused by withdrawal from Requip after augmenting on it. Gee. At least he knew about augmentation ... or or did you tell him about that?

[issuesman50]

Hi - thanks for the replies.

Actually, my doctor was going to gradually ease me off the Requip. I was still taking my Requip at the time I started the gamapentin, so I really think it was the gamapentin that caused my worsening symptoms. It was when I called and told him that the RLS syptoms were somewhat worse and he recommedned a higher dose of the gamapentin that the sysmptons really got bad (perhaps some strange interaction between the two?).

Also, I did get a ferritin test, and my level was at 19 - so we started on iron supplements. Things are much better now that I am off the gamapentin and back only on Requip.

[ViewsAskew]

Huh - could be! Nothing surprises me. We see so many people who have different reactions than are expected. Doctors don't usually - but all of us with weird reactions come here and post about them. I was seeing Dr Buchfuhrer, a well-known specialist - and he told me he'd never seen anyone react as I did to a few things - and he sees hundreds of people.

Sounds like it's a good thing to avoid that for the time being.

Now, slowly cutting down Requip without a replacement could cause increased symptoms. if it happens, do go back and tell your doctor. Ask for something like a moderate opioid or tramadol if it's not too bad, or a stronger opioid if it is really bad. Hopefully you won't need anything.

[badnights]

Well, maybe don';t ask, but tell him you heard it was generally needed and ask him if he's heard that too....
Dr. B has a paper in press, I can't wait til it's published so I can post it here and distribute it. - and in that paper he clearly recommends opioids to relieve symptoms during DA withdrawal.

[EeFall]

Hi - thanks for the replies.

Actually, my doctor was going to gradually ease me off the Requip. I was still taking my Requip at the time I started the gamapentin, so I really think it was the gamapentin that caused my worsening symptoms. It was when I called and told him that the RLS syptoms were somewhat worse and he recommedned a higher dose of the gamapentin that the sysmptons really got bad (perhaps some strange interaction between the two?).

Also, I did get a ferritin test, and my level was at 19 - so we started on iron supplements. Things are much better now that I am off the gamapentin and back only on Requip.

Gamapentin for me didn't really do much, I could take it like candy and nothing. Requip did the same thing to me that you are talking about Gamapentin doing to you. I took it and had the worse RLS symptoms ever! I paced back and forth all night while waving my arms I must have looked like an idiot, but it wasn't funny at the time. I have no idea why some people have opposite reactions but the doctor told me that happens and took me off of it immediately and the symptoms went away (I think at the time he put me on Methadone).

[rthom]

issuesman

Are things better now on the requip or are they fluctuating for you?

[Apollocruise]

I started on Gabapentin two weeks ago and have found that my daytime symptoms have escalated to the point where it is indistinguishable from the peak symptoms that kick in at 10:00 pm. Has anyone had a similar experience with Gabapentin?

[rthom]

Is this your first type of med you've tried for WED? How much are you on?

[ViewsAskew]

I started on Gabapentin two weeks ago and have found that my daytime symptoms have escalated to the point where it is indistinguishable from the peak symptoms that kick in at 10:00 pm. Has anyone had a similar experience with Gabapentin?

Are you using it to replace another drug, such as Requip, Neupro, or Mirapex?

I can't recall of hearing anything to suggest gabapentin would do that unless you were using it after stopping a dopamine agonsist. I'm not up-to-date on Dr Buchfuhrer's posts on the So Cal Support group site, though. Could be that this has indeed happened to others.

[badnights]

This is interesting that both you and issueman50 seem to have had increased symptoms from gabapentin. I haven't seen it mentioned anywhere before that gabapentin, or any of the anti-convulsants, cause augmentation, but I had (possibly) withdrawal from gabapentin, which is also unreported.

I was on a moderately high dose of gabapentin - 1200-1800mg/day - when I stopped abruptly (on the advice of a neurologist, who really hadn't a clue what was happening with me). At the same time I stopped 150mg/day of codeine - I was taking both and symptoms were still out of control. (The neuro switched me to 5 mg oxycodone, which he should have bloody known was vanishingly small compared to the dose of EITHER of the other drugs I was taking, never mind both! - but I digress).

I suffered the most awful withdrawal and lost a month of work (read: of life) waiting til the neuro could be contacted again (!!!!!!!!)(sorry, another digression. It's still hard for me to talk about this). I was convinced at the time that this was how bad my baseline symptoms were; then I became convinced it was gabapentin withdrawal, and I still think it probably was. I can 't be absolutely sure, though, because I stopped codeine at the same time, so it conceivably could have been opioid withdrawal. I did have that tiny dose of oxy for a while, and I had leftover codeine that I used at times, neither of which seemed to touch the symptoms at all; you'd think if it was opioid withdrawal they would have helped? Anyway - who knows. It was withdrawal of one or the other, because the intensity abated over 4 weeks.

So I am not surprised that gabapentin might cause augmentation in some people.

[ViewsAskew]

I have no proof of anything....but it's possible that Horizant made my symptoms worse. I stopped it two days ago and as of today, I feel back to normal. I had constant agitated feelings in my limbs - arms and legs - all day with the Horizant. Not enough to make me need to get up, but I was constantly winding my feet and shaking out my arms. It also could have been hormones or a flare - it's never completely contstant. I won't likely know. But, it does make be a bit suspect.

Dr B said he has had some patients who did not respond to 1200 mg of Horizant, but did to 1800 mg. I suppose if I went up to this dose, I'd know for sure. I've asked not to for the moment because I can't function during the day with that much sleepiness.

[Polar Bear]

Ann - I'm disappointed for you that Horizant isn't working for you on the current dosage. Another learning step in the journey of WED.

[ViewsAskew]

I wasn't all that hopeful since gabapentin and Lyrica did not help me. But I don't remember either of them making it worse. And, I'm not sure this did, either, just that it happened when taking it. I might try it again when I don't have 40 work weeks!