newbie on 3 rd night of Requip

[Polar Bear]

You took your .25mg requip and slept well - for several nights
Last night you did not take the requip and you did not sleep.
I would reckon there was no sleep because of no requip.

I used a drug interaction site and checked with regard to requip amd imitrex and it came up with 'no result' This usually means there is no negative interaction between the two medications and you 'should' be able to use them together.

See what happens tonight when you take your usual .25mg of requip - I hope you have a good night's sleep.

I also hope your migraine has gone.

[ViewsAskew]

Bah, I had an AWFUL night last night. I was getting a migraine so I took Imitrex (which is also newly prescribed for me). Because I had only taken it once before, I did not take my Requip before bed....needless to say it was a sleepless night. I checked the linked of drugs to avoid and didn't see Imitrex there. Do you have any guess as to if the Imitrex exacerbated WED, or do you think I had an awful night because I didn't take the Requip. I'm only taking .25 for 5 days, would skipping a day cause it to be worse than before? It was one of the worst nights I can remember.
Thanks

People who have frequent headaches, particularly migraines, are also more likely to have WED/RLS. I can't find anything to suggest that Imitrex worsens symptoms, but it's possible that it's just not that common and hasn't been noted by anyone.

So many things could be happening. It could be that the drug was involved (Imitrex). It could be that it was someone hormonal or something else you ingested bothers you. It could be that you are sensitive to ropinerole (Requip) and it's causing increased symptoms.

Once the migraine is gone, hopefully things will settle down.

[sleeplessinMA]

It's a hormonal migraine for sure, I get them every month, but just started using Imitrex for them (which so far has worked wonders). I was afraid to mix the two because I was so new to both drugs...but tonight I will be taking my Requip regardless. I'm curious as to the suggestions that the requip could be causing increased symptoms...like a rebound effect? It almost was like I was good for 4 days, and then when I didn't take the Requip, my body was making up for those 4 days all in one night! Perhaps I need a better understanding of augmentation...does it actually make your sympotoms WORSE permanently, or just that you have the same symptoms that require MORE or different medications because they no longer work for you....(I know augment means to make bigger, but dose that mean bigger dose or bigger symptoms). Now I'm confused...I need to do more reading...

[ViewsAskew]

Augmentation is when the drug makes your symptoms worse, stronger, last longer, and so on. When you augment, you need more drug to cover the symptoms. BUT - and this is the truly weird part - when you stop the drug, this increases ten-fold. Your symptoms go absolutely NUTS! There is a LOT of information on the board about it - the search engine works well.

For 99.9 percent of people (I'm making this up, but it is very high), if and when augmentation occurs, it's at least a year after starting the drug. But, a very small subset of people have it occur within days or weeks of starting the drug. I'm one of that teensy group. I augmented within a week of starting pramipexole and rotigitine, and one dose of two other WED drugs, ropinerole and carbidopa/levadopa. No one know why some of us have this happen.

The symptoms are worse for 3 days to 3-4 weeks after stopping the drug. Then they usually revert to their prior level. The doctors say they always do. Several of us here had not had that happen. But, we can't prove it's the drug (and it may not be). It could simply be progression of the disease.

It's VERY unlikely that it would be augmentation. But, since it can happen, just be watchful. The period of time of increased symptoms is beyond anything you can imagine. As soon as it starts - whether today, in two years or ten years, know what to look for and deal with it immediately.

[sleeplessinMA]

will the requip work if I don't take it everyday? I mean, can I just take it as needed or maybe the nights before I have to work the next day? It seemed to work the first night i took it...although I don't have WED symptoms EVERY night, so it could have just been a good night.

[jakesmom]

The bad thing about WED, not that there is anything good about it, is that you need to know when you normally have symptoms and take the medicine at least an hour before that. If you let your symptoms set in, unless they are very mild, it is very difficult to get them to stop. When I took Mirapex, if I waited until I needed it, I was walking the dog, lying in bed kicking my legs, swinging my legs off the bed, anything I could think of to relieve them until the medicine kicked in.

Others may disagree, but I say take a low dose, but take it consistently.

I'm curious as to what others will advise.

Hope tonight is better for you.

[ViewsAskew]

The bad thing about WED, not that there is anything good about it, is that you need to know when you normally have symptoms and take the medicine at least an hour before that. If you let your symptoms set in, unless they are very mild, it is very difficult to get them to stop. When I took Mirapex, if I waited until I needed it, I was walking the dog, lying in bed kicking my legs, swinging my legs off the bed, anything I could think of to relieve them until the medicine kicked in.

Others may disagree, but I say take a low dose, but take it consistently.

I'm curious as to what others will advise.

Hope tonight is better for you.

I think what the OP is saying (Oh, OP is original poster) is that he/she would only take it on nights when he/she had to be awake early or when there was a busy day at work. Because the OP's symptoms only happen when falling asleep and sleeping, that would work. It would be harder to do if your symptoms occurred in the earlier evening, especially if they were random. But in this case, it's like taking insurance. If you don't have it, you sleep but don't feel rested. If you do have it, you sleep and awake refreshed.

[badnights]

A few responses I would like to make to your posts of the last week:

Take iron tablets with a good dose of vitamin C, and on an empty stomach if you can handle it. Some things to avoid taking at the same time as iron - I can't remember, but there is a good site somewhere - sorry, please look it up on google, I have to leave again soon.

Your worsened symptoms that one night don't quite fit into the rebound or augmentation category but seem to be something similar to both. I would call it rebound, except the "official" definition of RLS/WED rebound due to DA use is that it happens as the drug's effectiveness wears off, which means morning. At any rate, your worsened symptoms were clearly due to not taking ropinirole that night. It is best to be cautious in mixing drugs. A call to the pharmacy is good for that sort of stuff.

Can you look into getting an iron dextran infusion done according to Dr. Earley's protocls, which he is happy to share (search previous posts for more info if you're interested)? I think in order to keep on using rpinirole, and definitely before you raise it to 0.5 (if ever), try to increase your ferritin to over 100. If an infusion is too hard to get, go the oral route. I raised my ferritin from 23ish to 60ish with ferrous glutamate tabs over 6-8 months, but they have way less elemental iron in them and take too long. I then raised it from 60ish to over 120 in two months on two tablets daily of ferrous sulfate (325 mg each), at night on a (usually mostly) empty stomach with 500 mg vitamin C.

Regarding intermittent use, that's actually a good idea if your body can handle it and doesn't react like that one night without. It only took 3-4 nights to get your body to a point where it reacted strongly to absence of the drug, which is not good news. Or am I just jumpy about augmentation.

[badnights]

Free article, haven;t read it all, but it seems to refer to augmentation as a withdrawal phenomenon, vs. a worsening while taking the drug. Like you experienced.

http://www.dovepress.com/articles.php?article_id=13803

[sleeplessinMA]

Thanks for replying. It seems like that bad night was an anomaly, I haven't had it that bad since. I have not been taking the Requip every night, mostly just on nights where I have to work the next day....and it seems to be working for me that way. I have not increased the dose, so I'm taking .25. I have started the Ferrous Sulfate....working on figuring all this stuff out, thanks for your input.

[ViewsAskew]

Free article, haven;t read it all, but it seems to refer to augmentation as a withdrawal phenomenon, vs. a worsening while taking the drug. Like you experienced.

http://www.dovepress.com/articles.php?article_id=13803

I saw this and thought they may have missed something. I think of it as BOTH. The withdrawal phenomenon is that horrid period we go through, but I don't think it's horrid unless augmentation started prior. But, that's my bias. I just don't recall people saying it was hard to stop if they'd not already had dose increase and coverage issues.

Hmmm. Would love to see how they came to this. I can't recall if there was research cited (and am too lazy to look right now).

[badnights]

views: still haven;t read it. Am leaving on Sunday, so I can't find time for everything. But from skimming the abstract I thought it was odd.

sleeplessinMA : don;t forget to take vitamin C with the sulfate. Good luck! You're certainly on the right track, keeping the ropinirole dose as low as possible.

[cornelia]

It's probably me but I don't understand why withdrawal was so short when on Gabapentin and so long on Tramadol? I must have missed something..

Corrie

[ViewsAskew]

It's probably me but I don't understand why withdrawal was so short when on Gabapentin and so long on Tramadol? I must have missed something..

Corrie

Not sure....