Transitioning to new meds

[ViewsAskew]

If you augmented before, you will augment again.

You can take it - just not everyday for weeks. Try this, but take a break from the pramipexole every 3-5 days or so for at least one to two days.

Tramadol definitely can cause nausea for some. That's too bad, because it works exceptionally well for many.

[shelby1]

I have taken Requip or ropinerol since 2006 and was on 2mg 4x a day for 8mg a day. Also on gabapentin at 300 x 3 a day. I believe the side effects from the ropinerol piled up and resulted in hallucinations, swollen feet and ankles, weight gain of about 40 pounds increased heart rate and blood pressure to name the most prominent ones. My neuro has taken me off the Ropinerol over 4 weeks and increased the gabapentin to 2100 mg/day. However on the 4th week of the transition, the gabapentin is not working at all. I am going through hell for several hours from about 3 - 10 pm and also from 6pm all night and still having problems at 8am. The highest does are taken at 5pm and 8 pm so night time should be good. NOT!!!! Have call in to see what we should do as I am at my wits end!

[Polar Bear]

Well done for getting off the ropinerole. I applaud you.
I've been on ropinerole for several years and can empathize with regard to some of your side effects.

Have you seen this book - it is easy to read and can be used for discussion purposes with your doctor.
Clinical Management of Restless Legs Syndrome by Lee, Buchfuhrer, Allen and Hening. Make sure to get the second edition. These Authors are at the top of the league when it comes to the treatment of WED/RLS. It can be found on Amazon.

Also, have you had your ferritin serum level checked, this is important. It is a blood test that is not normally done with routine blood works and you need to ask for it. This tells the level of iron stored in your brain – and that is what is important to us sufferers of WED/RLS. We need a level of around 100, especially if we are taking a DA drug such as pramipezole or ropinerole. When getting the results of this test please ask your doctor for the actual level = do not accept ‘normal’ as an answer. Doctors and Labs may consider 20 to be normal… but it isn’t normal for us. Some folks find symptoms ease up with a higher ferritin.

[Frunobulax]

I have taken Requip or ropinerol since 2006 and was on 2mg 4x a day for 8mg a day. Also on gabapentin at 300 x 3 a day. I believe the side effects from the ropinerol piled up and resulted in hallucinations, swollen feet and ankles, weight gain of about 40 pounds increased heart rate and blood pressure to name the most prominent ones. My neuro has taken me off the Ropinerol over 4 weeks and increased the gabapentin to 2100 mg/day. However on the 4th week of the transition, the gabapentin is not working at all. I am going through hell for several hours from about 3 - 10 pm and also from 6pm all night and still having problems at 8am. The highest does are taken at 5pm and 8 pm so night time should be good. NOT!!!! Have call in to see what we should do as I am at my wits end!

Gabapentin is a neurotransmitter that achieves saturation at some point (most neurologists over here consider ~1500mg a day as maximum), so higher doses won't do anything except more side effects. Chances are that even at saturation level, Gabapentin is not the answer for you. You should consider switching to Horizant, which doesn't have the saturation effect.

However, due to augmentation it is quite possible that you need stronger medication until the augmentation resolves. Adding L-Dopa is worth a try, but if this doesn't work then you'll probably need to switch to opioids.

Regards, F.

[ViewsAskew]

shelby1 - while you are withdrawing from ropinerole (can take a week to several weeks) there is NO way Horizant will cover you. Once you've augmented, there are always increased symptoms and they SUCK!!!!!!! In ten years here, I've only seen two people manage to stop a DA once augmented without using an opioid. The rest of us (me included) couldn't do it. I tried three times!

[shelby1]

In answer to the ferratin level-I did have that checked and it is well over 100. I probably eat more protein than most people do so that helps that. After seeing neuro last week I am now on 300 gabapentin 9 x day for 2700. I finally got over effects-at least it would seem so anyway-of the ropinerole and believe me I went through holy hell! I am to go back in 2 months and if no improvement in swollen feet and ankles then the narcotic is the next avenue. So I will go along with the protocol for now and see what happens. I am not able to drive and in a town of 350 people and the nearest town is 45 miles away I do feel confined! Thanks for your posts!