Postby badnights » Sat Apr 29, 2017 11:42 am
Caldwell, it very likely is augmentation. Tolerance to the medication would probably not build up so quickly. Are your symptoms starting earlier in the day than before you started ropinirole? Are they more intense, have they spread to your arms? If some or all of these things are true, you could be experiencing augmentation.
When you say 1 pill, is that a 1 mg pill of ropinirole? How big (how many milligrams) is your gabapentin pill?
I would not advise you to increase the ropinirole, since 1 mg is the maximum recommended daily dose for WED/RLS patients (recommended by specialists, although the manufacturer and other sources will say that up to 4 mg is fine). You might try to split the ropinirole (you might need a drugstore pill splitter) and take half of it a bit earlier, to address symptoms that start earlier in the day. Or take half later, to provide better coverage through the night.
You could probably increase the gabapentin - according to the book "Clinical Management of Restless Legs Syndrome", WED/RLS patients can take up to 900 mg up to 3 times a day (for a maximum daily dose of 1800 mg).
The best thing for you to do, and I can't stress the importance of this enough, is to find a doctor who has experience treating augmented WED/RLS. Second best, is to take some literature on augmentation and its treatment to your regular doctor. Make an appointment strictly to discuss augmentation, nothing else. Show him the literature and tell him you think you're augmenting, then ask him if he could please tell you what he thinks of it all.
And ask for a serum ferritin test. We tend to have low levels of ferritin, and this is linked to greater severity of symptoms, and to greater likelihood of augmentation. So get that test, and ask for the actual concentration - the number, like 30 ng/ml - not just a statement that it's normal, because normal for regular folks can be as low as 20, but normal for WED/RLS patients should be at least 100.
In my signature there is a link to some resources on augmentation. I recommend that you download and read the following, and decide for yourself if you think you might be experiencing augmentation. Print the ones you find most relevant and take them to your appointment. :
The "Need for New Treatments" paper
Buchfuhrer's 2012 paper
the Study Group's white paper on augmentation
Extract from Clinical Management
You will also see instructions for how to access the RLS Foundation's publications, which include a number of brochures on augmentation. All of these are useful.
Beth -
Wishing you all restful sleep tonightWED/RLS AUGMENTATION:
viewtopic.php?f=5&t=6532&p=61601#p61601Discussion Board Moderator's posts don't reflect the RLS Foundation's opinion & are not medical advice