Is your DA causing augmentation?

Use this section to discuss your experiences with prescription drugs, iron injections, and other medical interventions that involve the introduction of a drug or medicine into the body. Discuss side effects, successes, failures, published research, information about drug trials, and information about new medications being developed.

Important: Posts and information in this section are based on personal experiences and recommendations; they should not be considered a substitute for the advice of a healthcare provider.
fuz_mind
Posts: 20
Joined: Sun Apr 23, 2017 4:27 pm

Re: Is your DA causing augmentation?

Postby fuz_mind » Tue Apr 25, 2017 6:03 am

thanks so much for all the opinions! looks like i have to go back to my neuro again for another fight

my ropinirole has been increased at the rate of almost once every 2-3 months, which has been very troubling to me. but my neurologist is more concerned about my use of tramadol and clonzapam

the only reason why I have stuck to my neuro although he's clueless (and he admits so) is because he was the only one who didn't dismiss my concerns and is open to suggestions. he eventually gave me an iv iron infusion as well because i wasn't responding to oral iron. i saw 5 other neurologists who dismissed the pain as psychosomatic

been a painful journey in all sense :)

badnights
Moderator
Posts: 4295
Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

Re: Is your DA causing augmentation?

Postby badnights » Tue Apr 25, 2017 7:38 am

In my signature line is a link to a post that contains links to information on augmentation and iron. The full paper by Buchfuhrer that Polar Bear quoted from is there (same link as Ann gave you). Buchfuhrer has a lot of clinical experience and was one of the authors of the original Mayo Clinic algorithm for treating RLS/WED.

Your doc might like the New paper, first one on the list, as support for and expansion on the Buchfuhrer one.

There is also an extract from the book that Polar Bear quoted, and instructions for accessing the Foundation's publications, including the Medical Bulletin for healthcare providers, which would be a good one to give them. And other good resources.
Beth - Wishing you all restful sleep tonight
WED/RLS AUGMENTATION:
viewtopic.php?f=5&t=6532&p=61601#p61601
Discussion Board Moderator's posts don't reflect the RLS Foundation's opinion & are not medical advice

Caldwell
Posts: 5
Joined: Fri Oct 07, 2016 3:55 pm

Re: Is your DA causing augmentation?

Postby Caldwell » Sat Apr 29, 2017 5:36 am

The month of December 2016, brought great relief to me of my RLS, with 1 Ropinerole & 1 Gabapentin taken at 7pm every night. Now, 5 months later, I am right back in the throes of nightly RL,with no relief from the above doses of meds. Is this augmentation? Should I do a trial of increasing the dosage of one or both meds? Please advise! Caldwell.

badnights
Moderator
Posts: 4295
Joined: Tue Mar 10, 2009 4:20 pm
Location: Northwest Territories, Canada

Re: Is your DA causing augmentation?

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 tonight
WED/RLS AUGMENTATION:
viewtopic.php?f=5&t=6532&p=61601#p61601
Discussion Board Moderator's posts don't reflect the RLS Foundation's opinion & are not medical advice


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