advice sought changing from Sifrol to Lyrica

[Daniel]

Hi, I am considering changing from Sifrol to Lyrica as I am experiencing some augmentation on Sifrol and there appears to be significant research suggesting Lyrica (pregabilin) has less incidence of augmentation. My GP has offered to transition me from Sifrol to Lyrica but has not done this with a patient before (I am trying to avoid paying $350 to see my specialist.

The advice I seek is has anyone changed from Sifrol to Lyrica?
What schedule did you use of transitioning medications?
Any other comments are welcome on your experience of the change from Sifrol to Lyrica.

Thanks for your help

Daniel

[ViewsAskew]

In the US, people know Sifrol as Mirapex. The generic name is pramipexole.

In the past, doctors would do one of two things. If the augmentation was mild, they'd just switch you directly. If it was more entrenched, they would have you stop the dopamine drug, use an opioid to cover the increased symptoms (when you stop and are augmented, you almost always have increased symptoms for 1 to 3 weeks), then when things were stable in a few weeks, switch to the pregabalin or other similar drug.

In the US, many docs seem to like the newest in that series - often called alpha 2 delta drugs and includes gabapentin and pregabalin along with the new one, gabapentin encarbil. The gabapentin encarbil is formulated to work differently and more of it gets in your system, if I remember correctly.

Because many people come and go on the board - and some take breaks and aren't here regularly - if you use the search function, it may take you awhile to sift through the posts, but you will likely find many over the past few years.

Another option is to write to Dr Buchfuhrer. He is a specialist in California and he writes back to patients and answers their questions. His email is somno@verizon.net.

[Daniel]

Hi Ann, thanks so much for your thorough and very helpful response. I'm being brave and swapping directly to lyrica, my sifrol dose is .375mg which I think is relatively low. I'll try to post my progress. Thank you again for you help, it's very much appreciated.
Regards
Daniel

[Polar Bear]

Daniel - If I remember correctly, the experts recently have agreed that the doses of DA previously approved and prescribed, are too high. The recommended daily level of pramipexole/sifrol is .25mg.
The dose of .375mg that you are taking is therefore above the now recommended daily dose and is not considered to be a low dose.
This may be a factor in your success in swapping directly to lyrica.

Please do keep us updated with your progress.
The experiences of any sufferer is always of interest and benefit to all of us.

[Joanie60]

Ann, I have been meaning to ask. How much does Dr Buchfuher charge for email consult?

[ViewsAskew]

Ann, I have been meaning to ask. How much does Dr Buchfuher charge for email consult?

For his patients? Nothing as far as I know. At least, he doesn't charge me. I go through the portal for most stuff - I email his office, they talk to him, he or his staff will respond.

[Joanie60]

Gotcha! I am not a patient, so I assume there would be a consultation fee...otherwise the poor guy would be answering emails all the time!!

I have an appointment with Dr Salas in late April. I think I can make it on 10mg Methadone for the next month and a half. Today, for example, I just now took 5gm (it is 6:30pm East Coast time) when I usually take all 10mg between noon and 2:00pm. I'm flying tomorrow so since I am not losing my mind right now, I figured I would try to stash an extra 5mg for tomorrow. This is the longest I have been able to go during the day until taking the meds!! Yay!! Perfect timing, with flight tomorrow

Hope everyone has a great weekend. Happy Spring! (Which we celebrated with 2-3" snow here in Maryland haha)

Joanie

[ViewsAskew]

Gotcha! I am not a patient, so I assume there would be a consultation fee...otherwise the poor guy would be answering emails all the time!!

I have an appointment with Dr Salas in late April. I think I can make it on 10mg Methadone for the next month and a half. Today, for example, I just now took 5gm (it is 6:30pm East Coast time) when I usually take all 10mg between noon and 2:00pm. I'm flying tomorrow so since I am not losing my mind right now, I figured I would try to stash an extra 5mg for tomorrow. This is the longest I have been able to go during the day until taking the meds!! Yay!! Perfect timing, with flight tomorrow

Hope everyone has a great weekend. Happy Spring! (Which we celebrated with 2-3" snow here in Maryland haha)

Joanie

Joanie - he DOES answer all the emails sent to his somno@verizon.net account, whether a person is a patient or not. I am sure he has saved resplies for some things - such as basic augmentation. He will go into surprising detail if it's something outside of normal - many of us have taken one of his emails to our doctor and said, 'Here is what the expert said I should do."

He won't, however, give scripts or anything. But, the advice is pretty much free.

[Yankiwi]

Dr. B is great, he really helped me with good advice over the course of several emails back and forth. I printed out our email conversation and showed them to my GP who took his suggestions on board.

[Polar Bear]

I have also taken Dr B's printed out responses to my GP who was happy to read them.
And his responses are to your own email, not just a generic piece of information.
There was no charge from Dr B.
He is truly dedicated.

[Sojourner]

I transitioned from Gabapentin to Lyrica so my case is not the same. But, because of my relative long standing relationship with my primary and her relatively good experinece with wed, I think she transitionws me a little bit more quickly (initial higher dose) than perhaps might ordinarily occur (or not). I also think, again because of our history, she was a little more confident in letting me have some control over the doaing within a perhap[s 25 mg range depending on how things were going. I guess what I'm saying is she was not particularly rigid in the iniitial dosing. So, your primary may start you at something a little different than a standard dose depending on your knowledge of each other. Best of luck and wishing you some peace this night.