Help Crazy Joe

[crazy joe]

Hey Guys..... Ive been on reuipp off and on for 3 plus years... I took nuepro patch for a short time and felt sleepy during the daytime however I wasnt sleeping well due to rotary cuff problem...on .75 requipp currently and want to switch to nuepro... do i have to wean off the reuipp to get onto nuepro? These were the only 2 meds that have kinda worked for me....seeing dr b oct 5th for consult.... may try MM as a adjucnt med since monotherapy seems to have its problem....

[crazy joe]

I am considering switching to mirapex from requipp---- anyone have input about doing this? and has anyone had success with this for awhile?

[JimmyLegs44]

I see no long-term benefit in doing this, assuming you are currently augmenting on Requip. You will most likely augment on Mirapex as well. Based on everything I've read and experienced, once you augment on a dopamine agonist, don't bother trying to switch to another one; get off of the dopamine agonist ASAP. Be grateful for the period of relief that you got from the DA, realize that those days are gone forever, and move on to a different class of drugs if possible. Some lucky folks even realize they no longer need drugs once they are off the DA.

[Polar Bear]

It is possible that the same thing may happen, but I think that ropinerole and mirapex work slightly differently to each other and it's just possible that one may be more suitable than the other.

[sleepdancer2]

I did it the other way around. Augmented on Mirapex then transitioned to Requip. Maybe someone will come along and report that changing to another dopamine agonist worked for them. For me, after just weeks the 2nd option began to cause augmentation and had to go through another round of getting off.

[ViewsAskew]

I am considering switching to mirapex from requipp---- anyone have input about doing this? and has anyone had success with this for awhile?

Crazy Joe, I moved your question to its own topic instead of leaving it in the other topic that was about another person's issues with pramipexole. I also added another one of your questions to this topic. I think it will likely help you - and us - to keep them together so you get better answers. You've talked about MM, kratom, and many other things, so you clearly want to do something different. I remember you said you had pain, but I don't know if it's a painful type of RLS/WED or if you have neuropathy or other type of pain in addition to the RLS/WED. I feel I'm not able to help you much as I'd like because your information is not in front of me and I am not sure what you've posted along the way.

In terms of your question about switching to pramiepexole from ropinerole, the only benefit that I can think of is that you may have different side effects - it works on slight different receptors - as Polar Bear indicated. Pramipexole lasts a bit longer, but takes longer to work. Dosing is different - it takes 2-3 times the amount of ropinerole as pramipexole.

In general, as JL44 noted, there isn't any clinical reason to do this. If to help with augmentation, it will not do so. The paper that was posted recently from the IRLSSG, it says that there is no benefit to be gained from switching from one DA to another in most circumstances. That mirrors what many of us here have found.

Please, tell us - have you augmented? Do the medications not work as well? What are you taking and how much of it? What problems do you have and what do you want help with?

[ViewsAskew]

Hey Guys..... Ive been on reuipp off and on for 3 plus years... I took nuepro patch for a short time and felt sleepy during the daytime however I wasnt sleeping well due to rotary cuff problem...on .75 requipp currently and want to switch to nuepro... do i have to wean off the reuipp to get onto nuepro? These were the only 2 meds that have kinda worked for me....seeing dr b oct 5th for consult.... may try MM as a adjucnt med since monotherapy seems to have its problem....

Why do you want to switch to rotigotine? What problems are you having with ropinerole?

If you have augmented, a switch to rotigotine may or may not be wise. There is no need to stop a DA before switching to another DA - but Dr B will likely provide you with his protocol. It can vary from specialist to specialist.

In terms of monotherapy, what issues are you concerned about? I am not sure example what is concerning you, but when I though about it, it seems to me that most of the issues we face are do to taking a drug without a break, rather than using one drug at at a time. Regular breaks from a DA prevents augmentation. Regular breaks from an opioid or a benzo prevents dependence. But taking MM with a DA, wouldn't prevent augmentation.