Restless Legs Syndrome (RLS) Discussion Board

I have been taking Gabapentin for my RLS for 9 months (after getting off of Mirapex). Started on 300mg and progressed up to 2100mg. It has become obvious that this is not a long term solution as it tends to lose effectiveness every 4-5 weeks requiring increase in dose. After discussions with my doctor, I have begun tapering down off Gabapentin going down by 300mg every other day. I have also started Methadone (2.5mg). The Methadone seems to be working very well. My sleep cycles have been best I have had in years. Unfortunately I am experiencing overwhelming fatigue around 12:00pm every day since starting this new process. I trying to figure out if fatigue is from Gabapentin withdrawal or from starting Methadone. Any thoughts or experiences that might be helpful? The rate at which I am decreasing Gabapentin has me a bit concerned that it is causing fatigue.

Sucks that I am sleeping better than I have in a long time yet feel more fatigued than ever!!

Congratulations on getting more sleep, I can appreciate that since I have only recently started sleeping for more than 4-5 hrs per night.

I cannot say for certain, but my guess is that since you are still on 2.5mg of methadone, that it is the gabapentin. What time of day are you taking your remaining pills? There is a daily variation in both dopamine and glutamate concentrations in the part of the brain that controls sleep and is also involved with RLS. They don't know exactly how gabapentin works, but it is a number of chemical similarities to glutamate, so perhaps you need a bit longer to allow your natural cycles of glutamate and dopamine production to establish themselves.

I concur, it would seem that the rapid gabapentin reduction might be the culprit. It's not recommended that anyone stop gabapentin quickly because of the common occurrence of various withdrawal symptoms (anxiety, insomnia, nausea, pain, sweating, restlessness, disorientation, confusion). Although rare, sometimes the symptoms are bad enough that the patient is unaware of who or where he/she is. Maybe talk to your doctor about a slower taper?