Ropinirole + trazadone + clonazepam

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Madmom02
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Ropinirole + trazadone + clonazepam

Postby Madmom02 » Fri Oct 07, 2016 12:02 am

Neuro visit went as expected today. He does not believe I augmented (although I didn't use that word - I said worsening) on pramipexole as he has patients who have used it for years with no problems.

He prescribed ropinirole (Requip) .25 mg to be taken in addition to increasing the trazadone to 50mg and continuing the .5-1.5 mg clonazepam.

I started the trazadone last night. 25mg and it made me a little sleepy but even with 1.5 mg clonazepam, I still had bad enough RLS that I only slept three hours.

I asked him what the chances were that the ropinirole would work for awhile and then make things worse like the pramipexole did and he said he hadn't seen that.

We also discussed the fact that when I'd tried the ropinirole in 2007 it made me so nauseated I had to stop after four days (no mention in his notes if it helped the RLS but I suspect it didn't because he increased the clonazepam right after that). He told me I should take it with some food.

So, I'm either going to be RLS free soon, drugged out of my mind or overdosed on all these seating drugs. But, I'm going to think positive. Oh, and I'm going pin down a psychiatrist appointment tomorrow because he suggested that, too.
:?

Sweet sleep to everyone and I hope your legs are calm and quiet.

ViewsAskew
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Re: Ropinirole + trazadone + clonazepam

Postby ViewsAskew » Fri Oct 07, 2016 7:13 am

And, is there any other doctor in your network you can see?

Keeping positive with you :-).
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Madmom02
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Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Fri Oct 07, 2016 5:52 pm

I'm hanging my hat on the neurologist I'll see in December at the Sleep Clinic. She researches RLS in pregnancy so ?

Ropinirole nausea is a awful thing! Now, I see why I only lasted four days last time I tried it. I threw up in my mouth (sorry, gross) about five times from about 5:30 am until 11ish and I still feel nauseated. And the RLS is as present as ever.

The combo of the three drugs left me very dizzy and almost too weak to walk - not so great for someone who also has MS balance issues, faulty proprioception, and gait ataxia (= I'm a klutz.)

I took .25 ropinirole at 7:00 last night after dinner. At 10:00pm the RLS kicked up from mild to very bad (I use a five point scale: none, mild, bad, very bad, severe). I took the 50mg trazadone and .5mg clonazepam.

At 12:16am I took another .5mg clonazepam. I finally fell asleep sometime after 2:00am (last time I checked my clock) and woke up at about 5:30am.

So, tonight I'm going to take the trazadone earlier and with food. I'm wondering if I should just take 1/2 of the ropinirole?

And how do people take ropinirole on a part-time basis (alternating it with other things)? Does the nausea go away? When?

I'm a little whiney today. I'm sorry.

Ann, thanks for keeping positive with me. I'm trying. Really.

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Re: Ropinirole + trazadone + clonazepam

Postby ViewsAskew » Fri Oct 07, 2016 6:58 pm

Not sure I'd go with clonazepam and trazedone - even without balance issues, I'd likely be flopping like a fish...with them? Yikes.

Nausea could go away...might not. here are some facts that may help you (or not...)

Ropinerole requires 2-3 times the amount as pramipexole.

Nausea tends to go away within a week or two with regular use. Not sure if would with intermittent use.

You can take some nausea drugs, but not many.

Trazedone will not help the RLS at all, just knock you out.

Clonazepam may help the RLS, but is less likely to than it's not likely to. And, it will knock you out.

December is a long way away. Can you be put on a waiting list for an earlier appointment?

You don't have to be positive!

it's OK to whine, whine, and whine some more.

At least those are the facts as I see them :-).
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Madmom02
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Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Fri Oct 07, 2016 11:20 pm

ViewAble, thanks for the info about the nausea (& the permission to whine :wink: ) I can last two weeks if it's really helping the RLS.

I am planning on weaning myself off the clonazepam - it doesn't help me sleep or the RLS and I think I'm taking it because it's habit and because I tapered off it completely in the Spring and I'm not 100% ready to do that again (although it wasn't bad because I did the slowest taper I could). I'm thinking I would wait until I saw what the trazadone does because maybe the combo of the two will knock me out.

Of course, if I have another morning like this morning, I may get knocked out going down the stairs. Think I'll start tapering the clonazepam tonight and have faith that the trazadone will make me sleepy.

I just noticed that the trazadone says take with food and the ropinirole doesn't. Should I take the trazadone earlier, too?

The RLS has been marginally quieter this afternoon. However, I took 5mg oxycodone at 2ish so it's probably that. Sigh.

Madmom02
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Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Sat Oct 08, 2016 6:23 am

I am in RLS hell. :( Tonight I took 50mg of trazadone at 6:15 , .25 mg of ropinirole at 7:00. I was planning on going to bed at 9:00 (my first mistake maybe?)

I tried but couldn't sleep so I took .5 mg of clonazepam at 9:48. The RLS went from mild to bad by 10:26. After walking, massaging, cold water, and more walking, I took another .5mg clonazepam at 11:30. The RLS is severe.

Did I take the ropinirole too early? Is there some kind of window you have to fall asleep in for it to work?

I took .5mg less clonazepam tonight than last night but I usually don't take all three doses in a night. The trazadone did not make me sleepy at all.

I know this will pass because all things do, eventually. I'm just frustrated and mad. I think my expectations were too high for the second night on the ropinirole and full dose of trazadone. Tomorrow I'll take them later?

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Re: Ropinirole + trazadone + clonazepam

Postby Rustsmith » Sat Oct 08, 2016 3:00 pm

Ropinerole has a half life of 6 hrs, so taking it 2 hrs before bedtime should not have been your trigger. Yes, you would have had less in your system 2 hrs after taking it, so unless your dose is right at the edge of the minimum is required to control your RLS, it should have still be effective.

So your experience may simply be one of you have a bad RLS day. I know that sometimes things happen during the day so that my RLS is worse that evening. Maybe it was some additional stress, a change in my daily routine or the alignment of the planets, but some days are simply worse than others. So if you were having one of those more severe RLS days and then combined it with the earlier dose, it would seem that it was the timing of taking your med when in reality, you would have had a difficult night anyway.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Madmom02
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Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Sat Oct 08, 2016 9:13 pm

I think I'll take the ropinirole a little later. I did did get stressed out by some news so maybe that was it. Or maybe this whole increase in the RLS since early September is progression. :cry:

Well, at least I can still walk if I need to although because of the new weakness and dizziness from the trazadone and/or ropinirole, I'm using my cane in the house. The walls should be happy about that. My husband says he's going to put the baby gate back up at the top of the stairs :wink: .

Madmom02
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Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Sun Oct 09, 2016 1:57 am

Severe RLS attacks again! :(

I'm still very sleepy from everything I took last night and maybe because I didn't fall asleep until after 3:30am. I slept until 9:30am and took a NAP from 11:30am to 1:30pm! I've had no meds during the day and the RLS was quiet until 4:15pm when it kicked in a little.

I'm groggy, weak, and hungry but not nauseous. However, I'm eating and eating and I can't seem to stop.

I took the ropinirole and trazadone at 8:00pm tonight. At 8:15pm the RLS went from mild to severe. It's almost 9:00pm and no change. How long does it take before the ropinirole works if it's going to work?

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Re: Ropinirole + trazadone + clonazepam

Postby badnights » Sun Oct 09, 2016 9:32 pm

You poor thing! I can't believe ----

I can :(

Did he say if his patients who've been on pramipexole for years without worsening were RLS patients? Maybe they were Parkinson's patients. A doctor once used the same line on me, only he was open minded and curious to hear more about how it could worsen wED/RLS.

I totally agree with getting off teh clonazepam. It will only cause grief while hte symptoms aren't controlled.

Is your ropinirole a generic that can be cut in two? If it can be, you could try taking it in two doses - one a couple hours before bed and one at bedtime.

If you're going to survive until December, you might have to just let your body offset its day. I don't know if you've mentioned here whether you work; if you have, I've forgotten. If work would allow you, it might be easier until you can see a doctor who knows how to treat you and not damage you, to plan to stay awake during the bad hours. Aim for bed at midnight, maybe, or at least a couple of hours later than usual.

Is there any way you can travel to a real doctor - darn I was trying to stop myself from using those words, a doctor who knows how to treat RLS/WED - sooner than December?
Beth - Wishing you a restful sleep tonight
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Madmom02
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Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Sun Oct 09, 2016 10:49 pm

Happy news! I slept from about 1:15 am until 9:30am! No RLS, not groggy, mild dizzy and milder nausea with a lot less weakness! :D :D

Still really hungry but controlling it better. And, it's 4:45pm and NO RLS yet! :!:

I don't know if Dr Neurologistbutknowsnothing was speaking specifically about RLS v Parkinson's. Maybe I just assumed it.

The ropinirole is a generic but is not scored so it might be hard to cut in half.

I think my body is just naturally (courtesy of weeks of RLS & 2-4 hours of early am sleep plus new ropinirole and trazadone) moving to a later sleeptime. I'm going to go with the flow (which is kind of what you suggested).

I no longer get to work - on SSDI after two failed attempts to return to work. I have a teenager who does that teenage sleep thing (Up late, hard to get up in the morning, and sleeps in on the weekends. Why don't they change high school start times?). So, it's ok if I don't sleep until later and wake up late.

I am going to ask the doctor about increasing the trazadone because it's supposed to be helping me sleep.

Definitely tapering off the clonazepam - I took .5mg last night at 1030pm and .25mg at midnight. I'm following the same taper I did in the Spring only a little faster. I had no withdrawal last time.

Thank you for your suggestions and support. Hope all is well with you!

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Re: Ropinirole + trazadone + clonazepam

Postby ViewsAskew » Mon Oct 10, 2016 10:03 am

YAY!
Ann - Take what you need, leave the rest



Managing Your RLS



Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Madmom02
Posts: 113
Joined: Sun Jul 10, 2016 11:27 pm
Location: My heart lives in the mountains

Re: Ropinirole + trazadone + clonazepam

Postby Madmom02 » Mon Oct 10, 2016 1:43 pm

Spoke too soon. :( Had mild RLS beginning at 6:00pm, by 7:46pm it was bad and it just kept getting worse. Took the trazadone and ropinirole at 8:00pm. Then took .5mg clonazepam at 9:00pm as part of my taper. By 10:15pm the RLS was severe. I took 5mg of oxycodone at 10:30pm. No change in the RLS. Fell asleep sometime after 1:30am, woken up by nausea & RLS at 4:45am.

I don't see how this is possible but I think the ropinirole is making the RLS worse or maybe it's the trazadone.

Have sent an email message to the neurologist and am calling the Rochester Mayo today. So frustrated and sad.

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Re: Ropinirole + trazadone + clonazepam

Postby Stainless » Thu Oct 13, 2016 4:27 pm

I quit clonazepam after 20 years because it is a nasty drug for any people. I seem to do well on it. I tried DAs and ended up on ropinirole that just made my RLS miserable. At first it was a miracle, to go days without the dreaded feelings, but that did not last long. My doctor quickly had me on 4 mg. extended release and my whole life revolved around RLS. I gave it nine months and have been off for two.

Ropinirole made my RLS crazy. Symptoms morning, noon, night, insomnia, good days, bad days, shaking in bed like I had MS and constant pains in my thighs. A much more unpleasant feeling (if there can be such a thing) than how my RLS had been for the last 20 years.

I quit ropinirole overnight which was far easier than the 6 month horror of getting off clonazepam. I went back to just clonazepam, nothing else. I deal with the RLS I get in the late afternoons and evenings like I have for 45+ years. I get a good night sleep, no hangover and usually no RLS until 4 or 5 in the afternoon. I do a bit of nightwalking starting 7 or 8 and wiggle my legs to sleep.

I would encourage no one to go down this path as clonazepam is a dangerous drug and like heroin to get off of. My plan is low number of drugs (1) at as low a dose as I can get by with. I’m on 2 mg. clonazepam, when I quit I was on 3 mg. I don't think the clonazepam has not fully saturated my brain and I expect the RLS will improve. In between I tried nothing but supplements for a few weeks but do not think that quality of life is bearable. I think DAs change the disease, at least for me. I hate to see people on multiple drugs but know you have to do what you have to do. Rick

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Re: Ropinirole + trazadone + clonazepam

Postby Yankiwi » Fri Oct 14, 2016 12:11 am

At first it was a miracle

My words exactly. How many have said that after starting on a DA? And my prescription said to keep taking it up to 4mg but luckily I was on this forum and caught the augmentation in time which stopped me getting on the drug roller coaster. I still have symptoms every night but with a small (.25mg) dose of ropinerole and a raft of stretching, rubbing etc, its managed. I'd rather have some discomfort than the horror show augmentation brings.
I think DAs are like evil clowns — at first they seem benign until they come and stab you in the back.


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