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Quitting Neupro Cold Turkey

Posted: Tue Mar 14, 2017 2:56 am
by IThinkImInTorture
I am overweight and taking 6 bp meds for hypertension. My neurologist tells me to try harder to lose weight when I tell him about the compulsive eating, spending etc on Neupro. Now, with a clearer understanding that augmentation is with the Dopamine Antagnonist and not the Ultram which my Neurologist thinks is the case I can now say I want to get rid of Neupro and just stick with Ultram. The Neupro does allow me to get out of bed easier and offset the dopey look all day but ironically I am not doing so well at work because of perhaps sleep deprivation. I need to get more sleep and maybe the ultram will knock me out.

The last time I did this I couldn't fall asleep and was edgy the next day. My confidence waned walking around dopey tired all day so I went back on Neupro.

I am going to commit to a week this time.

Has anybody been in the same situation? Advice?

Re: Quitting Neupro Cold Turkey

Posted: Wed Mar 15, 2017 10:20 am
by badnights
Interesting note about the eating. Dopamine agonists (they're not antagonists, btw) can cause Impulse Control Disorder, which might manifest as compulsive eating. Another good reason to get off the Neupro.

You might have a better chance of success if you can commit to 2 weeks. Things might be hellish for the first 3 or 4 days but should slowly improve after that. You might start getting a reasonable amount of sleep before a week is out. That's roughly the pattern most people experience. When I came off pramipexole after augmenting, it didn't even last that long.

Do you think your doctor would increase your tramadol/Ultram for a couple of weeks, or swap it for a more potent opioid? Does he know that withdrawal from Neupro will cause you to have temporarily very bad RLS/WED symptoms?

Go to - Member Portal - Publications
or click here
Scroll down to Advanced. There are three brochures about augmentation. The best one for you would be A Quick Guide to Augmentation, but you have to become a member to access it. You used to be able to request a "scholarship" membership if you can't afford the $35; probably you still can.

Keep scrolling down to Information for Healthcare Providers. Get the 2017 Medical Guide and give to your doctor, so he can start learning how to help you. If you only give him one thing, give him that. You would be classified as severely augmented, since you augmented on Neupro, so he should follow the instructions for treating a severely augmented patient. I mean, don't tell him that, but give him the bulletin and ask what he thinks.

Re: Quitting Neupro Cold Turkey

Posted: Wed Mar 15, 2017 10:21 am
by badnights
Another thing, have you had your ferritin tested? If it's under 100 ng/ml you might get some relief by taking oral iron pills.

Re: Quitting Neupro Cold Turkey

Posted: Wed Mar 15, 2017 1:52 pm
by IThinkImInTorture
I had my ferritin tested at Johns Hopkins University Hospital, an outstanding facility and staff. My ferritin is normal between 100 and 150.

I didn't take Neupro last night. I couldn't fall asleep until 2am and ate 3 PB sandwiches.

I'm at work today and feel muscle spasms in my calves. But not a show stopper for me.

My Neurologist wants me to take more antagonists to get off Ultram, stating I will need more and more ultram until my liver gives out.

I need to find a new good neurologist in the Northern Virginia area that specializes in RLS.

Monday I was called to the carpet for asking too many questions, need more attention to detail and being more autonomous after a year in the job. I attribute this to the meds as my short term memory is crap and it has always been my strong point.

I take Coenzyme Q daily, half of a B3 tablet twice daily and 50,000IU of Vitamin D weekly.

I think removing Neupro, will allow me to be more disciplined on the Nutrisystem diet. I've lost 10 lbs but fell off due to logistical lapse in delivering food month to month. My Neurologist just tells me to try harder to lose weight. I'm down to 284 from 297. Getting down to 230 will allow me to cut out all bp meds, getting down to 200 will be my losest possible ever weight possible. My job is on the line here and the doctors, meds just make life worse not better. Except for the ultram and my Neuro is trying to get me off of it.

Re: Quitting Neupro Cold Turkey

Posted: Wed Mar 15, 2017 5:30 pm
by QyX
You have to keep in mind that the Tramadol / Ultram may have a potent stimulating effect on you after the Neupro is gone. This could happen because the Ultram is not only a opioid, it also has effects similiar to SSRI antidepressents.

Looking for a doctor who has more experience with RLS is something I strongly recommend.

Classic opioids like Morphine, Oxycodone or the synthetic Methadone will offer a better relief then Ultram.

However depending on the doctor's fear and opinion, tolerance to opioids will become sooner or later a part of the discussion. Your dose will definitely go up and maybe this is ok for the doctor or he will start complaining when the first dose adjustment is necessary. Every doctor is different when it comes to this.

You could stay on Ultram if it works for you but it is a weak opioid and taken alone you will soon find that it is necessary to increase the dose. Tramadol is limited to 400 mg daily and it is really not wise to increase the dose further because of possible side effects.

So your doctor is somehow right that it is not a long term solution. Just the reason he has given is somehow "misleading" in my opinion.

Re: Quitting Neupro Cold Turkey

Posted: Wed Mar 15, 2017 7:15 pm
by IThinkImInTorture
I'm also taking a high dose of Cymbalta, 90mg. Which also exacerbates RLS.

Re: Quitting Neupro Cold Turkey

Posted: Thu Mar 16, 2017 7:02 am
by badnights
Good info QyX,

IthinkImintorture has been stable on current dose of tramadol for 3 years. Tolerance isn't the immediate issue (though it may eventually be) but effectiveness is. InTorture has been on pramipexole, ropinirole and now Neupro, possibly without a break inbetween, and seems likely to be augmented based on what has been shared here. So tramadol won't cut it for the withdrawal.

Re: Quitting Neupro Cold Turkey

Posted: Thu Mar 16, 2017 7:04 am
by badnights

Do you think you might have impulse control disorder? It's a possible side effect of DA's like Neupro and Requip. It could make it next to impossible for you to control your eating.

You really need to find a more knowledgeable neurologist -
or try out your current neuro with the Foundation's 2017 Medical Bulletin and see if he responds any differently.

Re: Quitting Neupro Cold Turkey

Posted: Thu Mar 16, 2017 7:04 am
by badnights
You might want to order some kratom, it might help to relieve the torture as you come off the Neupro.

Re: Quitting Neupro Cold Turkey

Posted: Thu Mar 16, 2017 10:39 am
by IThinkImInTorture
I stopped neupro on Sunday. It is Thursday morning 6am. Ive been up all night as my calves wouldnt let me sleep.

Re: Quitting Neupro Cold Turkey

Posted: Thu Mar 16, 2017 1:07 pm
by Polar Bear
You could do with something to help you come off the Neupro.
badnights has suggested kratom to help, have you considered this ? - however, you stopped on Sunday (cold turkey) so that's 4 days already. Having got this far is the biggest step, it is so difficult. Well done on reaching day 4.

Re: Quitting Neupro Cold Turkey

Posted: Thu Mar 16, 2017 11:17 pm
by ViewsAskew
For most of us, by day 4 it is at its worse. Some people find day 5 is the hump day and it starts getting better, some not until day 10 or later. But, the average is somewhere between 6-10 days it is getting better, I would guess.

Re: Quitting Neupro Cold Turkey

Posted: Fri Mar 17, 2017 12:33 am
by IThinkImInTorture
Interesting you mention the timeline as I thought "whats the half life of the drug?" Sunday will be 7 days. I have an appt April 27 with a new Neurologist here in Northern Virginia.
My RLS calves are in full swing just sitting at the dining table tonight. I took two advil at 8pm and will wait to take my three ultram until 10pm.
"What does Eastern medicine have for RLS?" Matt wondered out loud.
Ill bet you lunch the solution to RLS will be to alleviate pressure points on the arteries blocking blood flow or shock absorbers for the calves, just walking really slow till then might make a difference, perhaps?

Re: Quitting Neupro Cold Turkey

Posted: Fri Mar 17, 2017 1:13 am
by QyX
You might discuss if stopping Cymbalta is an option. I strongly recommend not to take any drugs who exacerbate RLS and do the best to avoid drugs who possibly do so.

Stopping Cymbalta could improve your RLS however in some cases stopping Cymbalta can be extremely difficult. In this case there is a workaround with Fluoxetin, a classic SSRi.

Right now the Tramadol is not potent enough to control your RLS. It maybe might in some weeks after the withdraw but somehow I am sceptical.

If you can't get any sleep in the next days it would be much better to ask for immediate release Oxycodone.

I know how hard it became to get opioids in the U.S.

The thing with Tramadold is that it can exacerbate RLS symptoms. I don't know how often it happens but together with the Cymbalta I do see a relatively big potential for worsening your RLS.

My own experience is that SSRi drugs and DA can work very well together but without the DA I could not tolerate drugs anymore who do have SSRi effects. Your response to Cymbalta and Tramadol can change a lot after the withdraw from DA. It doesn't meen it is gonna happen for sure but it is something that needs careful observation.

Good Luck

Re: Quitting Neupro Cold Turkey

Posted: Fri Mar 17, 2017 3:33 am
by IThinkImInTorture
I'm really annoyed, 1125pm Thursday night. The RLS is really in full swing. I paged my Neuro but he didn't call me back. I have three bottles lined up on the kitchen counter, 1mg Requip, .25mg of Mirapex and an old vile of Oxycodone/APAP 5-325mg tab from my appendectomy June 2010. I am contemplating taking one Oxycodone tonight to get some sleep then Fri and Sat if necessary in concert with my 3x50mg ultram. Im weary of taking drugs outside of the recommended treatment but if oxycodone can treat the RLS then I can sleep. But what happens if my Neurologist disagrees with taking oxycodone for RLS? If I can continue after the 10 day weaning with ultram then this will just be a bump in the road. But if I really need something more than ultram then I have no choice but to go back onto Mirapex or Neupro and then discuss weaning off DA with my new Neuro during my orientation April 27. What a spot to be in. I paged the doctor an hour ago so I will give him until midnight then either take the Oxycodone or page him again.