Restless Legs Syndrome (RLS) Discussion Board

jim wrote:I wonder if alcohol will cause the same problems with Horizant?

The problem, I suspect, is not the mix of drugs (alcohol with whatever); rather, something in some (or all) alcoholic drinks (maybe alcohol itself) is a trigger for WED.

I thought at first that draft beer and red wine would trigger it for me, but I've since found that some white wines do, and some red wines don't, so I'm not sure of anything anymore. Sometimes I can have a couple of beer or glasses of wine and nothing bad seems to happen - - but I drink very rarely now because sometimes it causes sheer hell and I just can't predict which it's going to be.

I'm wondering whether I should just be happy with where I am with the 250mg or whether there is a possibility that, after a few days, I could cut back to 200mg and have the same good results.....or whether I should leave well enough alone and not mess experiment at all.

Why not wait a few days - a week or two - to see if you're stable, then try to drop back? I really have no idea, but I would be leery of rocking the boat too soon,

Beth, I always thought that sugar set off my legs, whether it was in alcohol, ice cream, etc which were my favorites in the evening. I gave those up years ago but don't think my RLS got any better. I may try a little experimentation with very small amounts of different 'stuff' though red wine is my favorite. Another thing that might work would be to move the Lyrica an hour or two later and any alcohol a couple of hours earlier. Thankfully, I don't really need it so I could just give up alcohol but, like Steve, I do enjoy it.

You're right about upsetting the apple cart.....these nights with sleep are wonderful! I'll wait like you suggest before I cut back. In the meantime I'll still talk with my doc about Horizant and see where that goes. I spoke with my pharmacist and he couldn't say for sure but he thinks I'd likely have the same issue with Horizant.

Jim

rvjimzhr1 - I like what goodnights says...... if all is good at the moment I'd be inclined not to push it just yet. Enjoy the good time a little longer to be certain that it is steady, then if you make a change which turns out negative you can more more considered that it was the change, and not just a coincidence.

It just goes to show, you can't tell a thread by its name and it's good to at least skim all of them.

I find I can get away with taking a drink (or even two) if I take it earlier in the day - any time up to about 5. I find it gloriously decadent to drink at lunch time occasionally. I also notice that spirits (whiskey or rum) seem to have less impact on the legs than wine or beer.

I would agree with Badnights and Polar Bear. Give yourself a break and catch up with your sleep. There will be plenty of time for experimenting. Keep a med diary for now so tgàt you have a record of what is working well.

Legs, that's interesting about the whiskey vs. the wine or beer. I'll work with that at some point. If you might drink up 'til 5, what time do you take your meds and which meds? Lyrica per chance? Sorry if you mentioned that in an earlier post.

I'm a little confused. Last night I was out of town late and didn't get home to take my Lyrica until 2230. And I'd had, literally two very small sips of champagne at 2030. So when I went to bed at 2330 I was expecting to read a bit and then sleep. My legs started immediately so I got up and started walking. I couldn't sit until 0230. I went to sleep and slept 'til 0800. So was it the 2 sips of wine or the fact that I took the Lyrica 2 hours later than normal. Whatever, I did not anticipate such a bad case of 'legs' and insomnia. Must I adhere to a strict timetable ? And zero wine? Or was it just a bump in the road as I get used to this new drug?

Jim

It might have been the late Lyrica. My guess. If you let it get away from you - for instance, if the symptoms start before you remember to take your med, they might not respond to the usual dose. Like a boulder rolling downhill.

To rvjimzhe1---

I've forgotten, but do you take Gabapentin? The warning on the drug said "NO alcohol"... I guess it might lower your respiration beyond the "just sleepy" effect it provides. (I take Gabapentin and wouldn't dare drink).... Perhaps quite a few of our drugs have warnings about alcohol.
Pardon my ignorance if Lyrica IS Gabapentin. I'm bad at remembering all the names out there! (Ropinirole is Requip, but other names I don't remember); I honestly think the medications do a job on memory

gabapentin is often marketed as Neurontin, whereas pregabalin is marketed as Lyrica. They're both alpha-2-delta ligands, which bind to the alpha-2-delta protein in the calcium channels of nerve cells (those channels are gateways for calcium ions to enter and leave cells). The alpha-2-delta ligands are one form of anti-convulsant. Gabapentin encarbil is also a blah blah (I hate typing that name - alpha-2-delta ligand ); it's prodrug of gabapentin (meaning it turns into gabapentin after it has been absorbed). It and pregabalin are absorbed well, whereas gabapentin absorption is erratic, being affected by lots of things.

Memory loss, memory problems, and dementia are listed as possible side effects of pregabalin and gabapentin. On the subject of drug-related brain issues, Lyrica is apparently known to mess up words - to make you have difficulty finding the right word, or to say a word similar to the one you want but wrong. That's from my GP, not from internet sites.

Sleepy, Lyrica is Pregabalin. My experience with alcohol, one small glass of wine so far, does not make me sleepy and there's no way I can sit or lie down and sleep because the RLS goes crazy,

Great! I guess there's really no 'silver bullet" which will cure all ills with no ill effect. At least I'll be sleeping better while I lose my mind.
I had another good night last night with 5 1/2 hours of very nice sleep.

Jim

At least I'll be sleeping better while I lose my mind.

Just had my third straight night of 5 1/2 - 6 hours of uninterrupted sleep with Lyrica! Not wanting to leave well enough alone, I've been looking into Horizant, which my doc had originally wanted to prescribe.

Horizant is not in the VA formulary and they won't prescribe my Lyrica unless I go on gabapentin first and prove that it is not effective. Then I would need to have my doc send that info to the VA, they would review the chart notes and then "might" agree to prescribe the Lyrica. So I either stay on Lyrica and pay the $180 or so a month or look at Horizant which is less expensive.

Today my doc gave me about a 3 week supply of 600mg Horizant. I'll be interested to see how effective it is and whether I have the same 'drugged' feeling I have with the Lyrica. If the Horizant doesn't give me the 5+ hours of sleep I'll just go back to the Lyrica. Is there a problem of augmentation with either of these drugs? I may have read it here but forgot

Jim

Nope, no augmentation issues on this class. Only with the dopamine agonists. So, YAY! Hope the less expensive one works.

If Horizant works, you might also want to give gabapentin a try. Horizant is specifically approved by the FDA for treating RLS. But it turns into gabapentin once it enters the blood stream. Gabapentin is not as reliably adsorbed through the intestines for some people and there are foods that can also interfere with adsorption as well if you don't take it on an empty stomach. But since gabapentin is a generic, it costs a LOT less than either Lyrica or Horizant.

I've taken the Horizant for 2 nights. To a slightly lesser degree I feel like I did when I was withdrawing from the Requip. The first night I slept for 30 minutes about 3 hours after taking the pill. Then I was awake with leg and arm movement which kept me awake all night. The movement was not so bad that I had to get out of bed. The second night I didn't get to sleep for nearly 5 hours after taking the pill and then I slept for nearly 3 hours, made a pit stop and slept for another 1 1/2 hours. Total sleep...4 1/2 hours.

I spoke with a doctor/pharmacist supervisor at my local VA and he told me it could take 7-10 days for the Horizant to take real effect whereas gabapentin might take 30 days. At this point I know the Lyrica will give me 5-6 hours uninterrupted sleep. My hope is that Horizant, or maybe gabapentin, will give me more uninterrupted sleep than the Lyrica. Is that realistic? I feel like I've come a long way in the last month or so with the considerable help and advice from so many here on this site! I'm close to finding one drug which really works and which I can afford.

On another subject, since a number of moderators are commenting in this thread, when do I need to start another thread? That appears to be a real concern to some who are not moderators.

Jim