DAWS OR AUMENTATION

[buglegs]

I was taking 4-MG requip and the dosage became less effective, the nurse raised me to 6-MG which I took for approximately 2-years. My Requip was lowered back to 4-MG daily by the doctor, suffered through taking 4-MG for about 5-months, RLS was terrible. The doctor switched me to Pramapexole 1-MG twice a day (1MG Pramapexole is equivalent to 6-MG Requip) so I guess I was on 12-MG Requip daily, sounds like treatment plan for Parkinsons. This worked like a charm for about 9-10 months then terrible side effects, RLS worse, nasal congestion, shortness breath, suffocation feelings, anxiety, weight gain, vision problems, etc.....called VA Hospital, had them restart my 4-MG requip, dropped from 12-MG Requip to 4-MG Requip overnight, thought I was gonna die after about 4-days...I stayed on 4-MG for about 2-weeks and dropped to 3-MG nightly, which is the dosage I'm currently on. So, in approx. 52 days I've dropped from 12-MG Requip twice a day to 3-MG daily at bedtime. I've been having some awfully weird withdrawal symptoms, burning, tingling, pulling/stretching feelings in my muscles, mostly calves and legs but also in my bicep muscles. The symptoms seem to constantly cycle around to different areas in my body in addition to sciatica, mostly let leg, thigh area, numb from hip to knee and burning like fire. I'm at the point to where I can't figure out what is DAWS or what is augmentation, how much more I can take is becoming questionable, I'm very tired from only seeping 2-3 hours at night, fragmented during the night, usually take 3-MG requip around 8:00 PM and I can go to sleep around 10:00 PM fighting for 2-3 hours sleep through the night. There is no possibility of taking a nap, even sitting the RLS starts bad, I have to take Requip 3-MG for any possibility of becoming unconscious basically because the 2-3 hours aren't doing any good don't seem like anyways. I go back to the doctor on 22nd, I'm hoping for some answers, especially when I taper-off the remaining 3-MG Requip. The only thing that is keeping me sane is smoking marijuana 2-3 times daily, hopefully I can find some other medication to switch over to that will stop this RLS / DAWS / Augmentation or whatever I'm experiencing lately.

[Polar Bear]

The RLS experts would say that the max daily dose of ropinerole should be 1mg. For pramipexole it's about .25mg daily. You are likely to be augmented. Also to drop from 12mg ropinerole to 4mg overnight was so wrong. You are now on 3mg which is still 3x the max daily dose.
Is your doctor at all experienced in treating RLS.
You will need to come off the ropinerole completely, weaning slowly. Hopefully with the support of a low dose opioid.
A treatment plan needs to be discussed going forward. Take a look at the link in my signature. Would your doctor be amenable to reading this for guidance. Tell him this has been written by some RLS experts and ask his opinion. Don't just say you found it on the internet.
Do you know your ferritin serum level, it should be up around 100. Get the figure, don't just accept being told it is normal. You have to specifically request this test. Your doctor should have done this.
Read the Augmentation Forum.

[Rustsmith]

If you are in the US, you need to call the nearest RLS Foundation Quality Care Clinic tomorrow and explain to them that you have been receiving heavy doses of dopamine agonists for a long time and need to get off of them. You may need to travel for an appointment, but the time and expense will be well worth it. The Quality Care Centers are very familiar with treating cases like yours and most of them will be happy to prescribe an opioid to help you get off of the dopamine agonists.

One word of caution, I haven't heard lately, but the last thing that I had heard was that the Johns Hopkins center is only allowed to accept residents of Maryland. Also, if you are anywhere near Connecticut, the doctor at the sleep center at the VA near Yale is also in charge of the Yale QCC and has a great reputation for treating RLS.

Finally, if you cannot make it to a QCC, read the document that the link in my signature points to and then share it with all of your doctors. Some may not be receptive, but hopefully at least one will be willing to read it to learn about what they have been doing wrong so that any other patients don't have to experience the agony that they have put you through. There is a second publication that may be even more appropriate to your situation. You can find it at https://www.mayoclinicproceedings.org/a ... X/fulltext

Good luck and please come back to keep us updated as you transition off of dopamine and onto a treatment that isn't has damaging.